Infant formula is a booming business in the United States: sales of the drinks have more than doubled in recent years as companies convince parents that their young children need extra fluids. But many experts warn that these products, which are designed for children ages 1 to 3, do not meet nutritional needs beyond what is available in a typical toddler’s diet, much less infant formula. are subject to regulation, and are expensive.
Additionally, some parents breastfeed infants even though they do not meet federal standards for infant formula and may not provide the infants with adequate nutrients to sustain their growth.
Pediatricians and federal health officials say that when most babies turn 1, they can start drinking cow’s milk or an unsweetened plant-based milk alternative. In a 2019 “consensus” statement, the American Academy of Pediatrics and other health and nutrition organizations recommended against the use of infant formulas, stating that “they do not contain any of the nutrients obtained from healthy foods.” do not offer unique nutritional value; moreover, they may contribute additional sugars to the diet.” Infant formulas often contain sweeteners and fats that add calories.
Some of the same companies that make infant formula—including Enfamil, Gerber, and Similac—also make toddler formula, as do some smaller, boutique brands that advertise that they are organic or have other special features. Infant formulas are available almost everywhere baby formulas are sold and are marketed as providing additional nutrients to help babies develop brains, immune systems and eyes, among other benefits. . They differ from medical formulas recommended for children with special needs.
A 2020 study found that sales of infant formula in the United States increased from $39 million in 2006 to $92 million in 2015.
According to a study led by marketing and public health researcher Jennifer Harris at the University of Connecticut, parents are often confused by formula marketing. It found that 60% of caregivers falsely believe that infant formulas contain nutrients that infants cannot get from other foods.
Dr. Anthony Porto, a pediatric gastroenterologist and professor of pediatrics at Yale University, said he is concerned that these products are giving young children more nutrients and calories than they need. Unlike those designed for infants, toddler formula has no nutritional regulations: experts say it’s impossible to standardize supplements for toddlers’ diets because no two babies are alike.
In focus groups, Harris said, parents report feeding their children infant formula to fill nutritional gaps when a child is not eating enough, a common concern among parents.
“Kids are often picky eaters,” said Dr. Stephen Daniels, chair of pediatrics at Children’s Hospital Colorado. But at about one year of age, babies start to grow, she said, and “they’re suddenly not as hungry as they used to be.” That can make parents nervous, he added, but “it’s completely normal.”
If parents are concerned about their child’s diet, they should consult a pediatrician or family doctor, Daniels said.
Blanche Lincoln, president of the Infant Nutrition Council of America, which represents the makers of Enfamil, Gerber, Simlake and Store brands, said in an email that toddler formulas can be helpful because they provide “nutritional support” during this transition period. can fill the gap of. at the dinner table.” Lincoln, a former U.S. senator from Arkansas, said the drinks “help meet the specific nutritional needs of young children by providing energy and key nutrients as well as essential vitamins and minerals during this critical period of growth and development.” “
But toddler formula isn’t the only thing toddlers are eating — it’s being fed to infants, too. In a recent study, Porto and colleagues found that 5% of parents of infants reported giving their children beverages marketed to the older age group. And Harris’ research indicated that 22 percent of parents of babies older than 6 months had fed their babies toddler formula in the past month. Both studies were conducted before the recent infant formula shortage, which may have exacerbated the problem.
“Infant formula and toddler formula go hand in hand in the supermarket,” Harris said. “They look the same, but toddler formulas are cheaper than baby formulas. So people confuse them, and they grab the wrong one. Or they think, ‘Oh, it’s less expensive. I’ll take this in return.”
According to an email from FDA spokeswoman Lindsay Hauck, toddler drinks do not meet the definition of infant formula, so they are not subject to the same requirements. That means they don’t have to go through the clinical trials and pathogen safety testing that pediatric versions do. “Unlike infant formulas, toddler formulas are not necessarily designed to meet the nutritional needs of their intended consumers,” Hawke said.
In a statement to KHN, the Infant Nutrition Council of America said, “Toddler beverages have a specific use and infant formula has a nutritional makeup. The two are not interchangeable. Beverage labeling clearly identifies the product as a toddler drink intended for children 12 months and older on the front of the package label.”
However, many expensive infant formula brands made by smaller companies — often made with goat’s milk, A2 whole milk (which lacks a common milk protein), or vegan ingredients that don’t contain soy — lack nutritional value for babies. meet the requirements, and some advertise it.
Harris argued that it also confuses parents, and should not be allowed. Just because a toddler formula has the nutrients required for infant formula by the FDA doesn’t mean it has met the other tests required for infant formula, he said.
Federal regulators have not forced any companies to recall these products. In an email, FDA spokeswoman Mariana Nome said, “FDA does not comment on potential compliance actions.”
One company, Nature’s One, whose infant formulas are labeled “Babies Only,” received warning letters from the FDA about their marketing to infants a decade ago. The case was closed in 2016. The company’s website states that Baby’s Only formula “meets the nutritional needs of a baby” and that “Baby’s Only Organic® can be offered up to age 3.” Critics say the language implies that formula is fine for babies under 1 year old. The company’s website and its Instagram account include customer testimonials from parents who report feeding their babies formula, as well as photos of infants drinking it.
Nature’s One CEO and President Jay Hyman said Babies Only is clearly labeled as an infant formula and that the back of the can says “Babies Only 1 year or older.” For an older child or when directed by a healthcare professional.” He also said that since the company started in 1999, its formulas have met all the nutritional, manufacturing, and safety standards required for infant formula, although they are not required. “We acted like we were an infant formula, but we were selling it as a toddler formula,” Hyman said.
He said the clinical trials required by the FDA are a huge barrier to bringing a new infant formula to market, and many other countries do not require clinical trials. Babies recently completed a clinical trial, and the company hopes to be able to sell it as an infant formula soon, he said.
Despite this, pediatricians and nutritionists continue to warn parents about young children’s consumption of beverages. “There’s no question that infant formula is very important in the first year of life,” Daniels said. But he doesn’t recommend the toddler version “because it’s not as useful, because it’s confusing, because it’s expensive.”
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