Interview transcript (edited for clarity):
Contemporary pediatrics®:
Why did you want to discuss infant formula at the 2023 American Academy of Pediatrics National Conference & Exhibition?
George J. Fuchs, III, MD, FAAP:
There is a category of nutritional products that have different names, but they are mainly aimed at toddlers 12 months and older, the subgroup starts at 6 months, and their presence has increased significantly in this country. There is considerable confusion about these products among parents, other caregivers, and pediatricians and child care providers. So we thought it was time to revisit this category and try to determine its place in the options for young children.
Contemporary pediatrics:
Can you explain the difference between infant formula and toddler formula, and how the confusion comes into play?
Fuchs:
Infant formula, which is different, targets infants 0-12 months, is regulated by the FDA, must be reviewed and approved. Production facilities are inspected annually and constitute complete nutrition for an infant. The FDA does not have a category for children over 12 months. He ranges in age from 12 months to 22 years. These products are therefore absolutely not regulated. They are not nutritionally complete. In other words, they are designed for healthy children who eat other foods. Now part of the problem is that they have been co-branded with infant formula, often with sequential names or similar logos, stage 1, stage 2, stage 3, etc. This therefore implies that they supplement their nutrition. This also implies that there is a continuum of formulas that are beneficial for the young child, which is simply not the case. So part of the confusion comes from how companies present them to the public. I have to tell you that there is also a huge amount of confusion among pediatricians and other health care providers.
Contemporary pediatrics:
How can pediatricians advise parents regarding infant formula?
Fuchs:
I think number 1, breastfeeding is best. Even up to the age of 2 and beyond. From around 6 months of age, we recommend introducing complementary foods, solid foods. So breast milk is number 1. If for some reason they are not providing breast milk to their infant, then infant formula for the liquid part of the diet until the age of 12 months. At 12 months, for an otherwise healthy child, we simply recommend a varied diet with whole cow’s milk. Or if it is a risk of obesity in children, then 2%, but cow’s milk. Drinks in the toddler category don’t actually provide any additional nutritional benefits. So there’s nothing they can’t get otherwise. I understand that some studies from company sites say that there are nutritional deficiencies in children’s diets. In fact, the most relied upon studies show that, in general, they are quite adequate. So there can be deficiencies in vitamin D, E and fiber for toddlers and infants and then iron, especially in infants, but if they are taking iron-fortified infant formula, which is now essential, they should do it. GOOD. Rather than upgrading to considerably more expensive toddler drinks, simply advise parents on how to feed their child to fill in any gaps. Besides, most children do not have any deficiencies. I might mention that this is not a scientific investigation, but just looking online at Amazon, Walmart, and Target, the cost differences are really quite striking. Cow’s milk costs on average between 2 and 6 cents per ounce. The cheapest I saw in toddler form was 30 cents an ounce. It is the cheaper. Most of them are much more expensive, up to $1.25 or more. So more than 20 times more expensive than cow’s milk. And most people don’t have that disposable income. But what has happened is that there is a perception among parents, among mothers and surveys have shown, that these drinks for toddlers provide something that they cannot. not obtain breast milk, nor cow’s milk through a regular diet.
