Nutritional formula is poured into a baby bottle. There is a second, empty bottle beside the one being filled. They sit on a wooden countertop.

The formula may be appropriate for infants, but experts warn that young children do not need it

Baby formulas are a booming business in the United States: Beverage sales have more than doubled in recent years as companies have convinced parents that their babies need extra fluids. But many experts caution that these products, designed for children ages 1 to 3, don’t meet any nutritional needs beyond what’s available in a typical toddler diet, are subject to fewer rules than infant formula, and are expensive.

In addition, some parents feed toddler versions of infants even though they do not meet the federal standards for infant formula and may not provide children with adequate nutrients to sustain their growth.

Pediatricians and federal health officials Say that when most children reach age 1, they can start drinking cow’s milk or an unsweetened plant-based milk alternative. in 2019 Statement of compatibilityThe American Academy of Pediatrics and other health and nutrition organizations have recommended against using formulas for young children, saying that “they do not offer unique nutritional value other than what can be obtained from healthy foods; moreover, they may contribute to the addition of sugars to the diet.” Formulas for young children often contain sweeteners and fats that add calories.

Some of the same companies that produce infant formula — including Enfamil, Gerber and Similac — also make formula for young children, as do some smaller brands that advertise that they have organic or other specialty recipes. Baby formula is available almost everywhere infant formula is sold and marketed as providing additional nutrients to help babies’ brain, immune system and eye development, among other benefits. They differ from medical formulas prescribed for children with special needs.

a Study 2020 It found that sales of infant formula in the United States rose to $92 million in 2015 from $39 million in 2006.

Parents are often confused by formula marketing, according to a study by Jennifer Harris, a marketing and public health researcher at the University of Connecticut. I found it 60% of caregivers It is wrongly believed that formulas for young children contain nutrients that young children cannot obtain from other foods.

Dr. Anthony PortoA pediatric gastroenterologist and professor of pediatrics at Yale University, said he worries that these products may provide young children with more nutrients and calories than they need. Unlike designed for infants, toddler formula has no dietary regulations: Experts say standardizing supplements for toddlers’ meals is impossible because no two kids are alike.

in focus groupsHarris said parents have reported feeding their children infant formula to fill in nutritional gaps when a child is not eating enough, a common concern among parents.

“Infants are often voracious eaters,” he said. Dr. Stephen Daniels, chief of pediatrics at Children’s Hospital of Colorado. But at about a year old, he said, the kids are growing up plateau, “and suddenly they’re not hungry the way they used to be anymore.” That could worry parents, he added, but it is a “completely normal phenomenon”.

Daniels said that if parents have concerns about their children’s diet, they should consult their pediatrician or family doctor.

Blanche Lincoln, president of the Infant Nutrition Council of America, which represents the makers of the Enfamil, Gerber and Similac brands and stores, said in an email that formulas for young children can be beneficial because they can fill “nutrition gaps during this transition period for table foods.” Lincoln, a former U.S. Senator from Arkansas, said the beverage “helps meet the specific nutritional needs of young children by providing energy and important nutrients, as well as essential vitamins and minerals during this important period of growth and development.”

But infant formula is not only eaten by young children – it is also fed to infants. in recent studyPorto and colleagues found that 5% of parents of infants reported offering their children drinks marketed to the older age group. Harris’ research indicated that 22% of parents of children over 6 months of age had fed formula in the previous month. Both studies were conducted before the recent shortage of infant formula, which may have exacerbated the problem.

“Infant formulas and toddler formulas tend to be next to each other in the supermarket,” Harris said. “They look alike, but toddler formulas are cheaper than infant formulas. So people confuse them, and they catch the error. Or they think, ‘Oh, that’s less expensive.’ I’ll get this instead. “

According to an email from an FDA spokeswoman, Lindsay Haake, drinks for young children do not meet the definition of infant formula, so they are not subject to the same requirements. This means that they do not have to undergo the clinical trials and pathogen safety tests that the child copies do. “Unlike infant formulas, toddler formulas are not necessary to meet the nutritional needs of their intended consumers,” Hack said.

In a statement to KHN, the Infant Nutrition Council of America said: “Baby drinks have distinct uses and nutritional makeup from infant formula. The two are not interchangeable. Nutritional drink labels for Toddlers expressly identify the product as a toddler drink intended for children 12 months and older. on the front of the package label.

However, many brands of expensive infant formula made by smaller companies – often advertised as being made with goat’s milk, are made by smaller companies. A2 full fat milk (which lacks a single common milk protein), or plant-based ingredients that aren’t soy – meet the nutritional requirements of infants, some advertise it.

Harris argued that this also confuses parents, and should not be allowed. She said that just because infant formula contained the nutritional ingredients required by the Food and Drug Administration for infant formula did not mean that it had met other tests required for infant formula.

Federal regulators have not forced any of the companies to withdraw these products. “The FDA does not comment on potential compliance measures,” FDA spokeswoman Mariana Naoum said in an email.

One company, Nature’s One, named its formulas for young children “Baby’s Only.” Warning messages A decade before the Food and Drug Administration regarding its marketing to infants. This case closed in 2016. The company’s website says Baby’s Only formula “Meets the nutritional requirements of infants“that”Baby’s Only Organic® can be offered up to 3 years old. Critics say the language suggests that the formula is good for children under 1 year. The company’s website and Instagram account display customer testimonials from parents who have reported feeding their children this formula, as well as photos of children drinking it.

Jay Hyman, CEO and President of Nature’s One, said Baby’s Only is clearly categorized as a toddler formula and that the back of the box states that “Baby’s Only is for a child 1 year of age or older or when directed by a healthcare professional.” He also said that since the company’s launch in 1999, its formulas have met all the nutrition, manufacturing and safety standards required for infant formula even though they don’t have to. “We acted like it was baby formula, but we were selling it as an alternative milk for toddlers,” Heymann said.

He said the FDA-required clinical trials are a significant barrier to bringing a new infant formula to market and that many other countries do not need a clinical trial. He said Baby’s Only recently completed a clinical trial, and the company expects to be able to sell it as infant formula soon.

However, pediatricians and nutritionists continue to warn parents about the use of drinks for young children. “There is no doubt 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 useful, because it’s confusing, because it’s expensive.”

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