Is “Toddler Milk” Bad for Your Child’s Teeth?

Have you noticed drinks marketed toward older babies and toddlers in the infant formula aisle at your local store? Or perhaps that your preferred brand of infant formula offers “Stage 1”, “Stage 2”, and “Stage 3” drinks? If you’ve ever wondered what these drinks are or felt confused about the difference between them and regular infant formula, you aren’t alone.

In this article, we will help answer the following questions:

• What is toddler milk?
• Is toddler milk the same as infant formula?
• What’s in toddler milk?
• Is toddler milk bad for toddlers’ teeth?
• What kind of milk do experts recommend for children?

What Is Toddler Milk?

“Toddler milk” is essentially a substitute for breastmilk and/or cow’s milk that is intended for older infants and toddlers. For simplicity, we will use the name “toddler milk” in this article, but this type of beverage goes by a wide variety of names. Some of the labels you might encounter include

• Toddler milk,
• Toddler formula,
• Toddler drink,
• Toddler nutritional drink,
• Growing up formula,
• Growing up milk,
• Follow-up formula,
• Follow-on formula, or
• Transition formula.

Often, manufacturers sell toddler milks and infant formulas together as a line of products, with the infant formula labeled as “Stage 1” and the toddler milks labeled as “Stage 2” and “Stage 3” formulas. As noted by the World Health Organization, manufacturers may label products this way in hopes of “building loyalty to an entire product line.”

The manufacturer suggested ages for these drinks vary by brand, although a manufacturer suggested age range of either 6 to 12 months or 9 to 18 months is common for “Stage 2” toddler formulas and a manufacturer suggested age range of 12 to 36 months is common for “Stage 3” drinks.

As noted by the American Academy of Pediatrics, the increasingly popular toddler milks have been an important source of revenue for infant formula manufacturers that has helped to make up for a decline in sales of infant formula.

Is Toddler Milk the Same as Infant Formula?

No, toddler milk is not the same as infant formula.

Infant formulas sold in the United States are required to meet the requirements of the Infant Formula Act of 1980, a law that helps ensure that infant formulas both are safe and meet the nutritional requirements of infants under 12 months of age.

In contrast, toddler milks are not subject to this law, and the United States does not currently regulate the composition of toddler milks. Despite the fact that some packaging indicates that toddler milks are appropriate for infants under 12 months, toddler milks are not legally required to meet the nutritional needs of an infant. According to the World Health Organization, toddler milks may “contain more protein and lower levels of essential fatty acids, B vitamins, and multiple minerals than is recommended by WHO for adequate growth and development of infants.”

The American Academy of Pediatrics recommends that, for infants younger than 12 months, “the liquid portion of the diet should be provided by human milk or standard infant formula that has been reviewed by the FDA based on the Infant Formula Act,” not toddler milks.

The labels within a product line can be confusing. The World Health Organization has noted that many mothers do not realize that “Stage 2” and “follow-up” formulas are not the same as infant formula.  If you are intending to purchase infant formula governed by the Infant Formula Act, make sure to read the packaging carefully.

What’s in Toddler Milk?

Although the precise ingredients used in different toddler milks vary, the ingredient lists for many of these drinks follow a basic pattern. Often, they are a combination of the following:

• Milk powder (from cow’s milk or goat’s milk) or a non-dairy alternative (such as soy protein, whey protein, oat milk powder, pea protein, etc.),
• Sweeteners (such as cane sugar, corn syrup solids, lactose, etc.),
• Oils (such as canola oil, palm oil, soybean oil, etc.),
• Added vitamins and minerals, and
• Other food additives (such as maltodextrin, modified corn starch, etc.).

Is Toddler Formula Bad for Toddlers’ Teeth?

Toddler milks typically contain added sugars, and consuming drinks with added sugars is known to increase the risk of cavities in children. Consequently, the American Academy of Pediatric Dentistry recommends against giving toddler milk to children.

How much added sugar is in toddler milk? It depends on the product, but it may be more than you’d think. At the time of this writing, a few popular toddler milks contain 6 or more grams of added sugars per 4 oz serving. To put that in context, that’s roughly half the amount of sugar contained in the quintessential sugary drink – Coca Cola (a 4 oz serving of which contains 13 grams of sugar).

In fact, when it comes to toddler milks, added sugars are frequently either the first or second ingredient on the nutrition label. Be aware that these added sugars can take many forms. For example, some toddler milks list corn syrup solids as the first or second ingredient. Corn syrup solids are corn syrup with most of the water removed.

As another example, numerous high-end and organic brands of toddler milk list lactose as the first or second ingredient. This ingredient can be confusing because many people think of lactose as a naturally occurring sugar found in dairy products, not an added sugar. However, lactose can be an added sugar; manufacturers sometimes artificially add lactose to foods and beverages to increase their sweetness. Look for lactose listed as a separate ingredient in the ingredient list – naturally occurring lactose will not be listed separately – and always make sure to check nutrition labels for the amount of added sugars (which will typically be listed either immediately before or after the amount of total sugars).

What Kind of Milk Do Experts Recommend for Children?

In short, for most toddlers ages 12 months and over, plain, unflavored cow’s milk or breastmilk are the best choices. (For more information about cow’s milk, see our article on how cow’s milk affects children’s teeth.)

In 2019, the American Academy of Pediatrics, the American Academy of Pediatric Dentistry, the Academy of Nutrition and Dietetics and the American Heart Association issued a consensus statement in which the only milk they recommend for toddlers is plain, pasteurized cow’s milk. With respect to toddler milks, the expert panel recommends that

• Children under 12 months avoid toddler milk and instead meet their nutritional needs primarily through human milk and/or infant formula, and
• Children 1 to 5 years old avoid toddler milk and instead meet their nutritional needs primarily through a healthy diet.

More recently, in 2023, the American Academy of Pediatrics issued a report on toddler milks explaining that, for most toddlers, a varied diet of healthy foods (and supplements if needed) is preferable to toddler milk. The report notes that toddler milks are often marketed in such a way as to make parents mistakenly believe that toddler milks provide micronutrients that their children could not get from a regular healthy diet. Toddler milk packaging often contains claims related to child brain development and immune function, leading parents to believe that their children will be smarter or healthier if they give them toddler milk. Unfortunately, many parents do not realize that these claims do not require FDA approval and are not required to be based on scientific evidence. The report concludes that

• Toddler milks are not acceptable or beneficial for infants younger than 12 months, and these infants should instead drink human milk and/or standard infant formula, and
• For children 12 months and older, toddler milks “do not provide a nutritional advantage in most children over a well-balanced diet that includes human milk (preferred) and/or cow milk.”

If you have concerns about your child’s nutrient intake, try discussing with your child’s pediatrician rather than turning to toddler milk.

Children’s Dentist in Dallas-Fort Worth

Hurst Pediatric Dentistry’s Dr. Lin is a board-certified pediatric dentist located in Hurst, Texas. If you have concerns about your child’s teeth, schedule an appointment today by calling us at 817-510-6400.

Hurst Pediatric Dentistry proudly serves children from Hurst, Bedford, Euless, Colleyville, North Richland Hills, Southlake, Arlington, Irving and the surrounding area.

This article is intended to provide general information about oral health topics. It should not be used
to diagnose or treat any disease or as a substitute for the advice of a healthcare professional who is
fully aware of and familiar with the specifics of your case. Always seek the advice of your dentist or
other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.