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WASHINGTON – These products are not nutritionally complete and are not to be confused with formulas for infants younger than 12 months.
“Toddler drinks do not offer anything nutritionally exceptional,” said George J. Fuchs III, MD, a pediatric gastroenterologist at the University of Kentucky, Lexington, who presented a clinical report on toddler formulas from the American Academy of Pediatrics at the group’s annual meeting. The products are not regulated by the U.S. Food and Drug Administration and should not be given to infants younger than 12 months in place of infant formulas, but murky marketing can leave parents and caregivers confused as to whether these products are essential for good health, Dr. Fuchs said.
Despite the rise in marketing of formulas pitched as toddler milks, growth milks, or transition formulas, among other names, the AAP says these formulas are both unregulated and unnecessary for the vast majority of toddlers because they have adequate diets and do not require supplementation.
Clinicians should understand and explain the distinction between products formulated for infants younger than 12 months and those designed for children aged 12 months or older, Dr. Fuchs added.
Formulas for infants younger than 12 months represent a distinct product category for the FDA and are required to be nutritionally complete for this age, Dr. Fuchs said. Infant formulas sold in the United States must meet nutrition requirements as defined by the Infant Formula Act of 1980 (updated in 1986), and the facilities that manufacture them are regularly inspected by the agency.
In contrast, toddler formulas are not regulated or categorized by the FDA and therefore may vary widely in composition and are not nutritionally complete for any age, he said.
One area of concern is that parents or caregivers misunderstand and give these products to infants younger than 12 months instead of infant formulas, he said.
Also, mass-market toddler formulas are inadequate for children with disease-specific requirements, such as malnutrition, gastrointestinal disorders, metabolic disorders, or food allergies.
Questionable composition, misleading marketing
Toddler formulas are not only unnecessary but could be detrimental to children’s health, Dr. Fuchs said. Some formulas have high sodium content relative to cow’s milk or may be high or low in protein. Other products have added sweeteners, which could contribute to an increased preference for sweetened foods as the children get older, he noted.
However, manufacturers of regulated infant products often market them alongside their infant formula, which can be confusing for parents and caregivers. The products often have similar names, images, slogans, and logos, and may suggest benefits such as immune system support, brain development, and digestive health, he added.
A 2020 survey published in Maternal and Child Nutrition found that 60% of approximately 1,000 caregivers of children aged 12-36 months agreed with the marketing claim that toddler formulas or powdered milks provide nutrition that is not available from other food and drinks, Dr. Fuchs said.
Balanced diet is best for healthy children
For infants younger than 12 months, the AAP recommends that the liquid portion of the diet should come from human milk or a standard infant formula that has been reviewed by the FDA based on the Infant Formula Act, Dr. Fuchs said.
Children aged 12 months or older should receive a varied diet with fortified foods. Formula can safely be used as part of a varied diet; however, it offers no nutritional advantage for most children over a well-balanced diet that includes human milk and/or cow milk, “and should not be promoted as such,” Dr. Fuchs noted.
“The category of these toddler drinks has grown and the landscape has changed quite a bit; we thought it was appropriate that we review this category,” Dr. Fuchs said in an interview.
Dr. Fuchs advised pediatricians in practice to follow the AAP’s guidance for breastfeeding infants if possible and progression to formula as needed for infants up to age 1 year, followed by transition to cow milk (or alternatives for those with cow milk allergies) and the addition of a healthy mixed diet.
Formula choices pose practice challenges
In an interview, Cathy Haut, DNP, CPNP-AC, CPNP-PC, a pediatric nurse practitioner in Rehoboth Beach, Del., pointed out that not only are parents often baffled by formula choices, but many are also hesitant to make a switch to regular milk as children get older because they worry that cow’s milk is inadequate for nutrition or is not as “clean” or “sterile” as formula.
In some cases, parents may have had difficulty in acquiring genuine infant formulas, which were relocated to locked cabinets in stores during recent shortages and began using toddler formulas as an alternative for infants younger than 1 year, she added.
“If breastfeeding is not possible, using approved infant formula is preferred, switching to whole cow milk at 1 year of age,” she said. “Nutritional assessment is an important part of well-child visits, with caregiver counseling regarding importance of intake of variety of fortified foods [that] offer vitamins, calcium, iron and zinc,” Ms. Haut added. Although toddler formulas are safe additions to the diets of most young children older than 1 year, supplementation of specific nutrients such as vitamin D if needed is a more effective option, she said.
“National health studies indicate that U.S. toddlers have nutritional gaps in their diet often related to picky eating,” an Abbott spokesperson said in an interview. “When [toddlers] don’t do well transitioning to table foods or won’t drink milk, our toddler drinks contain many of the complementary nutrients, such as vitamins and minerals, that they may be missing in their diet. Toddler drinks may be an option to help fill nutrient gaps for these children 12-36 months of age. Abbott does not recommend or indicate its toddler drinks for infants under 12 months of age,” according to the company.
Dr. Fuchs had no financial conflicts to disclose. Dr. Haut had no financial conflicts to disclose.
A version of this article first appeared on Medscape.com.
WASHINGTON – These products are not nutritionally complete and are not to be confused with formulas for infants younger than 12 months.
“Toddler drinks do not offer anything nutritionally exceptional,” said George J. Fuchs III, MD, a pediatric gastroenterologist at the University of Kentucky, Lexington, who presented a clinical report on toddler formulas from the American Academy of Pediatrics at the group’s annual meeting. The products are not regulated by the U.S. Food and Drug Administration and should not be given to infants younger than 12 months in place of infant formulas, but murky marketing can leave parents and caregivers confused as to whether these products are essential for good health, Dr. Fuchs said.
Despite the rise in marketing of formulas pitched as toddler milks, growth milks, or transition formulas, among other names, the AAP says these formulas are both unregulated and unnecessary for the vast majority of toddlers because they have adequate diets and do not require supplementation.
Clinicians should understand and explain the distinction between products formulated for infants younger than 12 months and those designed for children aged 12 months or older, Dr. Fuchs added.
Formulas for infants younger than 12 months represent a distinct product category for the FDA and are required to be nutritionally complete for this age, Dr. Fuchs said. Infant formulas sold in the United States must meet nutrition requirements as defined by the Infant Formula Act of 1980 (updated in 1986), and the facilities that manufacture them are regularly inspected by the agency.
In contrast, toddler formulas are not regulated or categorized by the FDA and therefore may vary widely in composition and are not nutritionally complete for any age, he said.
One area of concern is that parents or caregivers misunderstand and give these products to infants younger than 12 months instead of infant formulas, he said.
Also, mass-market toddler formulas are inadequate for children with disease-specific requirements, such as malnutrition, gastrointestinal disorders, metabolic disorders, or food allergies.
Questionable composition, misleading marketing
Toddler formulas are not only unnecessary but could be detrimental to children’s health, Dr. Fuchs said. Some formulas have high sodium content relative to cow’s milk or may be high or low in protein. Other products have added sweeteners, which could contribute to an increased preference for sweetened foods as the children get older, he noted.
However, manufacturers of regulated infant products often market them alongside their infant formula, which can be confusing for parents and caregivers. The products often have similar names, images, slogans, and logos, and may suggest benefits such as immune system support, brain development, and digestive health, he added.
A 2020 survey published in Maternal and Child Nutrition found that 60% of approximately 1,000 caregivers of children aged 12-36 months agreed with the marketing claim that toddler formulas or powdered milks provide nutrition that is not available from other food and drinks, Dr. Fuchs said.
Balanced diet is best for healthy children
For infants younger than 12 months, the AAP recommends that the liquid portion of the diet should come from human milk or a standard infant formula that has been reviewed by the FDA based on the Infant Formula Act, Dr. Fuchs said.
Children aged 12 months or older should receive a varied diet with fortified foods. Formula can safely be used as part of a varied diet; however, it offers no nutritional advantage for most children over a well-balanced diet that includes human milk and/or cow milk, “and should not be promoted as such,” Dr. Fuchs noted.
“The category of these toddler drinks has grown and the landscape has changed quite a bit; we thought it was appropriate that we review this category,” Dr. Fuchs said in an interview.
Dr. Fuchs advised pediatricians in practice to follow the AAP’s guidance for breastfeeding infants if possible and progression to formula as needed for infants up to age 1 year, followed by transition to cow milk (or alternatives for those with cow milk allergies) and the addition of a healthy mixed diet.
Formula choices pose practice challenges
In an interview, Cathy Haut, DNP, CPNP-AC, CPNP-PC, a pediatric nurse practitioner in Rehoboth Beach, Del., pointed out that not only are parents often baffled by formula choices, but many are also hesitant to make a switch to regular milk as children get older because they worry that cow’s milk is inadequate for nutrition or is not as “clean” or “sterile” as formula.
In some cases, parents may have had difficulty in acquiring genuine infant formulas, which were relocated to locked cabinets in stores during recent shortages and began using toddler formulas as an alternative for infants younger than 1 year, she added.
“If breastfeeding is not possible, using approved infant formula is preferred, switching to whole cow milk at 1 year of age,” she said. “Nutritional assessment is an important part of well-child visits, with caregiver counseling regarding importance of intake of variety of fortified foods [that] offer vitamins, calcium, iron and zinc,” Ms. Haut added. Although toddler formulas are safe additions to the diets of most young children older than 1 year, supplementation of specific nutrients such as vitamin D if needed is a more effective option, she said.
“National health studies indicate that U.S. toddlers have nutritional gaps in their diet often related to picky eating,” an Abbott spokesperson said in an interview. “When [toddlers] don’t do well transitioning to table foods or won’t drink milk, our toddler drinks contain many of the complementary nutrients, such as vitamins and minerals, that they may be missing in their diet. Toddler drinks may be an option to help fill nutrient gaps for these children 12-36 months of age. Abbott does not recommend or indicate its toddler drinks for infants under 12 months of age,” according to the company.
Dr. Fuchs had no financial conflicts to disclose. Dr. Haut had no financial conflicts to disclose.
A version of this article first appeared on Medscape.com.
WASHINGTON – These products are not nutritionally complete and are not to be confused with formulas for infants younger than 12 months.
“Toddler drinks do not offer anything nutritionally exceptional,” said George J. Fuchs III, MD, a pediatric gastroenterologist at the University of Kentucky, Lexington, who presented a clinical report on toddler formulas from the American Academy of Pediatrics at the group’s annual meeting. The products are not regulated by the U.S. Food and Drug Administration and should not be given to infants younger than 12 months in place of infant formulas, but murky marketing can leave parents and caregivers confused as to whether these products are essential for good health, Dr. Fuchs said.
Despite the rise in marketing of formulas pitched as toddler milks, growth milks, or transition formulas, among other names, the AAP says these formulas are both unregulated and unnecessary for the vast majority of toddlers because they have adequate diets and do not require supplementation.
Clinicians should understand and explain the distinction between products formulated for infants younger than 12 months and those designed for children aged 12 months or older, Dr. Fuchs added.
Formulas for infants younger than 12 months represent a distinct product category for the FDA and are required to be nutritionally complete for this age, Dr. Fuchs said. Infant formulas sold in the United States must meet nutrition requirements as defined by the Infant Formula Act of 1980 (updated in 1986), and the facilities that manufacture them are regularly inspected by the agency.
In contrast, toddler formulas are not regulated or categorized by the FDA and therefore may vary widely in composition and are not nutritionally complete for any age, he said.
One area of concern is that parents or caregivers misunderstand and give these products to infants younger than 12 months instead of infant formulas, he said.
Also, mass-market toddler formulas are inadequate for children with disease-specific requirements, such as malnutrition, gastrointestinal disorders, metabolic disorders, or food allergies.
Questionable composition, misleading marketing
Toddler formulas are not only unnecessary but could be detrimental to children’s health, Dr. Fuchs said. Some formulas have high sodium content relative to cow’s milk or may be high or low in protein. Other products have added sweeteners, which could contribute to an increased preference for sweetened foods as the children get older, he noted.
However, manufacturers of regulated infant products often market them alongside their infant formula, which can be confusing for parents and caregivers. The products often have similar names, images, slogans, and logos, and may suggest benefits such as immune system support, brain development, and digestive health, he added.
A 2020 survey published in Maternal and Child Nutrition found that 60% of approximately 1,000 caregivers of children aged 12-36 months agreed with the marketing claim that toddler formulas or powdered milks provide nutrition that is not available from other food and drinks, Dr. Fuchs said.
Balanced diet is best for healthy children
For infants younger than 12 months, the AAP recommends that the liquid portion of the diet should come from human milk or a standard infant formula that has been reviewed by the FDA based on the Infant Formula Act, Dr. Fuchs said.
Children aged 12 months or older should receive a varied diet with fortified foods. Formula can safely be used as part of a varied diet; however, it offers no nutritional advantage for most children over a well-balanced diet that includes human milk and/or cow milk, “and should not be promoted as such,” Dr. Fuchs noted.
“The category of these toddler drinks has grown and the landscape has changed quite a bit; we thought it was appropriate that we review this category,” Dr. Fuchs said in an interview.
Dr. Fuchs advised pediatricians in practice to follow the AAP’s guidance for breastfeeding infants if possible and progression to formula as needed for infants up to age 1 year, followed by transition to cow milk (or alternatives for those with cow milk allergies) and the addition of a healthy mixed diet.
Formula choices pose practice challenges
In an interview, Cathy Haut, DNP, CPNP-AC, CPNP-PC, a pediatric nurse practitioner in Rehoboth Beach, Del., pointed out that not only are parents often baffled by formula choices, but many are also hesitant to make a switch to regular milk as children get older because they worry that cow’s milk is inadequate for nutrition or is not as “clean” or “sterile” as formula.
In some cases, parents may have had difficulty in acquiring genuine infant formulas, which were relocated to locked cabinets in stores during recent shortages and began using toddler formulas as an alternative for infants younger than 1 year, she added.
“If breastfeeding is not possible, using approved infant formula is preferred, switching to whole cow milk at 1 year of age,” she said. “Nutritional assessment is an important part of well-child visits, with caregiver counseling regarding importance of intake of variety of fortified foods [that] offer vitamins, calcium, iron and zinc,” Ms. Haut added. Although toddler formulas are safe additions to the diets of most young children older than 1 year, supplementation of specific nutrients such as vitamin D if needed is a more effective option, she said.
“National health studies indicate that U.S. toddlers have nutritional gaps in their diet often related to picky eating,” an Abbott spokesperson said in an interview. “When [toddlers] don’t do well transitioning to table foods or won’t drink milk, our toddler drinks contain many of the complementary nutrients, such as vitamins and minerals, that they may be missing in their diet. Toddler drinks may be an option to help fill nutrient gaps for these children 12-36 months of age. Abbott does not recommend or indicate its toddler drinks for infants under 12 months of age,” according to the company.
Dr. Fuchs had no financial conflicts to disclose. Dr. Haut had no financial conflicts to disclose.
A version of this article first appeared on Medscape.com.
AT AAP 2023