Toddler milk is ‘potentially harmful,’ AAP warns amid calls for stricter regulations
Toddler beverages ‘undermine breastfeeding and child health,’ the World Health Organization claims
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Toddler milk products have grown into a multibillion-dollar global business, despite warnings from health authorities that the benefits of this milk formula are unproven.
The products are marketed with claims of improving brain development or immune function, but the American Academy of Pediatrics (AAP) warned in an Oct. 2023 report that toddler formula is "unnecessary and potentially harmful to young children."
"For healthy toddlers without a specific medical diagnosis, there is no evidence of a need [for] or benefit from toddler milk," Dr. Jenelle Ferry, a neonatologist and director of feeding, nutrition and infant development at Pediatrix Medical Group in Tampa, Florida, told Fox News Digital in an interview.
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In spite of these warnings, toddler milk has grown into a $20 billion worldwide business, according to a recent report.
"It is disappointing that regulations have not been strengthened, given package claims and marketing messages that imply toddler milks are beneficial, or even necessary, for a toddler’s healthy growth," Fran Fleming-Milici, PhD, director of marketing initiatives at the Rudd Center for Food Policy and Health at the University of Connecticut, told Fox News Digital.
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Infant formula vs. toddler milk
Most infants in the U.S. receive some or all of their nutrition from formula, according to the U.S. Food and Drug Administration (FDA).
Standard infant formula can be supplemented with appropriate solid foods at around 4 to 6 months of age, ensuring intake of essential nutrients like iron, calcium and zinc, the AAP said in a previous statement.
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Infant formula is regulated under The Infant Formula Act, which requires that the products meet nutritional requirements as the only source for babies through the first 12 months of age, the statement added.
If a toddler beverage is intended for infants younger than 12 months, the product must comply with the FDA’s infant formula regulations in addition to all other applicable food regulations, an FDA spokesperson told Fox News Digital.
There are two different types of toddler milk on the market: transition formulas for infants and toddlers 9 months to 24 months old, and toddler milk for children 12 months to 36 months age, according to a previous research report from the NYU College of Global Public Health.
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Unlike infant formulas, toddler milks are not nutritionally complete, experts said.
"A healthy diet for toddlers would limit excess processed foods, salt and sugar."
Approximately 80% of toddler milks have higher sugar content than whole milk and 100% have less protein, the AAP stated.
After toddlers are weaned off breast milk or infant formula, Ferry recommends that they drink milk and water, with the majority of their nutrients coming from solid foods.
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"A healthy diet for toddlers would limit excess processed foods, salt and sugar," she said.
Regulation of toddler milk
"Toddler beverage products intended for children 1 year and older are regulated as conventional foods and must comply with the FDA’s labeling regulations," an FDA spokesperson told Fox News Digital.
"This includes providing the Nutrition Facts label, specifically for children 1 to 3 years of age."
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When it comes to marketing toddler milks, manufacturers must adhere to certain rules.
"Manufacturers cannot make claims regarding disease conditions, but can use language relating to symptoms, even if they are not supported by evidence," he told Fox News Digital in an email.
They can claim their product is lactose-free, for example — but cannot claim that it is helpful for lactase deficiency, he said.
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"Nutrient content claims or health claims are not allowed on food products intended specifically for use by infants and children under 2 years of age unless specifically provided for by regulation," added the FDA spokesperson.
"In general, the product labeling must be truthful and not misleading."
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Cross-promotion in marketing and packaging
Some experts warn that infant formula and toddler milk are often marketed and packaged in a way that may lead parents to believe they are the same in terms of nutritional content.
"The cross-promotion of toddler milks with infant formula … allows for the trust caregivers have for formula brands to be transferred to a product that is not regulated, contains added sugar, and is not recommended by the AAP," warned Fleming-Milici.
"Research shows that these messages lead caregivers to believe toddler milks are superior to their family meals and plain cow’s milk – which is much less expensive and is what experts recommend."
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A WHO report noted that "formula milk marketing, not the product itself, disrupts informed decision-making and undermines breastfeeding and child health."
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Showing parents educational videos to correct misleading marketing can help to reduce sugary drink consumption in the first few years of a child’s life, Fleming-Milici’s research found.
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"Exposure to the videos significantly reduced positive attitudes toward toddler milks and fruit drinks, and reduced intentions to serve both," she told Fox News Digital.
Potential nutritional benefits
Advocates, however, argue that toddler formula is helpful to many young children who don’t get the proper nutrients in their diet.
"In general, the product labeling must be truthful and not misleading."
"Research demonstrates that nutrient intake for young children often falls below adequate levels for iron, vitamins D and E, calcium, choline, potassium and fiber," a spokesperson from the Infant Nutrition Council of America (INCA) told Fox News Digital.
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INCA is a Washington, D.C.-based association of manufacturers of infant formulas and toddler milks, representing brands including Abbott Nutrition, Perrigo Nutritionals and Reckitt Benckiser.
"For kids 12 months to 36 months who need nutritional support, toddler nutritional drinks have been shown to contribute to nutritional intake and potentially fill nutrition gaps, as recognized globally in the international Codex Alimentarius standard," the INCA spokesperson added.
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When children need extra nutrition because of a medical condition — such as failure to thrive or an intestinal or metabolic disorder — they should receive specialty liquid nutrition rather than products marketed as toddler milk, Ferry noted.
A spokesperson from Nestlé, which makes a variety of powdered milk products for toddlers, said in response to an earlier Fox News Digital query that the company "seeks to provide a range of foods and beverages to support consumers at all stages of life."
The spokesperson added, "Nestlé has consistent standards that apply to our responsible marketing for products intended for babies and young children. Those standards and practices fully comply with the WHO [World Health Organization] code and follow either local law or our own policy — whichever is stricter."
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A spokesperson from Similac also submitted a statement to Fox News Digital in response to an earlier query as well.
"National health studies indicate that U.S. toddlers have nutritional gaps in their diet often related to picky eating," the spokesperson said. "When they 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."
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The spokesperson also said, "Toddler drinks may be an option to help fill nutrient gaps for these children 12 to 36 months of age. Abbott does not recommend or indicate its toddler drinks for infants under 12 months of age."
Fox News Digital also reached out to other companies that make powdered milk products for toddlers.
Parents of young children should always check with their pediatricians for the best and latest nutrition advice.
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Melissa Rudy of Fox News Digital contributed reporting.