September 8, 2022 — Parents who give their infants low-lactose formulas may put their children at increased risk of childhood obesity, new research shows.
Researchers have long noted that infants who drink formula instead of breast milk are already at increased risk of obesity. However, the new study found a difference in the type of formula and the consequences of childhood obesity.
Babies under the age of 1 who received reduced-lactose formula made partially from corn syrup solids had a 10% greater risk of becoming obese by age 2 than infants fed regular cow’s milk formula.
“This is even another reason not to use a low-lactose formula,” says Mark R. Corkins, MD, department head of pediatric gastroenterology, hepatology, and nutrition at the University of Tennessee Health Science Center in Memphis, TN. “Parents think that if babies are fussy or spit up, they have lactose intolerance, but when you look at the actual numbers, lactose intolerance in infants is rare.”
Corkins says many parents come to him with complaints about their children being fussy or spitting up, and believe their babies are lactose intolerant.
“The reason the low-lactose formulas are on the market in the first place is because parents want them and they think their child is lactose intolerant, but they aren’t,” says Corkins, adding that he usually tries to convince those parents to connect with lactation support services such as peer programs that can facilitate the breastfeeding process.
Researchers from the Southern California WIC program and the University of Southern California analyzed data from over 15,000 infants in Southern California. All were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutritional assistance program that provides low-income pregnant women or new mothers and their children up to age 5 with healthy foods and breastfeeding support.
Published in American Journal of Clinical Nutrition On August 23, records of infants born between September 2012 and March 2016 were divided into two groups: infants who had stopped breastfeeding by 3 months and started lactose-restricted formula, and infants who were all other types received from infant formula. Over 80% of the infants in both groups were Hispanic.
Infants fed the reduced-lactose formula with corn syrup solids had an 8% increased risk of obesity at age 3 than children fed regular cow’s milk formula and a 7% increased risk at age 4.
Tara Williams, a pediatrician and lactation medicine specialist with the Florida Chapter of the American Academy of Pediatrics, said the results should make pediatricians, parents and others stop and consider what infant formula contains.
She explained that babies who receive formula have a higher risk of obesity than babies who are breastfed overall. But research into the effects of different types of formulas is relatively new. She said there may be some reasons for the link between reduced lactose, solid-formula corn syrup and a higher risk of obesity.
“Adding corn syrup can really teach this kid to like sweet things,” Williams said, which in turn can lead to less healthy eating habits during childhood and into adulthood.
Or it may be that parents who tend to give their children low-lactose formulas are less tolerant of fussy babies and end up feeding their babies more, Williams surmised.
Additionally, recent research shows that corn syrup may act differently than other sugars in the gut microbiome and may be metabolized in the liver, leading to weight gain.
Although parents individually decide what type of infant formula to feed their infants, states play a major role in these decisions. In 2018, 45% of babies in the United States were eligible for WIC, which is funded by the federal government but administered by the states. State WIC programs solicit offers from formula manufacturers, and the selected products are then redeemed by parents at retailers.
“Now that we’re starting to see a signal that some formulas may have a potential additional risk of obesity for participants, states could say that when we’re helping mothers choose between formulas, we need to make that additional disclosure very clear.” Risk,” says Christopher Anderson, PhD, associate research scientist at the Public Health Foundation Enterprises WIC in California and lead author of the study.
Williams says more research is needed to do similar analyzes in other populations to draw cause-and-effect conclusions, while Corkins says he’d like to see more research on the amount of infant formula eaten and the links to types of infant formula.
“We know that once you sign up for baby registration with Target, you will receive formula samples in the mail. They’re marketed very aggressively, it’s a $55 billion industry,” Williams said. “And their goal is to sell their product, not to promote infant health.
“This research will certainly cause us to stop and think about what we’re feeding our infants in the United States and how we’re enabling companies to market their products.”