Just when you finally feel confident with feeding your baby, your pediatrician adds a new transition to the mix at their 12-month appointment: it's time to introduce cow's milk. There are some options on the grocery store shelves that can make this transition feel extra confusing.
"Toddler formula is a growing product category that's essentially billed as the next stage of formula feeding and has attracted the attention of the American Academy of Pediatrics (AAP). On Friday, the organization released a new report strengthening its stance against toddler formula: Parents shouldn't use it.[1]
Instead, the AAP recommends transitioning children to whole cow's milk when they reach 12 months. Pediatricians are also calling out toddler formula manufacturers for their misleading claims, and asking them to make a "clear and unambiguous distinction from standard infant formula." The AAP wants these products to go on different store shelves away from infant formula to avoid confusion and says these products shouldn't be labeled "formula" at all.
If you've got questions about toddler formula, here's what pediatricians want you to know.
What is toddler formula?
Toddler formula goes by several names, including transition formula, follow-on or follow-up formula, weaning formula, and toddler milk. Sometimes it's marketed as a subsequent "stage" of infant formula, such as stage 2 formula. In addition to having many different names, it can have varying contents.
"Because there are no standard criteria for formulas for children older than 12 months, there is a wide variability in the composition of these products," says Katie Lockwood, M.D., M.Ed., a pediatrician at Children's Hospital of Philadelphia.
It's also a rapidly growing product category. Recent research shows that toddler formula now makes up 48% of all sales around the world for breast milk substitutes.[2] Many parents also (mistakenly) think that toddler formula is superior to cow's milk or confuse toddler formula with infant formula.
These misconceptions have experts worried. The World Health Organization has spoken out about the misleading marketing practices used for toddler formula,[3] and another AAP project called it "unnecessary and potentially harmful to young children."[4]
How is toddler formula different from infant formula?
There are a few differences between toddler formula and infant formula. "Infant formulas are designed to meet the specific nutritional needs of infants under the age of 12 months," Dr. Lockwood says. While infant formulas are tightly regulated in this country, "the U.S. has no regulatory oversight of toddler formulas at this time," she adds.
Subsequently, the make-up of toddler formula can vary from brand to brand, says Danelle Fisher, M.D., a pediatrician and chair of pediatrics at Providence Saint John's Health Center in Santa Monica, California. It may also contain added sugar and high levels of sodium, which pediatricians don't recommend children have.
Why is whole cow's milk better than toddler formula?
"Cow's milk is better because it has protein and calcium that kids require," Dr. Fisher says. "Milk doesn't have additives and extras like toddler formulas that take up space that should be taken up by foods."
Most doctors recommend serving whole-f cow's milk until the second birthday unless the doctor has suggested transitioning to reduced-fat or non-dairy milk. If your child is allergic or sensitive to cow's milk, ask their pediatrician for acceptable alternatives, like fortified whole-fat soy milk.
Even if you have a picky eater, toddler formula won't fill in any nutritional gaps. Toddler formulas "are not nutritionally complete," the AAP report states.
Is toddler formula bad for toddlers?
Overall, doctors say it's best to skip buying toddler formula. But if you've used it in the past it won't cause your child any harm. Talk to the pediatrician about your child's nutritional needs, Dr. Lockwood advises. That can help you determine what — if any — supplements you'll need for your child.
"Toddler formula is significantly more expensive than cow milk, and since it does not provide a nutritional benefit, this additional cost is an unnecessary burden for families," Dr. Lockwood says.
Help your child transition to whole-fat cow's milk by mixing the formula you have with cow's milk, gradually increasing the amount of milk, Dr. Fisher advises. Prioritize solid foods in your toddler's diet as well. "It's good to move away from that liquid intake of all those calories and move them to solid food," she explains.