Search

Toddler milk is an ultra-processed beverage consisting primarily of powdered milk, caloric sweeteners, and vegetable oil. Pediatric health authorities do not support the use of toddler milk, and emerging evidence suggests that toddler-milk marketing practices may mislead consumers. However, studies have not synthesized the extent of toddler-milk marketing practices or how these practices affect parents decisions about whether to serve toddler milk. We aimed to summarize the literature about toddler milk to identify what is known about: (1) parents toddler-milk purchasing and feeding behaviors, (2) toddler-milk marketing, and (3) how marketing practices influence parents beliefs and perceptions about toddler milk. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), we systematically searched 8 databases (PubMed, APA PsycINFO, Scopus, Cochrane Central, Embase, CINAHL, Communication & Mass Media Complete, and Business Source Premier). We identified 45 articles about toddler milk. Studies were conducted in 25 countries across 6 continents. Five types of findings emerged: (1) consumption and feeding behaviors, (2) demographic correlates of toddler-milk purchasing and consumption, (3) misperceptions and beliefs, (4) increased sales, and (5) increased marketing and responses to marketing. The included articles suggested that toddler-milk sales are growing rapidly worldwide. Findings also revealed that toddler-milk packages (eg, labels, branding) resemble infant formula packages and that toddler-milk marketing practices may indirectly advertise infant formula. Purchasing, serving, and consumption of toddler milk were higher in Black and Hispanic populations than in non-Hispanic White populations, and parents with higher educational attainment and income were more likely to offer toddler milk to their children. Findings suggest a need for policies to prevent cross-marketing of toddler milk and infant formula, reduce provision of toddler milk to infants and toddlers, and prevent caregivers from being misled about toddler-milk healthfulness.

During the last decade, feeding patterns, more specifically those of children, have worsened—affecting dietary habits and Mediterranean diet adherence. Here, we examine the post-pandemic feeding habits of Spanish toddlers. A total of 2465 parents of children aged between 12 and 36 months completed an online 25-item multiple-choice survey asking about dietary habits and Mediterranean diet adherence. Only 34 children (1.38%) had an adequate intake of all of the food groups included in the questionnaire. Adherence worsened as toddlers grew (p < 0.0001). Further, lower compliance was found in children with a higher intake of fast food (p < 0.001), those with siblings (p = 0.0045), and children who were the second or third child (p = 0.0005). The food group with the most commonly reported adequate intake was fish (88% of children), followed by pulses (80%), water (79%), and meat (78%). Cow's milk was the most commonly consumed dairy product among all age groups analyzed. Half of the children exhibited a low consumption of milk and dairy products. These results showed that a lack of adherence to a balanced diet is common among Spanish toddlers in the post-pandemic period and that greater parent education could improve the nutrition of toddlers. [ABSTRACT FROM AUTHOR]

Background: Emerging clinical evidence indicates the potential gastrointestinal (GI) benefits of milk containing only A2 β-casein, but data from randomized controlled trials is sparse among pediatric populations. We aimed to evaluate the effectiveness of growing-up milk (GUM) containing only A2 β-casein on GI tolerance in toddlers. Methods: A total of 387 toddlers aged 12–36 months were recruited in Beijing, China, and randomized in a 1:1:1 ratio to consume one of two commercially available A2 GUMs (combined in the analysis as A2 GUM) or continue their current feeding regimen of conventional milk for 14 days. The primary outcome was the total Gut Comfort Score (GCS) (range: 10–60; higher values indicate greater GI distress) derived from a 10-item (score range: 1–6 per item) parent-reported questionnaire, reflecting GI tolerance. Results: The GCS (mean ± SD) was comparable between the A2 GUM and conventional milk groups on day 7 (14.7 ± 5.0 vs. 15.0 ± 6.1, p = 0.54) and day 14 (14.0 ± 4.5 vs. 14.3 ± 5.5, p = 0.51). Parents reported less constipation in those consuming A2 GUM vs. conventional milk on day 14 (1.3 ± 0.6 vs. 1.4 ± 0.9, p = 0.020). Among 124 participants with minor GI distress at baseline (GCS ≥ 17, top tertile range 17–35), GCS was significantly lower in those consuming A2 GUM on day 7 (18.2 ± 5.1 vs. 21.2 ± 6.8, p = 0.004) and day 14 (17.1 ± 5.3 vs. 19.6 ± 6.3, p = 0.026), as were individual GI symptoms (all p < 0.05). In the toddlers without GI issues at baseline (GCS < 17), a low GCS was maintained throughout the study period after switching to A2 GUM (mean values range 10–13). Conclusions: Growing-up milk containing only A2 β-casein were well-tolerated and associated with lower parent-reported constipation scores after two weeks when compared to conventional milks. In healthy toddlers with minor GI distress, A2 GUM improved overall digestive comfort and GI-related symptoms within one week. [ABSTRACT FROM AUTHOR]

Abstract ‘Growing‐up milks’ (GUMs)—breast‐milk substitutes targeted for young children (aged 12–36 months)—are commonly consumed in Indonesia. The World Health Assembly has stated that GUMs are not necessary for proper growth and development, and recently, the American Academy of Pediatrics declared that such products are not recommended for young children due to their common use of sweeteners. To contribute to the evidence base on the composition of GUMs and their appropriateness for young child diets, this cross‐sectional study documented the declared sugar content and presence of nutrient content claims of 99 GUMs newly launched in Indonesia between January 2017 and May 2019. Sugar content was evaluated against the draft 2018 Codex Alimentarius Standard for Follow‐Up Formula guidance on sugar content and the United Kingdom Food Standard Agency's front‐of‐pack (UK FSA FOP) colour coding system for sugar. Almost all (97%) GUMs contained one or more added sugars. None of the products were fully compliant with all three sugar content recommendations in the draft Codex standard. Seventy‐one per cent of GUMs were determined to have high sugar content according to the UK FSA FOP system. Nutrient content claims were found on 97% of GUMs. Median total sugar content was 7.3 g per 100 ml, similar to sugar content levels in sugar‐sweetened beverages. Many GUMs available in Indonesia claim to offer nutritional benefits; however, the current levels of sugar content in GUMs are a serious concern and are inappropriate for inclusion in the diets of young children.

Growing-up milk (GM) powders of contrasting colloidal behavior in aqueous suspension were studied by laser diffraction under wet and dry conditions. The reconstitution of the GM powders considered the interdependencies between particle size and the presence of encapsulated fat. The GM powders of low dispersibility presented fines associated with large particles. By contrast, the highly dispersible GM powder included fat encapsulated with fine particles (20 – 80 µm). Complementary analyses (morphological, SEM, spectroscopic, and thermal, DSA) analyses showed that the fine particles with free fat were more adhesive and presenetd poorer dispersibility, and lower soluble concentrations of macronutrients, eventually reducing the dispersibility in water. [Display omitted] • Accurate sizing of GM powder is obtained by laser diffraction in water. • Larger agglomerates are formed in WDG powders compared to PDG. • Individual fines are more prevalent in PDG powders. • Unencapsulated fat occurs in PDG fines, preventing reconstitution. • Interrelation between particle size and fat encapsulation define the colloidal dispersibility. [ABSTRACT FROM AUTHOR]

'Growing‐up milks' (GUMs)—breast‐milk substitutes targeted for young children (aged 12–36 months)—are commonly consumed in Indonesia. The World Health Assembly has stated that GUMs are not necessary for proper growth and development, and recently, the American Academy of Pediatrics declared that such products are not recommended for young children due to their common use of sweeteners. To contribute to the evidence base on the composition of GUMs and their appropriateness for young child diets, this cross‐sectional study documented the declared sugar content and presence of nutrient content claims of 99 GUMs newly launched in Indonesia between January 2017 and May 2019. Sugar content was evaluated against the draft 2018 Codex Alimentarius Standard for Follow‐Up Formula guidance on sugar content and the United Kingdom Food Standard Agency's front‐of‐pack (UK FSA FOP) colour coding system for sugar. Almost all (97%) GUMs contained one or more added sugars. None of the products were fully compliant with all three sugar content recommendations in the draft Codex standard. Seventy‐one per cent of GUMs were determined to have high sugar content according to the UK FSA FOP system. Nutrient content claims were found on 97% of GUMs. Median total sugar content was 7.3 g per 100 ml, similar to sugar content levels in sugar‐sweetened beverages. Many GUMs available in Indonesia claim to offer nutritional benefits; however, the current levels of sugar content in GUMs are a serious concern and are inappropriate for inclusion in the diets of young children. [ABSTRACT FROM AUTHOR]

The relationship of protein intake with insulin-like growth factor 1 (IGF-1) concentrations in well-nourished children during the second year of life is poorly understood. The aim of this study was to explore the effect of a reduced-protein Growing Up Milk Lite (GUMLi) or unfortified cow's milk (CM) on protein intake, growth, and plasma IGF-1 at 2 y. An exploratory analysis of a sub-sample of Auckland-based children (n = 79) in the GUMLi trial (a double-blind, randomised control trial, N = 160) completed in Auckland and Brisbane (2015–2017) was conducted. One-year old children were randomised to receive a reduced-protein GUMLi (1.7 g protein/100 mL) or a non-fortified CM (3.1 g protein/100 mL) for 12 months. Blood sampling and anthropometric measurements were made at 1 and 2 y. Diet was assessed using a validated food frequency questionnaire. Total protein intake (g/d) from all cow's milk sources was 4.6 g (95% CI: −6.7, −2.4; p < 0.005) lower in the GUMLi group after 12 months of the intervention, with a significant group-by-time interaction (p = 0.005). Length-for-age (LAZ) and weight-for-length (WLZ) z-scores did not differ between groups, however, mean body fat % (BF%) was 3.2% (95%CI: −6.2, −0.3; p = 0.032) lower in the GUMLi group at 2 y. There was no difference between the intervention groups in relation to IGF-1 and IGF-BP3 (p = 0.894 and 0.698, respectively), with no group-by-sex interaction. After combining the groups, IGF-1 concentration at 2 y was positively correlated with parameters of growth (all p < 0.05), total cow's milk intake (p = 0.032) after adjusting for sex, breastfeeding status, and gestation. Randomisation to a reduced protein GUMLi resulted in small reduction in %BF and lower total protein intakes but had no effect on growth. Plasma IGF-1 concentrations were independently associated with total protein intake from cow's milk at 2 y, highlighting a potential area of the diet to target when designing future protein-related nutrition interventions.Clinical Trial Registration: Australian New Zealand Clinical Trials Registry number: ACTRN12614000918628. Date registered: 27/08/2014.

BACKGROUND In Indonesia, animal protein intake in children is low and might contribute to a high prevalence of stunting. This study was aimed to evaluate the association between animal protein source consumption and stunting in toddlers. METHODS This cross-sectional study obtained secondary data from the Ironcheq questionnaire validation study to detect the risk of iron deficiency in toddlers. The Ironcheq study was carried out in five integrated health service posts (Posyandu) in Jakarta from 2013 to 2014. Data from 172 subjects, consisting of 41 stunted (height-for- age z-score less than -2) and 131 normal children, were analyzed to evaluate the association between animal protein source consumption and stunting using multivariate logistic regression test. RESULTS Stunted children tend to come from a family with low parental education and socioeconomic status. Consuming growing-up milk (GUM) ≥300 ml/day was protective against stunting (adjusted OR 0.28, 95% CI 0.13-0.63), whereas consuming red meat product ≥5 times/week was a risk factor (crude OR 3.70, 95% CI 1.17-11.74), however after adjusted to age, sex, and other variables in the questionnaire, the OR was not significant (adjusted OR 3.64 95% CI 1.00-13.26). CONCLUSIONS A daily consumption of 300 ml of GUM may be considered to prevent stunting in toddlers. Red meat products (sausage, nugget, and meatball), which are commonly consumed because of its practicality, could not be considered as significant animal protein sources because of a wide variation of their nutritional content. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This cross‐sectional survey assessed the characteristics of labels of follow‐up formula (FUF) and growing‐up milk (GUM) compared with infant formula (IF), including cross‐promotion practices between FUF/GUM and IF manufactured by the same company, sold in Phnom Penh, Cambodia; Kathmandu Valley, Nepal; Dakar Department, Senegal; and Dar es Salaam, Tanzania. All products were imported. A wide recommended age/age range for introduction was provided by manufacturers across all sites, with products with an age recommendation of 0–6 months being most prevalent in three sites, representing over a third of all products. Various age categories (e.g. 1, 1+ and Stage 1) commonly appeared on labels. A number of descriptive names (e.g. infant formula and milk formula) per category of age of introduction were used with some appearing across more than one category. Images of feeding bottles were found on most labels across all age categories, but prevalence decreased with older age categories. The majority of FUF/GUM manufactured by IF companies across all sites displayed at least one example of cross‐promotion with one or more of the company's IF: two‐thirds or more contained similar colour schemes/designs and similar brand names; 20–85% had similar slogans/mascots/symbols. A wide and potentially confusing range of ages/categories of introduction and descriptive names were found, and cross‐promotion with IF was common on FUF/GUM labels. Global guidance from normative bodies forms the basis of most low and middle income countries policies and should provide specific guidance to prohibit cross‐promotion between FUF/GUM and IF, and all three categories should be classified as breastmilk substitutes. [ABSTRACT FROM AUTHOR]

Utilization of expert recommendations in the development of food and beverage nutritional profiles represents an opportunity to merge science and food manufacturing to deliver nutritionally optimized products into the marketplace. This report details expert panel guidelines for the design of a nutritional product for children one to six years of age. This interaction demonstrates the essential synergy between academia and food manufacturers in translating nutrient recommendations to food for their delivery to a population. Important factors for such translation are the identification of applicable nutrient recommendations and selection of an appropriate delivery matrix. This report demonstrates the translation of expert nutritional recommendations to a milk-based product for children—one to six years of age. [ABSTRACT FROM PUBLISHER]

To investigate the efficiency of [6S]-5-methyltetrahydrofolate or Metafolin® ([6S]-5-CH3-H4folate) on the recovery of folate status, we conducted a depletion–repletion rat model study using a growing-up milk as the folate carrier. The effect of [6S]-5-CH3-H4folate was compared to that of folic acid (PGA or Pte-Glu), by feeding two groups of folate-depleted rats a diet of fortified growing-up milk containing either 1,000 μg/l (2.2655 μmol/l) of Pte-Glu or 1,041.91 μg/l (2.2655 μmol/l) of [6S]-5-CH3-H4folate over a 4-week period. At the end of the study, the folate concentration in plasma, erythrocytes and liver was measured to establish the folate status of the animals. The folate content was determined in the plasma and erythrocytes by a time-resolved fluoroimmunoassay method and in the liver by a HPLC method. Plasma, erythrocyte and liver folate concentrations were significantly ( P < 0.001) lower after a depletion period in rats fed the folate-deficient diet compared to rats fed a control diet. The folate form used significantly influenced the folate concentration in erythrocytes and liver, but not in plasma, after the rats’ body folate reserves were replenished by consuming the fortified growing-up milk. Thus, rats fed [6S]-5-CH3-H4folate-fortified growing-up milk showed significantly higher folate content in erythrocytes and liver (1,100.37 ng/ml and 4.22 μg/g, respectively), than did those fed Pte-Glu-fortified growing-up milk (827.71 ng/ml and 3.04 μg/g, respectively, in erythrocytes and liver). We conclude that the natural diastereomer [6S]-5-CH3-H4folate may adequately serve as an alternative to folic acid for the folate fortification of infant foods. [ABSTRACT FROM AUTHOR]

Exclusive breastfeeding is the recommended feeding for all infants. Recent research has focused on the importance of balanced feeding during the first 1000 days, starting at conception with a balanced diet of the pregnant woman, up to the age of two years. The following step, a balanced diet after the age of two years is a challenge, as the dietary intake becomes more diversified. The role of young-child formula in this process is debated. This paper discusses the use of planted-based drinks, since they are a valuable and progressively more popular alternative for cow's milk, if nutritionally adapted to the requirements of toddlers. Plant-based drinks are per definition lactose free. [ABSTRACT FROM AUTHOR]

Nutrition in early life is a crucial element to provide all essential substrates for growth. Although this statement may appear obvious, several studies have shown how the intake of micro and macronutrients in toddlers differs a lot from the recommendations of scientific societies. Protein intake often exceeds the recommended amount, while the intake of iron and zinc is frequently insufficient, as well as Vitamin D. Nutritional errors in the first years of life can negatively impact the health of the child in the long term. To date, no clear evidence on which milk is suggested during the second year of life is yet to be established. In this study, we compare the nutrient profiles of cow's milk and specific formulas as well as nutritional risks in toddlers linked to growth and childhood obesity development. The purpose of this review is to resume the latest clinical studies on toddlers fed with cow's milk or young children formula (YCF), and the potential risks or benefits in the short and long term. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Common infectious diseases, such as diarrhea, are still the major cause of death in children under 5-years-old, particularly in developing countries. It is known that there is a close relationship between nutrition and immune function. To evaluate the effect of a growing-up milk containing synbiotics on immune function and child growth, we conducted a cluster randomized, multicenter, double-blind, placebo controlled clinical trial in children between 18 and 36 months of age in Vietnam. Eligible children from eight and seven kindergartens were randomly assigned to receive test and isocaloric/ isoproteic control milk, respectively, for 5 months. We found that the blood immunoglobulin A (IgA) level and growth parameters were increased in the test group. Compared to the control group, there was also a trend of decreased vitamin A deficiency and fewer adverse events in the test group. These data suggest that a growing-up milk containing synbiotics may be useful in supporting immune function and promoting growth in children.