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Background: Excessive use of specialized formula for cow's milk allergy was reported in England, but complete analysis has not been undertaken and trends in other countries are unknown. Some specialized formula products, especially amino‐acid formula (AAF), have high free sugars content. We evaluated specialized formula trends in countries with public databases documenting national prescription rates. Methods: Cross‐sectional analysis of national prescription databases in the United Kingdom, Norway and Australia. Outcomes were volume and cost of specialized formula, and proportion of infants prescribed specialized formula. Expected volumes assumed 1% cow's milk allergy incidence and similar formula feeding rates between infants with and without milk allergy. Results: Prescribed volumes of specialized formula for infants rose 2.8‐fold in England from 2007 to 2018, with similar trends in other regions of the United Kingdom. Volumes rose 2.2‐fold in Norway from 2009 to 2020 and 3.2‐fold in Australia from 2001 to 2012. In 2020, total volumes were 9.7‐ to 12.6‐fold greater than expected in England, 8.3‐ to 15.6‐fold greater than expected in Norway and 3.3‐ to 4.5‐fold greater than expected in Australia, where prescribing restrictions were introduced in 2012. In Norway, the proportion of infants prescribed specialized formula increased from 2.2% in 2009 to 6.9% in 2020, or 11.2‐ to 13.3‐fold greater than expected. In 2020, specialized formula for infants cost US$117 (103 euro) per birth in England, US$93 (82 euro) in Norway and US$27 (23 euro) in Australia. Soya formula prescriptions exceeded expected volumes 5.5‐ to 6.4‐fold in England in 1994 and subsequently declined, co‐incident with public health concerns regarding soya formula safety. In 2020, 30%–50% of prescribed specialized formula across the three countries was AAF. Conclusions: In England, Norway and Australia, specialized formula prescriptions increased in the early 21st century and exceeded expected levels. Unnecessary specialized formula use may make a significant contribution to free sugars consumption in young children. [ABSTRACT FROM AUTHOR]

Background: Diet cariogenicity plays a major role as both a protective and risk factor in the development of early childhood caries (ECC). Aim: Develop a scale measuring the cariogenicity of foods and beverages and employ it to describe the cariogenicity of young children's diets and predict dental caries outcomes. Design: Scores of cariogenicity and consumption frequency were applied to food frequency questionnaire (FFQ) collected from an Australian children's cohort study with three time‐points of data. One‐way ANOVA, with post hoc Tukey test compared mean cariogenic scale measured at 18 months between the subsample of children with caries classification at age 5 years. Results: At 6 months, children's mean cariogenic score was 10.05, increasing to 34.18 at 12 and 50.00 at 18 months. Mean cariogenic scale score at 18 months was significantly higher in children with advanced disease at 5 years (mean scale score: 59.0 ± 15.9) compared to those that were healthy (mean score 47.7 ± 17.5, P = 0.007) or had mild‐moderate disease (mean score 48.2 ± 17.3, P = 0.008). Conclusions: The cariogenic diet scale provides a useful indication of the increasing cariogenicity of children's diets with age and highlights the incorporation of discretionary choice foods and beverages into the diets of young children much earlier than nutritionally recommended. [ABSTRACT FROM AUTHOR]