A grocery store's baby formula aisle often stocks an overwhelming number of options. Aside from different brands of pastel-hued tins and tubs, there are specialized formulas — some for spit-up reduction, gas or colic. And in the past decade or so, companies have introduced formulas meant for toddlers who are leaving bottles behind.
"You're faced with a confusing array of labels that are similar looking, and it's not very clear when you're supposed to use one, or switch from one to the other, or actually stop using these, and give your child food," says Jennifer Pomeranz, a public health researcher at New York University who recently analyzed the toddler drinks in grocery store aisles. Her results appeared in the journal Preventative Medicine last month.
The abundance of options reflects how much care parents tend to put into feeding their youngest family members. There's plenty of science showing that what kids eat in their first few years lays a foundation for their physical growth and brain development for the rest of their lives.
But toddlers don't know how important their diet is. So when they push away new foods, parents get anxious. "For many parents, it's scary to move from breast-feeding or infant formula onto whole cow milk, that seems like a big change," says Steven Abrams, who chairs the American Association of Pediatricians Committee on Nutrition.
That, formula makers say, is where toddler milks come in. Toddler milks are marketed for picky eaters, framed as a familiar, but more grown-up, version of the breast milk or formula they're departing from. "Milk-based toddler drinks can contribute significantly to nutritional intake of older infants and young children," Mardi Mountford, the president of the Infant Nutrition Council of America, said in an email statement. The Infant Nutrition Council of America is an association that includes Gerber products and three other formula makers.
But what an anxious parent may not realize is that these toddler milks are typically more expensive than whole milk and less nutritious, Abrams says. "I don't believe them to be particularly harmful, but they're not necessary, and they're certainly not designed and regulated for infant use."
Still, manufacturers are pursuing this market with gusto. In 2015, manufacturers spent $16 million promoting toddler milks, compared with $9 million on baby formula, according to an analysis from the University of Connecticut. Mead Johnson Nutrition, the company behind Enfagrow toddler transitions formula, noted strong growth in U.S. and Canada for their "growing-up milks" in their two most recent annual reports, in 2014 and 2015.
We chatted with Pomeranz about what she discovered about these products. Our conversation was edited for length and clarity.
What, exactly, is a toddler milk, and how are these products different from formulas for infants?
This is actually a tough product category to nail down. When we first started this project, it took us months to determine what to call these things because there are so many names, and the European words are different than the ones used here.
Whether a product is called a follow-up formula, a follow-on formula, or a growing-up milk, these transition formulas all contain similar ingredients: powdered milk, corn syrup solids and other sweeteners, vegetable oil, and sodium. Infant formulas, too, contain powdered milk and corn syrup solids, but the FDA strictly regulates the nutritional composition of all formulas meant for babies under 12 months.
Without those nutritional regulations, most toddler milks have more sugar, fat and sodium than infant formula.
Why did you look into toddler milk labels?
Besides regulating the composition of infant formula, the FDA sets standards for labeling products for babies. Manufacturers have to include a specific nutrition panel and a statement to "use as directed by physicians," and they can only make certain kinds of claims about infant formulas on packaging.
Once a formula is intended for a child older than 12 months, those regulations don't apply, so it made sense to survey the 17 toddler milk labels available when this study was conducted.
In most cases, it's hard to tell infant formulas apart from the toddler milks on the shelf. They have similar colors and wording. But toddler milks are usually cheaper, and that lower price point means parents may mistakenly buy these products for infants.
Do you have recommendations about these formulas?
My view is that these companies created a fake feeding period that they filled with this new product. We're adding in now another few years of processed food consumption that didn't previously exist.
But to regulate the products that will remain in the market, it would help to assign them a standard name, so parents know what they're buying, she says. Requiring labels to clearly specify that toddler drinks aren't for infants would remove some of the confusion.
A directive encouraging parents to check with a pediatrician before feeding a child a toddler drink would also be good. Given that most toddlers do well with food, water, and milk, pediatricians don't typically recommend these transition formulas.