Toddler milk

What about follow-on formula for babies older than one year?

Companies make and promote various products aimed at older babies and toddlers to replace breast milk, cow's milk, and even infant formula. They have various names, including toddler milk, follow-on formula, and follow-up formula. Manufacturers claim these products are needed for proper growth, that they improve mental performance, and provide proper nutrition for picky eaters, but none of these claims has been demonstrated. There is no evidence they benefit children as long as their diets contain enough nutrients. Most toddler milk contains powdered milk, corn syrup or other added sweeteners, flavourings, and vegetable oil. There are concerns that they may increase a child’s preference for sweet tastes. They contain less protein and more salt than cow’s milk, are more expensive, and carry the risk of contamination. They are very different from infant formula and mistaking toddler milk for infant formula can have negative consequences.

A) Describing toddler milk

Breastfeeding babies do not need any other milk. If you are giving your baby an infant formula that is working well, continue with this until infant formula is no longer needed. This is usually by 12 months. You can then give your child limited amounts of whole cow’s milk and some water.

Recently, manufacturers have been aggressively marketing unnecessary commercial milks for children between the ages of 9 to 36 months (toddler milk). Even while not recommended, sales of toddler milk have dramatically increased in recent years (Lott 2019).

Toddler milk has various names, including:

  • Follow-on formula
  • Follow-up formula
  • Transition formula
  • Weaning formula
  • Toddler formula
  • Growing-up milk
  • Young child milk

Toddler milk is different from infant formula that is designed to provide babies under the age of one with appropriate nutrition. 

The labels on toddler milk may look very similar to those on infant formula and mistaking toddler milk for infant formula may not provide babies with enough nutrients to grow well. 

Please discuss any questions with your health-care providers.

B) Why toddler milk is not recommended

1) Unhealthy ingredients

Unlike infant formula, there are no standards for toddler milk ingredients. Most toddler milk contains powdered milk, vegetable oil, and significant amounts of unhealthy sugars such as corn syrup solids. 

It may be flavoured with items such as artificial vanilla. There are concerns that this can increase a child’s preference for sweet tastes.

It can contain less protein and more salt (sodium) than cow’s milk (Pomeranz 2018).

Just like infant formula, it carries the risk of contamination with bacteria or other unwanted ingredients.

2) No benefits have been shown

Toddler milk (Pomeranz 2018; Harris 2020):

  • Is not necessary for proper growth.
  • Has not been shown to improve mental performance.
  • Does not provide improved nutrition for picky eaters.

Toddler milk is not recommended, as there is no evidence it benefits toddlers as long as their diets contain enough iron and vitamins (AAP 1989; Critch 2014; Mak 2017; Smith 2013; WHO 2013). If these deficiencies are present, they are best treated by addressing the child’s diet and if necessary, with a multivitamin (O’Connor 2009).  

3) May replace breastfeeding

Breastfeeding children have no need for toddler milk. Using it can interfere with breastfeeding and therefore increase the risk of illness in mothers and their children

4) Is expensive

Toddler milk is expensive. It may be as much as four times the cost of regular cow's milk.

C) Marketing

Toddler milk is heavily promoted by manufacturers who are trying to replace breast milk and whole cow’s milk and even infant formula with their products (Berry 2010; Chen 2015; Choi 2020; Khazan 2018; Pomeranz 2018). Manufacturers of commercial milks may use toddler milk to keep a customer beyond the first year of the baby’s life, when infant formula is usually stopped.

Their marketing practices are questionable (Pomeranz 2018; Harris 2020).

In 2015, companies spent £21 (roughly USD $28) for every baby born in the UK on marketing toddler milk (APPG). Not surprisingly, one survey (Romo-Palafox 2020) of American caregivers reported that 11% gave toddler milk to their child.

References

All-Party Parliamentary Group on Infant Feeding and Inequalities (APPG). Inquiry into the cost of infant formula in the United Kingdom. 2018
 
Berry NJ, Jones S, Iverson D. It's all formula to me: women's understandings of toddler milk ads. Breastfeed Rev. 2010 Mar;18(1):21-30

Chen YC, Chang JS, Gong YT. A Content Analysis of Infant and Toddler Food Advertisements in Taiwanese Popular Pregnancy and Early Parenting Magazines. J Hum Lact. 2015 Aug;31(3):458-66

Choi YY, Ludwig A, Harris JL. US toddler milk sales and associations with marketing practices. Public Health Nutr. 2020 Apr;23(6):1127-1135

Critch JN; Canadian Paediatric Society; Nutrition and Gastroenterology Committee. Nutrition for healthy term infants, six to 24 months: An overview. Paediatr Child Health. 2014 Dec;19(10):547-52
 
Committee on Nutrition, American Academy of Pediatrics (AAP). Follow-up or weaning formula. Pediatrics 1989; 83(6)

Harris JL, Pomeranz JL. Infant formula and toddler milk marketing: opportunities to address harmful practices and improve young children's diets. Nutr Rev. 2020 Oct 1;78(10):866-883

Khazan O. The Epic Battle Between Breast Milk and Infant-Formula Companies The Atlantic 2018 Jul 10

Lott M, Callahan E, Welker Duffy E, et al.  Healthy Beverage Consumption in Early Childhood: Recommendations from Key National Health and Nutrition Organizations. Technical Scientific Report. Durham, NC: Healthy Eating Research, 2019 

Mak VS. How Picky Eating Becomes an Illness-Marketing Nutrient-Enriched Formula Milk in a Chinese Society. Ecol Food Nutr. 2017 Jan-Feb;56(1):81-100
 
Pomeranz JL, Romo Palafox MJ, et al. Toddler drinks, formulas, and milks: Labeling practices and policy implications. Prev Med. 2018 Apr;109:11-16
 
Romo-Palafox MJ, Pomeranz JL, Harris JL. Infant formula and toddler milk marketing and caregiver's provision to young children. Matern Child Nutr. 2020 Mar 10:e12962

O'Connor NR. Infant formula. Am Fam Physician. 2009 Apr 1;79(7):565-70
 
Smith J, Blake M. Infant food marketing strategies undermine effective regulation of breast-milk substitutes: trends in print advertising in Australia, 1950-2010. Aust N Z J Public Health. 2013 Aug;37(4):337-44
 
World Health Organization (WHO). Information concerning the use and marketing of follow-up formula. Geneva: World Health Organization; 2013