Good parents want their baby to grow up strong and healthy. So, when Kelly Henchel’s child was close to reaching toddler age in 1998, she wanted to know more about this new toddler milk product. She reached out to a representative for one of the formula companies on whether it was worth the buy. The verdict?
“He literally looked me in the eye and told me it was all just marketing. It was better to stay on my infant formula.”
As the medical director of the pediatric and adolescent medicine clinics at Johns Hopkins All Children’s, Henchel is one of many pediatricians who advise against the use of “toddler milk.”
The American Academy of Pediatrics published a clinical report Friday finding no nutritional benefits to “formulas” targeted toward toddlers between 6 months and 36 months of age.
“The words toddler formula is misleading,” said Jenelle Ferry, a neonatologist and director of feeding, nutrition and infant development at Pediatrix Medical Group in Florida.
Infant formulas are a nutritionally complete dietary source designed for babies from birth to 12 months and can act as a replacement for infants who can’t get human mother’s milk.
Toddler milk is not the same as infant milk, Ferry said, nor is it necessary for this age group.
Responding to the new AAP report, a spokesperson for Abbott Nutrition, which has a popular brand of toddler formula, said, “National health studies indicate that U.S. toddlers have nutritional gaps in their diet often related to picky eating. 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. 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.”
The first years of life are extremely important for growth and development. The AAP recommends infants younger than 12 months continue to drink infant formula and or breast milk. Toddlers, defined as children 12 months and older, are at an age when they are starting to eat solid food — a well-balanced diet of fruits and vegetables along with cow’s milk. Cow’s milk is an excellent source for vitamin D and calcium for building strong bones. The current Dietary Guidelines for Americans are 1⅔ to 2 cup equivalents of dairy a day for children 12 to 23 months of age.
For decades, advertisements have marketed toddler formula as nutritionally beneficial to toddlers, a claim the report finds misleading to parents. This finding aligns with a report the World Health Organization published last year detailing the aggressive digital marketing techniques formula milk companies use to sell their products. Among the tactics that WHO cited were companies inserting themselves into advice forums and social media groups for expecting parents and new mothers promoting false health claims on milk substitutes.
Research shows many mothers — especially those of Black and Hispanic populations — believe toddler milk is more nutritious than cow’s milk, according to a May study in Nutrition Reviews. Additionally, despite being more expensive, toddler milk contains less protein and more fat. “I have never recommended toddler milk in my practice,” Henchel said.
Despite growing concerns from pediatricians and professional organizations, the toddler formula industry is booming. Its marketing strategy, along with designing products to resemble infant formula, raised sales from $39 million in 2006 to $92 million in 2015, a 2020 study in Public Health Nutrition showed.
“One of our recommendations is to not call them formulas. This is a disservice to children and their parents,” said George Fuchs, a pediatric gastroenterologist and lead author of the new AAP report. “It implies a continuum of formula beginning from infancy all the way through 3 or 4 years of age.”
The AAP report found some toddler milk products fortified with micronutrients such as calcium. However, Fuchs warns this amount varied from product to product. Unlike infant formula, the US Food and Drug Administration does not regulate toddler milk. It is not federally mandated to meet certain nutritional requirements.
Toddler milk also has high sugar content. Federal guidelines state that toddlers under 2 should have no processed sugar, making even one of these sugar-sweetened beverages one too many to drink. Henchel said adding sweeteners can change a toddler’s palate to continue having a high preference for sweetened beverages throughout life. “I personally would not feed my child these products,” Fuchs added.
For parents who have already stocked up on toddler milk, Henchel said it’s OK to finish what you already have at home but to make sure it’s not the only thing the children are having. She recommends five fresh fruits and vegetables a day along with other dairy sources in their diet.
Even if a child is allergic to cow’s milk, Fuchs warns toddler milk is still not a suitable substitute because one-third of the products are cow-milk based. Additionally, toddler milk products will not be nutritionally complete. He said most parents in this situation provide their children with almond milk or other nut drinks that are nutritionally equivalent to cow’s milk in terms of calcium.
When in doubt, Ferry encourages parents to talk to their pediatrician for guidance. “Parents are trying to do the best for their kids, and there’s a lot of marketing that can be misleading,” she said. “A conversation with your pediatrician can help make sense of the confusion with product labeling and tailor nutrition to what’s right for your child.”
Editor’s note: Jocelyn Solis-Moreira is a New York-based freelance health and science journalist.
