Featured in the Journal of Nutrition Education and Behavior, the findings suggest the need for additional expert guidance to discourage inappropriate and unnecessary milk for young children.
The research team from Saint Louis University in the US are also keen for strategies to be put in place to assist in the transition from breastmilk (or commercially prepared infant formula) to cow's milk.
“It's important to note that infant formulas are not inherently bad. We are glad this product exists for moms who cannot breastfeed,” says Maria Romo-Palafox, study team member, who is based at the Department of Nutrition and Dietetics at Saint Louis University.
“But the public should have all the information so they can make an informed decision about what is best for their baby."
To assess the extent of the issue, the team began enrolling a total of 1,645 caregivers of children, aged 6–36 months.
These caregivers were then surveyed as to the frequency in which they served non-recommended milk beverages (i.e., toddler milk and plant milk) in place of and in addition to recommended milk-based products (including commercially prepared infant formula and cow's milk) for infants (aged 6-11 months), infants in transition (12 months), and toddlers (aged 13-36 months).
Findings revealed more than one-third of infant caregivers reported serving at least one non-recommended milk type to their infant in the past month, including toddler milk and/or cow's milk, with most providing them daily.
63% of caregivers looking after infants aged 6–11 months served only breastmilk and/or commercial infant formula.
65% of caregivers looking after 12-month-old infants served commercial infant formula, and 47% provided cow's milk.
The majority of caregivers (64%) of children aged 13–36 months served cow's milk with 51% also providing other non-recommended milk types.
Not independent behaviours
“Associations between milk types suggested milk-based drink provision should be evaluated as a pattern and not as independent behaviours,” the researchers recommended.
“Milk type provision was significantly associated with a child's age (months), household income, and race.
“Including agreement with marketing claims reduced the significance of associations between milk type provision and some sociodemographic characteristics.”
The findings of the study reflect the growing popularity of alternative milk and potential issues with serving them to young children.
The research team cites a study stating that from 2006-2015 manufacturers increased their advertising expenditures 4-fold with marketing claims that imply considerable benefits for toddlers’ development and promote them as superior to cow's milk.
The Healthy Eating Research (HER) panel has advised that a plant milk (eg, rice, nuts, oat milk) should not replace cow's milk unless medically indicated to meet specific dietary preferences (eg, vegan diets).
Most plant milk are not considered an adequate substitute for cow's milk because of a lack of evidence that added nutrients in these products are comparable to those that occur naturally in cow's milk and often contain added sugars.
Opportunities for education
“The results indicate an opportunity for public health education campaigns, community outreach, and additional guidance from health care providers, especially regarding potential nutrient deficiencies, dehydration, and undernutrition when providing cow's milk or plant milk to infants and replacing breastmilk (or commercially prepared infant formula),” the team concludes.
“Furthermore, health care and public health guidance could provide caregivers with strategies for weaning their 12-month-old child from commercially prepared infant formula and transition to accepting the taste of plain cow's milk.
“Research could explore if caregivers believe that these commercial products are necessary or beneficial for young children's nutrition and/or that cow's milk is not recommended or appropriate.”
Source: Journal of Nutrition Education and Behavior
Published online: DOI: 10.1016/j.jneb.2021.05.006
“Caregiver's Provision of Non-Recommended Commercially Prepared Milk-Based Drinks to Infants and Toddlers.”
Authors: Maria Romo-Palafox, Jennifer Harris