It seems like common sense that giving babies added sugar is unhealthy, so parents may be surprised to learn that the majority of infant formulas sold in the United States contain high levels of added sugar.
A study published Saturday found a "staggering" contrast in the U.S. formula supply and federal recommendations for healthy diets. The researchers concluded that "parents and caregivers cannot easily avoid added sugars in infant formulas on the US market as most available formulas were comprised of primarily added sugars. Thus, most of the formulas that parents and caregivers feed their infants likely present a substantial risk to their infant's health and development."
MORE: Limiting internet use on smartphones can help boost mental health, attention spans
Guidelines from the American Academy of Pediatrics advise parents to avoid giving children under 2 foods or drinks with any added sugar. Children 2 and older should have no more than 25 grams, or about 6 teaspoons, a day. Most children eat and drink "much more" added sugar than is recommended, according to the AAP.
A 2021 study noted that there is "limited" data on the amount of added sugars consumed by infants and toddlers in the United States. But it found more than 84% of children under 2 consumed added sugars on any given day. For infants, the primary sources of the added sugars were yogurt, baby food snacks and sweets, and sweet bakery products. For toddlers ages 12 to 23 months, the primary sources were fruit drinks, sweets and sweet bakery products.
"Breast milk, similar to infant formula, was presumed to have no added sugars," according to the study.
But the study published Saturday in the Journal of Food Composition and Analysis found that most infant formulas produced in the United States contain primarily added sugars, as opposed to naturally occurring lactose. A "small minority" of formulas – just 8% – contained primarily naturally occurring lactose. All of those were from Enfamil LIPIL formulas – no longer available in the United States.
"Furthermore, due to lax federal labeling requirements, parents and caregivers are unable to review the proportion and types of sugars present in infant formulas, as sugars are not required to be reported on US infant formula nutrition labels," the researchers wrote.
Breastfeeding is an obvious antidote to the problem of too much added sugar in formula, but giving infants breast milk is not an option for many women due to physical, medical and social issues. A 2011 "call to action to support breastfeeding" from the surgeon general noted barriers including lack of family and social support, lactation problems and employment and child care issues.
The federal Family and Medical Leave Act provides up to 12 weeks of leave to care for a newborn, an adopted or foster child, or another family member – but it is unpaid. Also, diabetes, thyroid and other diseases can affect milk production. Mastitis, inflammation in the breast that can turn into an infection, especially during the first three months of breastfeeding, affects up to 10% of women in the United States. And there is a lack of research and a lot of uncertainty about what medications are safe to take while breastfeeding.
"Given that the structure of the U.S. system and environment often leaves parents and caregivers with little choice but to use formula in some capacity, efforts should focus on requiring formula companies to produce products that primarily contain naturally occurring lactose and are designed to minimize risks to healthy infant development," the researchers concluded.