Young-child formulas (YCFs) and cow's milk (CM) are typically introduced into a child’s diet after they turn one year old. The second year of life is a sensitive period for food acceptance and the development of eating habits yet little is known about the influence of CM or YCFs on the formation of eating habits and nutrient intakes in two-year-olds.
Numerous researchers have expressed their concerns regarding YCFs as a substitute for a diverse diet, because children fed YCFs are more likely to become dependent on liquid food than those consuming regular homemade meals, and because YCFs may affect satiation in infants.
A recent position paper by ESPGHAN postulates that YCFs do not have to be administered routinely but could play a minor role in dietary strategies aiming to increase the intake of nutrients such as iron and vitamin D.
A team of researchers from the University of Lublin, Poland, sought to explore the connection between YCFs and cow’s milk CM and nutrient intakes in Polish children aged between 13-24 months.
The daily food ration model
The key aim of the study was to undertake a qualitative and a quantitative analysis of daily food rations of young children based on the recommendations of the daily food ration model developed by Weker et al. (2013).
During the study, the team also tried to establish whether the type of milk (YCF or CM) consumed adequately meets young children’s energy demands and contributes to the incorporation of different food groups into a balanced and healthy diet.
Participants involved in the study were parents of children aged 13–24 months who had introduced CM to their children’s diets at one year of age or who had continued to administer modified milk beyond the first birthday.
For the first part of the study, over a six-month period between October 2019 and March 2020, a total of 714 parents completed a food frequency questionnaire. In the second phase of the study, parents engaged in a dietary recall, where they would document all meals and food consumed by the children over a period of three days, and record these in a diary.
Failing to meet nutritional guidelines
On average, the intake of consumed milk (YCF or CM and fermented milks) amounted to 55.4% of the guideline values. The results showed that flavoured dairy products were consumed more frequently than fermented milks without added sugar or flavouring. Diets including CM were significantly more abundant in protein than YCF diets. Liquid consumption was somewhat higher in the children given YCFs, which was largely due to the higher consumption of fruit juice and sweetened hot beverages.
Children who were given YCF consumed considerably larger amounts of sweetened beverages such as tea sweetened with sugar, hot chocolate, than children consuming CM. The YCF group of participants was also distinguished by their higher consumption of sweetened dairy products, mainly cream cheese desserts, fruit yogurt, and yogurt with cereal, along with a lower daily intake of plain fermented milks.
Following these findings, the researchers analysed and compared the daily food intake and quality of the diets given to children with the food ration model. The portion number and size of products from all food groups were not in alignment with nutritional guidelines, suggesting Polish parents and caregivers only have limited knowledge of nutritional guidelines for toddlers.
Impact on infants’ consumption habits
The milk type consumed was found to affect children’s eating habits and preference for sweet-tasting foods. Both the excessive or deficient consumption of selected products, relative to the model food ration, can raise the risk of lifestyle diseases in later life, the researchers determined. Quantitative and qualitative modifications of the consumed diets, therefore, may improve the assessed children’s nutritional status.
Overall, the study found the majority of respondents selected milk formulas based on price and availability, rather than their nutritional content. Pediatricians and dieticians can, therefore, use these present findings to support parents and inform them about the nutritional composition of YCFs and the benefits of lowering the amount of sugar in children’s diets.
Kostecka M, Jackowska I and Kostecka J
“A Comparison of the Effects of Young-Child Formulas and Cow’s Milk on Nutrient Intakes in Polish Children Aged 13–24 Months”