Drinking or not drinking formula, this is a problem

toddler formula china public health 配方奶As a general practitioner working in China, I often come into contact with worried parents. One of the questions that they most often ask me is what kind of milk powder should be used after the child is one year old. Which kind of milk powder is best for picky eaters? Is there any milk powder that is most beneficial to your child's physical and mental development? And my answer is: Why do you have to let the full-year-old children drink formula? Even further, why do you have to drink milk?

Although breast milk is always the best food for all 0-1-year-olds, mothers may not be able to achieve full breastfeeding for a variety of reasons, so infant formula has become the choice of tens of millions of parents around the world. As for infant formula for children over 1-year-old, it is another matter. Infant formula is an invention of the infant formula brand in recent years, with the aim of making more money from the pockets of parents who are highly loyal to the brand. They usually advertise baby milk powder "more nutritious than milk", "designed for picky babies" and contain nutrients that support the immune system. No mainstream pediatric or family medicine group, including WHO, supports the use of infant formula as the first choice for any healthy child. For all children over the age of one year, the best choice for calcium and fat and other nutrients is always breast milk. WHO now recommends that mothers breastfeed their babies until they are two years old, followed by milk, and breast milk and milk. At this time, it should not be the main food for children, and its proportion in its balanced diet should be smaller and smaller.

The biggest dissatisfaction of paediatricians and nutritionists with infant formula is that they usually contain more sugar than milk and often add extra flavours such as vanilla extract. In 2010, there was even a chocolate-flavoured infant formula market that quickly exited the market after encountering numerous bad reviews. For example, in Enfagrow's ready-to-drink formula, every 100 grams of this formula contains 7 grams of sugar, while 100 grams of whole milk contains only 5 grams of sugar. Maybe it doesn't look like much, but the extra sugar is still not to be accumulated.

In modern society, the biggest threat to health is diabetes and obesity, while refined sugars and carbohydrates contribute a lot to these two major illnesses. So, with so many healthy foods to choose from, why take the risk of making your child fall in love with sweets and like sweet formula? Infant formula also claims to contain many other special nutrients that are also good for health – but other sources of nutrition, such as vegetables and meat, are far better than milk powder. Wendy Swanson, a Seattle paediatrician and mother of two children, wrote in her blog: "I will never recommend this type of formula, and I have communicated with me. The dozens of paediatricians, pediatric digestives, nutritionists, and childhood obesity experts are also not recommended. See Chapters 1 and 2. These milk powders are harmful to children... Children under the age of 1 do not need it at all. The formula, unless in very few cases, their paediatrician recommends a special formula."

When I was in California, I found that only a few parents let children over the age of 1 drink formula. However, in Beijing, I found that a large proportion of parents did not let their children drink fresh milk but instead drink formula milk, and among these parents, there are many Chinese. In China's online stores, you can see more types of a formula than the United States. Why is this so? Are the little babies in China who are picky eaters not like to drink milk?

As a doctor who has lived in China for six years, my answer to this question is clear: most Chinese people simply do not trust domestic dairy brands. To be honest, it is difficult for me to blame them, because everyone clearly remembers the melamine scandal that occurred in domestically produced milk powder in 2008, killing 6 children and treating 300,000 children. Although the incident has passed for 5 years, I can't find a parent or a doctor here. Whether they are Chinese or foreigners, they can make a ticket saying that a certain domestic dairy product brand can be 100% assured and absolutely safe for children. I can't judge whether the distrust of the local dairy company is reasonable, but if the parents decide not to let their baby be a mouse, I certainly understand it. But I also need to emphasize that the brand of dairy products is not completely reliable, and well-known brands such as Abbott, Corcoran, and Nestle have recalled products due to quality problems.

Therefore, we have to face this unique Chinese phenomenon: parents do not trust the local milk, but they have to let their little baby get the calcium and fat-rich in milk. Do they have other options?

As a parent of a baby, I have discussed with my wife many times what our child Alex should eat after he is full. The following are the foods that I recommend to replace infant formula:

Native organic milk: In Beijing, a small number of organically certified milk (and yoghurt) has been favoured by many foreigners and natives. However, I am not sure that it is 100% safe.

Imported high-temperature sterilized milk: Now in China's supermarkets and online stores, you can buy a lot of high-temperature sterilized milk from Australia, Germany, France, which is also the first choice for many people. I personally don't like the taste of this type of milk, and because of its long-distance transportation, I am extremely dissatisfied with the environmental impact of them. But they are very cost-effective and have a long shelf life, so they are quite convenient.

Strengthening Soymilk: Compared to milk, I prefer the taste of soy milk, and homemade soy milk is very easy. Home-made pure soy milk is not as rich in calcium as milk, so your little baby at home needs to drink soy milk. Imported soy milk is now available in many parts of China, especially in high-end supermarkets. In addition, other soy products are also a good source of calcium, such as tofu. In addition, in the supermarket where I live, there are various imported rice milk and almond milk. Still, others like goat milk. Maybe they are all possible alternatives, but I don't have much research on this, and I would rather insist on the recommendation of most paediatricians.

Yoghurt and cheese: I think yoghurt is better than milk for people of all ages, not least because yoghurt is easier to digest for most Asians. Yoghurt also contains a lot of probiotics, and more and more studies have shown that probiotics are good for health. One of the benefits is to reduce the possibility of obesity. It is easy to make yogurt at home. Another great option is a piece of cheese, which is rich in calcium, protein, fat, cholesterol and iron.

Canned fish: Salmon and sardines are rich in calcium and Omega 3, which is critical for brain development. Canned fish is actually better because you can even chew the fish bones and eat it!

Green vegetables: broccoli, kale and dark green vegetables are rich in calcium. But bioavailability is the key: spinach is rich in calcium, but only a small fraction can be absorbed, so it is not a particularly good choice.

Calcium-fortified foods: Many boxed orange juices are supplemented with calcium, which is especially useful for children who do not like to drink milk and prefer to drink the juice. There are also many portions of cereal added with calcium.

Multivitamins: Children's vitamins provide the vitamins and minerals needed daily, but this is the last resort choice. For children who are extremely picky eaters or other children with certain diseases, it is best to ask a paediatrician before taking it. opinion.

The most important thing is the balance and variety of food – to ensure that the children's plates are colourful and what kind of food is available.

Perhaps a few years later, the research institute can finally complete a comparative study on infant formula and milk to assess the effects and effects of formula on the health and development of young children. If these studies show that formula is really beneficial, and that WHO, the American Academy of Pediatricians, and the American Academy of Family Physicians explicitly recommend infant formula, then I will consider changing the perception of it. But at least for now, in the absence of relevant research and recommendations from professional organizations, I simply don't recommend infant formula as a food for children over 1-year-old – even in China.

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