Toddler Milk Research Articles

A young child formula supplemented with a synbiotic mixture of scGOS/lcFOS and Bifidobacterium breve M-16V improves the gut microbiota and iron status in healthy toddlers.

Early-life gut microbiota development depends on a highly synchronized microbial colonization process in which diet is a key regulator. Microbiota transition toward a more adult-like state in toddlerhood goes hand in hand with the transition from a milk-based diet to a family diet. Microbiota development during the first year of life has been extensively researched; however, studies during toddlerhood remain sparse. Young children's requirement for micronutrients, such as dietary iron, is higher than adults. However, their intake is usually sub-optimal based on regular dietary consumption. The Child Health and Residence Microbes (CHaRM) study, conducted as an adjunct to the GUMLi (Growing Up Milk "Lite") trial, was a double-blind randomized controlled trial to investigate the effects on body composition of toddler milk compared to unfortified standard cow's milk in healthy children between 1 and 2 years of age in Brisbane (Australia). In this trial, fortified milk with reduced protein content and added synbiotics [Bifidobacterium breve M-16V, short-chain galactooligosaccharides, and long-chain fructooligosaccharides (ratio 9:1)] and micronutrients were compared to standard unfortified cow's milk. In the present study, the effects of the intervention on the gut microbiota and its relationship with iron status in toddlers were investigated in a subset of 29 children (18 in the Active group and 11 in the Control group) who completed the CHaRM study. The toddler microbiota consisted mainly of members of the phyla Firmicutes, Bacteroidota, and Actinobacteriota. The abundance of the B. breve species was quantified and was found to be lower in the Control group than in the Active group. Analysis of blood iron markers showed an improved iron status in the Active group. We observed a positive correlation between Bifidobacterium abundance and blood iron status. PICRUSt, a predictive functionality algorithm based on 16S ribosomal gene sequencing, was used to correlate potential microbial functions with iron status measurements. This analysis showed that the abundance of predicted genes encoding for enterobactin, a class of siderophores specific to Enterobacteriaceae, is inversely correlated with the relative abundance of members of the genus Bifidobacterium. These findings suggest that healthy children who consume a young child formula fortified with synbiotics as part of a healthy diet have improved iron availability and absorption in the gut and an increased abundance of Bifidobacterium in their gut microbiome.

The Effectiveness of Milk Supplementation on Weight and Height/Length in Stunted Toddles

Stunting or a short child was described as a toddler whose height was lower than the standard height for toddlers his age. Until now, the prevalence of stunted toddlers in Indonesia is still high. The prevalence of stunted toddlers at the Plaosan Community Health Center in the last 3 years showed an increase. The cause of stunting, apart from infection, is also related to nutritional deficiencies (micronutrients and macronutrients). The adverse effected of stunting in the short term are disruption of brain development, intelligenced, impaired physical growth, and metabolic disorders in the body. Supplementary feeded is one of the solutions in handling stunting. This study aims to determined the effectiveness of milk feeded on the weight and height/length of stunted toddlers. The typed of research used was pre-experimental with a one group pretest posttest design. The sample used a total population of 56 toddlers. The dependent variable in this studied was the weight and height/length of stunted toddlers, the independent variabled is the provision of milk for toddlers. Data collection used weight and height measurement sheets and milk feeded observation sheets. Comparative data analysis was conducted using the paired samples t test statistical test. The results of the study show that the average body weight before giving milk was 8737.5 mm and after giving milk 8923.2 mm. Body height/length before milk feeding was 804.6 mm and after milk feeding was 806.63 mm. Different test using paired samples t test obtaining the conclusion that there is a significant difference in the increase in body weight of toddlers with a significance level of 0.000 (p <0.05) and there is a significant difference in increasing the height of toddlers with a significance level of 0.000 (p <0.05). Conclution: Milk is effective to increase the weight and height/length of toddlers, so it is advisable for mothers of toddlers to get their children used to a glass of milk everyday.

Toddler Milk Perceptions and Responses to Front-of-Package Claims and Product Warnings: A Qualitative Study of Caregivers of Toddlers.

Toddler milk products are ultraprocessed milk-based beverages promoted for children aged 9 through 36 months. They often contain added sugars, which may contribute to unhealthy dietary habits. Aggressive promotion of toddler milk, particularly to the Latinx population, has likely led to rapid rises in sales. The study aims were to qualitatively explore caregivers' experiences with, beliefs about, and attitudes toward toddler milk; to explore caregivers' reactions to health claims and product warnings on toddler milk packaging; and explore whether perceptions of toddler milk differ by Latinx ethnicity. Focus group discussions and in-depth interviews were conducted. Fifteen online in-depth interviews and 4 online focus groups with US caregivers of children aged 9 through 36 months who reported serving toddler milk to their children were conducted in2021. Audio files were transcribed, coded, and analyzed in NVivo. A thematic analysis with a hybrid analytical approach of deductive and inductive coding was conducted. Caregivers struggled to discern toddler milk from infant formula and perceived formula as a larger term that included toddler milk. Participants described offering toddler milk to their children for its convenience, nutritional profile, and perceived benefits tied to health claims present on the labels. Participants reported that health claims on toddler milk packaging attracted their attention; most participants did not express skepticism about the veracity of the claims. An "added sugar" warning increased understanding of the presence of added sugar in a toddler milk product. Latinx and non-Latinx participants largely reported similar perceptions, beliefs, and patterns of provision of toddler milk. Health claims may lead caregivers to perceive toddler milk as a nutritionally adequate product. Research is needed to investigate caregiver-directed interventions for informing caregivers about the distinction between infant formula and toddler milk.

Toddler milk: a scoping review of research on consumption, perceptions, and marketing practices.

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.

Nutrition Content of Young Child Formulas.

European Society for Pediatric Gastroenterology, Hepatology and Nutrition and the American Academy of Pediatrics state that young child formula (YCF) is not considered necessary for healthy children. Despite these recommendations, YCF accounts for approximately 13% of overall formula sales. Five percent of infants less than 1 year of age in the United States are being fed YCF. The purpose of this study is to identify the most Internet recommended and encountered YCF in the United States and determine if they meet nutritional recommendations for use in children 0-3 years. We used the search terms "toddler formula," "toddler milk," "follow-up formula," or "young child formula" in Google and DuckDuckGo to identify the most like encountered or recommended YCF on the Internet. We compared their labeled nutrients to Food and Drug Administration (FDA) Infant Formula Act (IFA) and international nutrient recommendations, given the absence of US nutrient requirements for YCF recommendations, for children 12-36 months. Twenty-nine YCF were reviewed. On average, YCF did not meet nutrient recommendations for infants and toddlers with 2.17 and 4.6 ingredients not meeting formula recommendations for younger and older infants, respectively, and between 3 and 4 ingredients for 12-36 months. Nutrition content of YCF are variable and do not meet FDA IFA requirements or YCF international recommendations. Increased US regulation is needed for YCF. It is important for health care providers to ask patients what they are feeding their infants and toddlers so they can educate parents on potential nutritional safety concerns.

A cross-sectional study of infant feeding practices in Vietnamese-born mothers living in Australia

BackgroundInfant feeding practices are a key modifiable risk factor for childhood overweight and obesity; and important for lifelong health and wellbeing. Despite the growing Australian immigrant population, it is unclear how infant feeding practices may differ between ethnicities living in Australia. Few studies have examined the infant feeding practices of Vietnamese mothers who migrate and give birth to infants in Australia – termed Vietnamese-born mothers. The aim of this study was to examine differences in infant feeding practices (breastfeeding, formula feeding and complementary feeding (other fluids and solids)) in Vietnamese-born mothers compared with Australian-born mothers living in Australia.MethodThis study analysed the Australian National Infant Feeding Survey dataset (2010–11), a large national cross-sectional survey measuring feeding practices of infants aged 0–24 months old. Infant feeding practices of Vietnamese-born mothers (n = 261) and a random sub-sample of Australian-born mothers (n = 261) were compared. Associations between ethnicity and infant feeding practices were examined through logistic and linear regression adjusting for maternal age, socioeconomic status, body mass index (BMI) at start of pregnancy, infant age at survey completion and parity. Compliance with the Australian national infant feeding guidelines was also assessed.ResultsCompliance with infant feeding guidelines was low, with differences in infant feeding practices between groups. At the time of survey completion, when infants were on average 7.2 months old, compared with infants of Australian-born mothers, infants to Vietnamese-born mothers were significantly younger when first exposed to fruit juice (b = -2.41, 95%CI: -4.54– -0.28); less likely to be exposed to solids (AOR: 0.15, 95%CI: 0.05–0.44) and more likely to be exposed to formula milks (AOR: 2.21, 95%CI: 1.10–4.43); toddler milks (AOR: 16.72, 95%CI: 3.11–90.09) and fruit juice (AOR: 2.37, 95%CI: 1.06–5.32) (p < 0.05).ConclusionLow adherence with breastfeeding (low breastfeeding and high infant formula use) and other fluids (toddler milks and fruit juice) recommendations outlined by the Australian infant feeding guidelines were observed in this group of Vietnamese-born mothers. To optimise feeding and growth in Vietnamese-Australian children, culturally appropriate infant feeding support targeting breastfeeding durations, reducing reliance on infant formula, and reducing inappropriate introduction to other fluids should be the focus of infant feeding promotion within these mothers.

Effects of Sugary Drink Countermarketing Videos on Caregivers' Attitudes and Intentions to Serve Fruit Drinks and Toddler Milks to Young Children.

Objectives. To test the effects of countermarketing videos addressing common misperceptions about ingredients and claims on children's sugary drinks. Methods. We conducted an online randomized controlled experiment in January 2021 with US caregivers (n = 600) of young children (aged 8‒37 months) to assess the effects of watching countermarketing versus control videos on intentions to serve sugary and healthy drinks (6-point scales) and attitudes (10-point scales) about fruit drinks and toddler milks. Results. The countermarketing videos significantly reduced positive attitudes about fruit drinks (mean difference = 0.92) and toddler milks (mean difference = 2.10), reduced intentions to serve both (mean difference = 0.50 and 0.92, respectively), and increased intentions to serve plain milk (mean difference = 0.52) versus control videos (all Ps < .001). Intentions differed by individual characteristics, but the videos remained effective after we controlled for these characteristics. Moreover, the videos were more effective for toddler milks versus fruit drinks, and effects on fruit drink intentions were greater for Black versus White caregivers and caregivers of children aged 24 months or younger. Conclusions. A countermarketing campaign aimed at diverse caregivers of young children designed to correct misleading children's drink marketing presents a promising public health approach for reducing sugary drink consumption in the first 1000 days. (Am J Public Health. 2022;112(S8):S807-S816. https://doi.org/10.2105/AJPH.2022.307024).

Regulated nutrition claims increase perceived healthiness of an ultra-processed, discretionary toddler snack food and ultra-processed toddler milks: A discrete choice experiment

There has been a prolonged increase in the sale and consumption of ultra-processed, discretionary foods and ultra-processed milks for toddlers, which display numerous on-pack claims that influence health perceptions. This study investigated the relative impact of different regulated and unregulated claims on parent perceptions of the healthiness of a toddler snack food and milk in Australia. Participants aged 18+ years completed an online survey, including discrete choice experiments for an ultra-processed, discretionary toddler snack food and an ultra-processed toddler milk, which displayed combinations of claims across nutrition, health, and other domains. Participants were asked to choose the ‘most and least healthy’ products between three alternatives over seven choice sets. Data were analysed using an ordinal logistic regression model. Likelihood-ratio tests revealed the most important contribution was variation in regulated nutrition-content claims. For the toddler snack, participants were nearly 14 times more likely to perceive a product with the regulated nutrition-content claim “no added sugar, no added salt” as most healthy (OR 13.71, p < 0.001), compared to when no regulated nutrition-content claim was present. For the toddler milk, participants were more than two and a half times more likely to choose a product that contained the regulated nutrition-content claim “2 serves = up to 50% of RDI recommended dietary intake of 14 vitamins and minerals” as most healthy (OR 2.65, p < 0.001) compared to when no regulated nutrition-content claim was present. In Australia, regulated nutrition-content claims can be displayed on packaged foods regardless of healthiness. These results indicate that such claims increase perceptions of healthiness of ultra-processed, discretionary toddler snack foods and ultra-processed toddler milks. Further controls are required to regulate the use of nutrition-content and health claims to facilitate informed consumer choice.

Marketing of sugar-sweetened children's drinks and parents' misperceptions about benefits for young children.

Despite expert recommendations, US parents often serve sugar‐sweetened children's drinks, including sweetened fruit‐flavoured drinks and toddler milks, to young children. This qualitative research explored parents' understanding of common marketing tactics used to promote these drinks and whether they mislead parents to believe the drinks are healthy and/or necessary for children. We conducted nine focus groups in Washington, DC and Hartford, CT with parents of children (9–36 months) of diverse race/ethnicity and socioeconomic status (N = 50). Semistructured discussions elicited parents' responses to four concepts designed to correct common misperceptions about toddler milks and sweetened fruit‐flavoured drinks (fruit drinks and flavoured waters) by providing information about drink ingredients and potentially misleading marketing tactics. Participants expressed widespread misperceptions about sweetened fruit‐flavoured drinks and toddler milks, including perceived healthfulness and benefits for children and confusion between sweetened and unsweetened drink categories (sweetened fruit‐flavoured drinks vs. juice, toddler milk vs. infant formula). They confirmed that common marketing strategies contributed to misperceptions, including front‐of‐package claims and marketing messages that imply benefits for children and/or hide problematic ingredients; cross‐branding and product extensions from trusted brands; side‐by‐side shelf placement at retailers; lower price than healthier products; and targeted marketing to children and parents. Some parents expressed anger about deceptive marketing and supported increased regulation and consumer education campaigns. Findings support the need for policies to address potentially misleading marketing of sweetened fruit‐flavoured drinks and toddler milks and revealed opportunities to reduce parents' provision of these drinks through countermarketing campaigns communicated via trusted sources.

Acute Metabolic Response in Adults to Toddler Milk Formulas with Alternating Higher and Lower Protein and Fat Contents, a Randomized Cross-Over Trial.

Protein intake in early life influences metabolism, weight gain, and later obesity risk. As such, a better understanding of the effects of protein intake on the postprandial metabolism and its dynamics over time may elucidate underlying mechanisms. In a randomized crossover study, we observed fasted adults who consumed two isocaloric toddler milk formulas concentrated as meals of 480 kcal with 67 g of carbohydrates 30 g (HP) or 7 g (LP) protein, and 10 g or 20 g fat, respectively. Anthropometry and body plethysmography were assessed, and blood samples collected at baseline and over five hours. Time-specific concentrations, areas under concentration curves (AUC), and maximum values of metabolites were compared by paired t-tests to examine the effects of protein content of toddler milks on postprandial plasma concentrations of insulin, glucose, branched-chain amino acids (BCAA), urea and triglycerides. Twenty-seven men and women aged 26.7 ± 5.0 years (BMI: 22.2 ± 2.5 kg/m2) (mean ± SD) participated. BCAA AUC, and Cmax values were significantly higher with HP than LP (144,765 ± 21,221 vs. 97,089 ± 14,650 µmol·min/L, p < 0.001; 656 ± 120 vs. 407 ± 66 µmol/L, p < 0.001), as were insulin AUC and Cmax values (6674 ± 3013 vs. 5600 ± 2423 µmol·min/L, p = 0.005; 71 ± 37 vs. 55 ± 28 µmol/L, p = 0.001). Higher glucose, urea, and triglyceride concentrations occurred in the late postprandial phase (≥180 min) with HP. In conclusion, we noted that higher milk protein intake induces increased postprandial BCAA concentrations for at least 5 h and led to higher initial insulin secretion. Gluconeogenesis due to an influx of amino acids and their degradation after HP meal might explain the late effects of protein intake on glucose and insulin.

The Impact of Toddler Milk Claims on Beliefs and Misperceptions: A Randomized Experiment with Parents of Young Children

BackgroundToddler milk (ie, a nutrient-fortified milk-based drink marketed for children aged 12 to 36 months) has been marketed increasingly in the United States with structure/function claims on product packaging that are potentially misleading. ObjectiveThis study examined how structure/function claims impact parents’ beliefs and perceptions about a toddler milk product. DesignThis was a 3-arm between-subjects randomized experiment. ParticipantsA diverse sample of 2,190 US parents of children aged 1 to 5 years were chosen to take an online survey. InterventionParticipants were randomly assigned to view a toddler milk package with either an unrelated claim (“new and improved,” ie, control condition), a “brain development” claim (ie, “brain” claim), or an “immunity-related” claim (ie, “immunity” claim). Main outcome measuresOutcomes included perceptions, intentions, and beliefs about the toddler milk product. Statistical analyses performedLinear regression for continuous outcomes and logistic regression for dichotomous outcomes. ResultsParents who were exposed to the “brain” claim or the “immunity” claim were more likely to incorrectly believe that the toddler milk was as healthy or healthier than cow’s milk compared with those who saw the control claim (89% for brain claim, 87% for immunity claim, and 79% for control; P < .001 for both comparisons). Parents exposed to either the brain or immunity claim had higher intentions to give the toddler milk to their child, higher perceived product healthfulness, and stronger beliefs that pediatricians would recommend the product compared with parents exposed to the control (all, P < .001). ConclusionsThese findings suggest that structure/function claims on toddler milk packaging may mislead parents and increase the appeal of toddler milk. Our findings support calls for public health policies to regulate marketing on toddler milk packaging.

Toddler milk perceptions and purchases: the role of Latino ethnicity.

Toddler milk (i.e. a nutrient-fortified milk-based drink marketed for children 12-36 months old) is increasingly being marketed in the USA despite not being recommended for young children. There is evidence of targeted toddler milk marketing to Latinos in the USA. This study aimed to explore toddler milk perceptions and behaviours among Latino and non-Latino parents. An online survey assessed toddler milk perceptions, behaviours and interpretations of nutrition-related claims. Multivariable logistic and linear regression explored socio-demographic correlates of parent reported past purchases and perceived healthfulness. Online. National convenience sample of 1078 US parents of children aged 2-12 years (48 % Latino). About half of parents (51 %) had previously purchased toddler milk and few (11 %) perceived toddler milk as unhealthy. Latino parents were more likely to have purchased toddler milk than non-Latino parents (P < 0·001), but there were no differences in perceived product healthfulness (P = 0·47). Compared to parents born in the USA, parents living in the USA 10 years or less were more likely to have purchased toddler milk (P < 0·001) and perceive toddler milk as healthier (P = 0·002). Open-ended interpretations of claims were primarily positive, suggesting 'health halo' effects. Common misperceptions about toddler milk healthfulness suggest stronger labelling regulations are needed. Greater reported purchases by Latino parents and recent immigrants warrant further investigation.

Parental Perceptions and Exposure to Advertising of Toddler Milk: A Pilot Study with Latino Parents.

Marketing of toddler milk (i.e., typically sugar-sweetened nutrient-fortified milk-based drinks marketed for children 12–36 months) is an emerging public health problem in the US. The American Academy of Pediatrics recommends against the consumption of toddler milk because it often contains added sugar and can displace nutrient-dense foods. Studies have not examined toddler milk perceptions among Latinos, an important gap given Latino children in the US are at high risk of having poor diet quality, and toddler milk is extensively advertised on Spanish-language TV. This study used an online survey of a convenience sample of 58 Latino parents to examine parents’ experiences with toddler milk, understand their perceptions of the healthfulness and the nutrition-related claims on toddler milk, and describe their exposure to toddler milk advertising. Nearly half (44%) of parents in the sample reported purchasing toddler milk. When asked to provide open-ended interpretations of claims on toddler milk, almost all parents gave positive answers, suggesting potential “health halo” effects of the claims. More than half (56%) of parents reported seeing toddler milk advertisements, most commonly on Spanish-language TV. The misperceptions about toddler milk identified should be explored in further research using larger, more representative samples.

CSR (Corporate Social Responsibility) Of PT. Sarihusada And Community Empowerment-Based Integrated Service Post (Posyandu) to Establish A Child Friendly Village In Yogyakarta Indonesia

Badran in Yogyakarta which is located in the river bank of Winongo river used to be known as a dirty and slum area. Some children were malnourished due to unhealthy food and environment. This situation led people to being determined to establish a village that is more conducive for children. In cooperation with PT. Sarihusada, the community empowered Posyandu(Integrated Service Posts) to help them improve their health especially toddlers. This research is a qualitative research since the research findings based on the research problems, purposes, approaches as well as analysis cannot be achieved by using statistical or quantitative approaches.This reasearch uses primary and secondary data sources. The sampling techniques used in this research are purposive sampling and snowball sampling. The data collecting technique was conducted through interactive methods including in-depth interviews, participant observation, and Focus Group Discussion (FGD).The data validation in this research was conducted by using the source triangulation and data analysis which consists of data reduction, data display and conclusions. The results of the research demonstrate that the Integrated Service Posts (Posyandu) that exist in Badran village are the results of collaboration between the people of the village and the CSR of PT. Sarihusada through Rumah Srikandi (The House of Srikandi). The operation of the Posyandu is managed fully by the cadres of the Posyandu itself who come from the Badran village. The nutritionists of PT. Sarihusada mentored the mothers who have toddlers the ways to process healthy and nutritious food. Furthermore, PT. Sarihusada also provides milk for toddlers everytime the service held at Posyandu. After the CSR program of PT. Sarihusada has been completed, people contributed 500 rupiahs a month for the operational costs of the Posyandu sustenance.

Nutrition and packaging characteristics of toddler foods and milks in Australia.

To analyse nutritional and packaging characteristics of toddler-specific foods and milks in the Australian retail food environment to identify how such products fit within the Australian Dietary Guidelines (ADG) and the NOVA classification. Cross-sectional retail audit of toddler foods and milks. On-pack product attributes were recorded. Products were categorised as (1) food or milk; (2) snack food or meal and (3) snacks sub-categorised depending on main ingredients. Products were classified as a discretionary or core food as per the ADG and level of processing according to NOVA classification. Supermarkets and pharmacies in Australia. A total of 154 foods and thirty-two milks were identified. Eighty percentage of foods were snacks, and 60 % of foods were classified as core foods, while 85 % were ultraprocessed (UP). Per 100 g, discretionary foods provided significantly more energy, protein, total and saturated fat, carbohydrate, total sugar and Na (P < 0·001) than core foods. Total sugars were significantly higher (P < 0·001) and Na significantly lower (P < 0·001) in minimally processed foods than in UP foods. All toddler milks (n 32) were found to have higher energy, carbohydrate and total sugar levels than full-fat cow's milk per 100 ml. Claims and messages were present on 99 % of foods and all milks. The majority of toddler foods available in Australia are UP snack foods and do not align with the ADG. Toddler milks, despite being UP, do align with the ADG. A strengthened regulatory approach may address this issue.

Determination and assessment of human dietary intake of per and polyfluoroalkyl substances in retail dairy milk and infant formula from South Africa

Dairy milk and infant formula play important roles in the diet of adolescents, adults and infants, respectively, in the South African population. However, data on the occurrence of legacy and emerging contaminants such as PFAS in these important food sources is lacking. In this study, the concentration of fifteen PFAS were measured in 23 pooled retail dairy milk and 7 pooled infant formulas by means of an ultrahigh performance liquid chromatography tandem mass spectrometric method. The concentrations of Σ15PFAS ranged from 0.08–15.51 ng mL−1 and 0.42–5.74 ng mL−1 in dairy milk and infant formulas, respectively. PFBA, PFPeA, PFuDA, PFTrDA and PFDoA were the most prevalent PFAS in both matrices with detection frequency > 96%. Highest PFAS concentrations of 2.02 ng ml−1 and 2.76 ng ml−1 were recorded for PFDoA in infant formulas and dairy milk, respectively. The concentrations of legacy PFAS –PFOA and PFOS, shows resemblance with global data, however, elevated concentrations of long chain C9 – C14 PFAS were observed in this study. Though, higher concentrations of PFAS were measured in full cream dairy milk, no statistical significant difference (P = 0.546) was observed for the various classes of dairy milk. The EDI of Σ15PFAS through infant formulas were 184.92, 329.47 and 166 ngkg−1BWday−1 for partially breastfed, exclusively formula fed and older infants, respectively. Similarly, the EDI of PFAS through dairy milk for toddlers, adolescents, female and male adults for the rural population were 14.17, 1.09, 2.59 and 3.16 ngkg−1BWday−1 respectively while they were 20.41, 3.84, 4.13 and 4.26 ngkg−1BWday−1 respectively in the urban population. Although, the EDI of PFAS through the consumption of infant formulas and dairy milk are lower than the daily tolerable limits, the relative importance of long-term exposure and the cumulative effects of multiple exposure pathways cannot be overemphasized.

Non-core food product advertising on free-to-air television in Hong Kong.

To study the extent and nature of free-to-air television advertisements for non-core products (e.g., fast food or soda) directed at children in Hong Kong. Television programs from two major Hong Kong free-to-air television channels airing between 06.00 and 24.00 hours from October 2018 to January 2019 were recorded. Eight nonconsecutive days (four weekdays and four weekend days) were selected for analysis. Pearson's χ2 tests were conducted to compare the pattern of food advertisements by program categories, days of the week, television viewing periods and persuasive marketing techniques. Free-to-air television programs. Not applicable. Of the 10 348 commercials identified, 18·4 % were for foods, and 35·2 % of these were for non-core items. Baby and toddler milk formula (19·5 %) were the most advertised food products, while the most frequently advertised non-core food was fast foods (12·3 %). There was a higher non-core to core product ratio during prime time than the children's time slot (7 v. 1·7). Non-sports celebrity endorsement (27·1 %) was the most frequently used persuasive marketing technique overall, while that for non-core products was sensory characteristics (38·2 %). Most food product placements recorded were non-core products, mentions of local and fast food restaurants and recipe additions. Non-core products were highly advertised in Hong Kong, while core product advertising was infrequent. Regulations on junk food advertising in Hong Kong should focus on prime time, as well as on food product placement, to reduce children's exposure to persuasive junk food marketing.

Nuclear Magnetic Resonance-Based Metabolomic Comparison of Breast Milk and Organic and Traditional Formula Milk Brands for Infants and Toddlers.

In recent years, new formula milk (FM) products based on milk from farms that strictly adhere to the "organic farming" practices became available. However, little is known about the differences in nutritional profile of these organic formulae with respect to traditional ones. We comprehensively evaluated the metabolite profiles of FM with nuclear magnetic resonance (NMR)-based metabolomic analysis. Five commercial brands of organic and nonorganic formula liquid milk for infants (0-12 months) and toddlers (1-3 years) were analyzed, together with human milk (HM) samples. Proton NMR (1H NMR) spectroscopy mapped molecular characteristics of FM linked to different production techniques, and identified differences between FM and HM samples. We performed a metabolic fingerprint analysis using multivariate and univariate statistical techniques. A clear distinction is found among different commercial brands of the FM samples. In addition, several differences in metabolomic profiles of FM have been found in comparison with HM for the first time. Notably, it was possible to identify, both in the formulations for toddlers and for infants, metabolites that vary in concentration between the formulae produced with milk obtained according to organic farming techniques, and those produced using nonorganic milk. In particular, organic and nonorganic formulations are differentiated by the levels of glucose, methionine, o-phosphocholine, butyrate, hippurate, creatine, and dimethyl sulfone. Importantly, the HM appeared to differ from both organic and nonorganic brands in a context of metabolites. These findings inform efforts to design FM in ways that closely mimic HM, and guide research to differentiate organic and traditional FM.

Nutritional Adequacy of Commercial Complementary Cereals in Germany.

Commercial cereals are among the first complementary foods fed to infants in Germany and elsewhere. The purpose of this national survey is to describe the nutritional adequacy of commercial complementary cereals. A comprehensive, cross-sectional survey of cereal manufacturer websites (n = 15) was conducted from March to April 2019. Food labels were analyzed for iron, zinc, iodine, sodium, and sugar contents in commercial complementary cereals, and ingredient lists were evaluated for whole grains and added sugars. Preparation instructions were evaluated for the type of liquid recommended for reconstitution. Among 164 commercial complementary cereals, few contain iron (n = 43, 26%), zinc (n = 23, 14%) or iodine (n = 43, 26%). Sodium contents fall within EU thresholds. Most cereals were single grain, containing only wheat (n = 54), with half of the products (n = 86, 52%) containing whole grains. The average carbohydrate content of dry cereals is 69 g/100 g ± 9 g of which 14 ± 15 g is sugar. Preparation instructions for breakfast porridges and cereals recommend formula or toddler milk, while few recommend human milk (n = 13, 18%). Few commercial complementary cereals contain appreciable amounts (at least 15% of daily reference values) of zinc, iron, or iodine. A quarter of cereal carbohydrates are sugar and one-third of the products contain added sugars. Future directives should stipulate minimum micronutrient levels, strictly regulate sugar contents, and include human milk among preparation instructions.

Effects of United States WIC infant formula contracts on brand sales of infant formula and toddler milks.

The United States (US) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides free infant formula to low-income families with infants. State WIC agencies periodically solicit bids from manufacturers for the exclusive contract to provide infant formula in exchange for considerable rebates. Using Nielsen 2006-2015 retail scanner data, we estimated a difference-in-difference model to examine how winning a WIC infant formula contract affects sales of the new (winning) and former brands, including effects on sales of products not eligible for WIC (spillover). One year following a contract change, volume sales of WIC infant formula increased 322% (p < 0.01) for the new brand and decreased 77% (p < 0.01) for the former brand. Spillover effects included a 43% increase in sales of toddler milks for the new brand 2 years after the contract change. State WIC contracts allow manufacturers to market formula directly to consumers and may reduce breastfeeding policy effectiveness.