Many US Baby Formulas Contain More Than 60 Percent Added Sugar: Study

Only five of 73 infant formulas studied met healthy sugar standards.
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Nearly all infant formulas sold in the United States contain mostly added sugars instead of the healthier lactose found in breast milk, according to new research.

The study found that up to 90 percent of the carbohydrates in many formula products come from added sugars—substances explicitly not recommended for children younger than age 2 by health authorities.

Up to 90 Percent Added Sugar

The study, recently published in the Journal of Food Composition and Analysis, investigated the sugar content in 73 U.S. infant formulas available in 2022. Researchers categorized these formulas into three types: standard, gentle, and lactose-free.

The primary difference between standard, gentle, and lactose-free baby formulas lies in the amount of milk sugar or lactose they contain. Formulas with “gentle” on their label typically have reduced lactose, while “lactose-free” formulas completely remove it.

Gentle formulas may also have partially hydrolyzed proteins for easier digestion, whereas standard formulas contain intact proteins, making them potentially harder for some babies to digest.

From a “What’s closest to breastmilk?” perspective, lactose would be preferred for infants, Aubrey Phelps, a registered functional dietitian specializing in perinatal and pediatric nutrition and certified lactation counselor, told The Epoch Times.

“It should also be the carbohydrate most easily digested by infants, as that’s what their bodies are designed to handle,” she said.

However, the study found that standard baby formulas had added sugars that surpassed lactose levels, with almost 60 percent of sugars coming from added sugar. Of the gentle formulas, on average, 85 percent of their carbohydrates were from added sugars, and it was 90 percent in lactose-free formulas.

Only five of the 73 formulas were found to contain a majority—between 70 percent and 90 percent—of naturally occurring lactose, the carbohydrate naturally present in human breast milk and therefore considered optimal for infants.

Lactose-free formulas also had  four to eight times more sucrose, commonly known as table sugar, and maltose, usually referred to as malt sugar.

The key difference between lactose, sucrose, and maltose in infant digestion is the specific enzyme needed to break them down. Infants primarily digest lactose using the enzyme lactase, while sucrose requires sucrase, and maltose needs maltase to be properly digested. Newborns have a high level of lactase to efficiently digest breast milk, which is primarily composed of lactose, unlike other sugars such as sucrose and maltose.
“Added sugars are contraindicated for infants and children under the age of 2—they’re not supposed to have them,” lead author Audrey Rips-Goodwin said in a statement.

Why Added Sugar Is Bad for Infants

To best promote healthy development and most directly align with the contents of human milk, standard infant formulas should contain lactose as the only sugar, according to the authors. They expressed concern that reliance on added sugars in infant formula may lead to a preference for sweet tastes, which can contribute to overfeeding and increased chances of obesity later in life.

Exposure to sweets in the first few years may predispose children to craving sugary foods.

“In addition, added dietary sugars impact how the body regulates blood sugar,” Dr. Erica Rabinovich, a pediatric gastroenterology fellow, and Erica Corwin, a pediatric gastroenterology dietitian, both from Cohen Children’s Medical Center in New Hyde Park, New York, told The Epoch Times in an emailed statement.

Rabinovich and Corwin pointed out that problems with glycemic control are known to be associated with many comorbidities later in life, such as rapid weight gain, obesity, Type 2 diabetes, asthma, hypertension, and cardiovascular disease.

“Finally,” they said, “There is mounting evidence that dietary sugar may have an adverse effect on the composition of the microbes that inhabit the intestine (gut microbiome).”
This potentially leads to an imbalance favoring less beneficial bacteria and potentially impacting their health development. This is because excessive sugar can promote the growth of certain microbes while hindering the growth of others considered more beneficial.

Researchers noted a lack of regulatory oversight, as the U.S. Food and Drug Administration does not mandate nutritional standards or labeling requirements for the types of sugars in infant formula.
Despite limitations, including a relatively small sample of 73 formulas and potential biases in nutrient assessment methods, the researchers defend their findings as accurately representing the U.S. formula market. The study employed advanced Bayesian statistical techniques to strengthen their analysis of sugar content across formula products available to consumers in 2022.

The Challenges of Breastfeeding

Senior study author Tera Fazzino noted certain factors that hinder breastfeeding, such as the lack of parental leave and dedicated public breastfeeding spaces.

“We have a massive systemic issue where parental leave is nonexistent at the federal level and not required,” she said. “With no structural support in place, exclusively breastfeeding becomes very difficult, despite being widely promoted as the best option for infant health.”

The lack of breastfeeding resources and the prominence of unhealthy formula options leave parents with few good choices, raising serious concerns about the implications for infant development.

“However, our findings suggest that infant formula itself may pose a significant risk to healthy infant development,” Fazzino said.

To support breastfeeding, Phelps said, mothers require good familial and community support and the ability and time to pump if they’re heading back to work.

“Some women don’t respond well to a pump—then what?” Phelps asked. Many don’t get paid leave at all, so asking them to pump around the clock to maintain a supply “while taking care of a new baby, potentially older children, and getting up to commute to work each day is insane.”
George Citroner
Author
George Citroner reports on health and medicine, covering topics that include cancer, infectious diseases, and neurodegenerative conditions. He was awarded the Media Orthopaedic Reporting Excellence (MORE) award in 2020 for a story on osteoporosis risk in men.