Formula: taking a closer look

“Perfect mix of science and love”

“Support your toddler’s immune system”

“Tailored 16 vitamins and minerals for your child’s normal growth and development”

Any of these sound familiar? They are claims belonging to various toddler milk formulas and designed to really make you believe your littlie NEEDS them to thrive. But do they?

First, we will make it clear that in this article we wish to separate the discussion around sugar content in infant formulas from those aimed at toddlers. We completely understand that formula has its place in the world! There are many who, for a variety of reasons, cannot breastfeed. Therefore formula can be life-saving, especially for infants (until they are ready to consume solids).

However, let’s ensure we are best informed about what we are feeding our kids, for when nature’s perfect liquid baby food isn’t available to you.

Powdered food
So, what really goes into these miracle powders to create a sparkly, highly functioning super baby?

Fortunately in Australia and New Zealand, standards are strict for what is included in infant formula (though currently under review). It must be nutritionally complete with specifics on energy, protein and fat content, and not contain gluten or an excessive level of heavy metals. However, there is no specific requirements for the amount of added sugar and carbohydrate content.

A proposal for changing the code for infant formula in Australia and New Zealand notes there is guidance for nutrient composition on ‘preferred’ sources of carbohydrate, and that sucrose and fructose should be avoided, but this is not mandatory.

The World Health Organization (WHO) and Food and Agriculture Organization (FAO) state there is no need for infants to have sucrose, and it along with added fructose, should be avoided.

Hopefully, strict legislation around added sugar content and carbohydrate source will come into effect in Australia and New Zealand in the near future. The good news is how infant formula is marketed in Australia and New Zealand is very restrictive, and nutritional claims cannot be made on the label. Infant formula companies must promote that ‘breast is best’.

However, it appears there are more leniencies with formula when the littlies move to the realm of toddler-hood, which may be of cause for concern.

Priming for sweetness
At the time of writing this piece, we had a look into the ingredients found in readily available at Australian supermarkets. Both Karicare Toddler and Nutricia Aptamil Junior Gold (each Stage 4 from 2 years) contain glucose syrup as its second ingredient.

Maltodextrin features further down the list – which is rapidly absorbed as glucose and created from corn or wheat, making the formula more allergenic; and glucose makes a second appearance on each ingredient list.

Given the ever-rising concern about added sugar intake and the early-life shaping of children’s palates and desires, along with the long-term health impacts from consuming too much sugar and too many processed foods, we think introducing restrictions around toddler formulas, especially how it is marketed and when they may be needed (e.g. in consultation with a qualified healthcare practitioner when managing a very fussy eater), is warranted.

Health experts around the globe do not recommend the use of toddler formula.

Science is quickly confirming the addictive qualities of sugar. So to sweeten the liquid meal deal, could we be creating sugar-loving kids considering the propensity for sugar dependence?¹

Aside from the sugar content, these products include heavily processed oils and other ingredients. Not ideal.

Big food, big influence
Several decades ago there was a decline in breastfeeding globally, associated with increased infant mortality, malnutrition, and diarrhoea. It seems big industry had significant influence, with companies such as Nestle marketing heavily either directly through advertising mediums, or indirectly in gifts to mothers and bribing healthcare workers.^2-3 This is especially true in developing countries, with a 10% rise in formula sales, whilst sales trend consistently in higher-income countries.³

Yet, these formulas need water, and clean drinking water isn’t always available. Secondly, compared with breastfeeding, purchasing formula is expensive! So many mothers, thinking they are giving their child the best chance, may need to work to purchase such goods, instead of being at home with their children.

Of course, this view may be an over-simplified observation. But it doesn’t seem quite right, does it?

As a result, there are now strong restrictions recommended by WHO on labelling, claims, and marketing infant formula – which essentially means no marketing at all.

But toddler formula has no such restrictions. Yet branding of infant and toddler forumla is made to look the same. This offers familiarity with the brand, subtly marketing their infant products without you even realising.

Just think carefully
We are by no means attempting to advise you away from using infant formula, nor judge you if you do. Infant formulas can be necessary. And thank goodness we have strict nutritional standards here in Australia and New Zealand to ensure our bub’s needs are met in those critical early months.

However, we want to offer some insight into the industry. If you have the choice, perhaps think twice about complicating an already wonderful nutrient delivery system for the bub. If you do not have the choice, choose your formula wisely.

And when it comes to toddlers, ideally they will be meeting their nutritional requirements through diet. If they are fussy eaters, consult with a qualified healthcare practitioner on ways to broaden their diet, and if you want to include formula, avoid the added sugars (lactose excepted).

As nature intended
We often overlook the magnificence of what nature can provide us, whether breast milk for an infant (whenever possible) or real, whole foods for after 12 months of age, relying on food as their main source of nutrition.

Here are a few of the key nutrients to consider for when your baby is becoming a toddler, ideally obtained from the diet, to help them grow big, smart, and strong:

• Omega 3 Fatty Acids (including DHA): Think oily fish, flaxseed, and chia seed,* for neurological and visual development. It also reduces the incidence of asthma, eczema, hay fever and upper respiratory tract infections.⁴
• Protein: Think meat, fish, eggs, legumes, nuts, and seeds,* for robust muscle development and immunity to keep up with the crazy amount of growth and number of illnesses experienced in the early years.
• Low GI/GL foods: Think foods high in fibre, healthy fats, and quality protein. High intake of high GI foods may predispose to later life diabetes and obesity. ⁵ 
• Micronutrients: Iron, zinc, and calcium are particularly important, as well as vitamin D. ⁶ Respectively, think foods such as meat, lentils, and leafy greens; meat, fish, and pepitas; dairy, beans, and leafy greens and vegetables such as kale and broccoli; and getting some sunshine for vitamin D synthesis!*

By Angela Johnson (BHSc Nut. Med)

*When referring to meat, fish, eggs or dairy, whenever possible, choose high quality, sustainably and ethically sourced.

References:

1. Avena, NM, Rada, P, & Hoebel, BG 2008, ‘Review: Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake’, Neuroscience and Biobehavioral Reviews, vol. 32, pp. 20-39
2. Brady, JP 2012, ‘Marketing breast milk substitutes: problems and perils throughout the world’, Archives Of Disease In Childhood, vol. 97, no. 6, pp. 529-532
3. Piwoz, EG, & Huffman, SL 2015, ‘The Impact of Marketing of Breast-Milk Substitutes on WHO-Recommended Breastfeeding Practices’, Food & Nutrition Bulletin, vol. 36, no. 4, pp. 373-386 14p
4. Birch, EE, Khoury, JC, Berseth, CL, Castañeda, YS, Couch, JM, Bean, J, Tamer, R, Harris, CL, Mitmesser, SH, & Scalabrin, DM 2010, ‘Original Article: The Impact of Early Nutrition on Incidence of Allergic Manifestations and Common Respiratory Illnesses in Children’, The Journal of Pediatrics, vol. 156, pp. 902-906.e1
5. Neu, J, Hauser, N, & Douglas-Escobar, M 2007, ‘Postnatal nutrition and adult health programming’, Seminars in Fetal and Neonatal Medicine, vol. 12, no. Nutrition, pp. 78-86
6. Hechtman, L 2012, Clinical Naturopathic Medicine, Churchill Livingstone, Chatswood, N.S.W.