Powdered drink mixes that are widely promoted as “toddler milks” for older babies and children up to age three are unregulated, unnecessary and “nutritionally incomplete,” the American Academy of Pediatrics (AAP) warned Friday.

The drinks, which are touted to parents on TikTok, in television ads and on other sites, often contain added sugar and salt. The manufacturers make unproven claims that the drinks boost kids’ brains or immune systems, said Dr George Fuchs, a member of the AAP’s nutrition committee, which released the new report.

Formula industry officials said the drinks could be useful for filling “nutrition gaps” in kids’ diets. But Fuchs said older babies and toddlers should be given a balanced diet of solid foods, as well as drink breast milk, fortified whole cow’s milk and water after age 1.

Here is what else you should know about so-called toddler milks:

The powdered milk mixes are sold in cans and made to be mixed with water. They are often produced by the makers of top brands of infant formulas, packaged with similar labels and sold in the same store aisles.

The products are typically marketed for babies older than six to 12 months and preschoolers up to age three as nutritious drinks for the next stage of development.

Yes. Infant formula is regulated by the United States (US) Food and Drug Administration and must meet certain nutrition requirements as a replacement for human milk for babies up to 12 months. The facilities where infant formula are made are regularly inspected.

There are no federal regulations governing milk drink mixes for older babies and toddlers. Also, toddler drinks are different than medical formulas prescribed for specific conditions, such as heart disease or problems digesting certain foods.

Fuchs and other experts point to the lack of common standards for toddler milks, which means the ingredients vary widely among brands.

Most contain added sugar and are targeted toward children who are at the age when they could develop a lasting taste for sweets, possibly leading to obesity and other diseases.

“It could be called the gateway sugary drink,” said Frances Fleming-Milici, director of marketing initiatives and a research professor with the Rudd Center for Food Policy & Health at the University of Connecticut.

The toddler milks are also more expensive than cow’s milk, experts said.

“They’re not only not as good as cow’s milk and a balanced diet, they’re worse,” said Fuchs, a paediatrics professor at the University of Kentucky.

Toddler milks are widely advertised, and sales have soared in recent years, from $39 million in 2006 to $92 million in 2015, according to a 2020 study.

Fleming-Milici said companies promote these products in a way that may lead parents to believe the drinks are nutritionally necessary.

“They look a lot like infant formula,” she said. “Parents really trust the formula they use for their children.”

In one study, 60 per cent of caregivers of toddlers said they believed the drinks provided nutrition that the children wouldn’t get from other foods.

Toddler milks are labelled explicitly for children older than 12 months and “can contribute to nutritional intake and potentially fill nutrition gaps,” according to the Infant Nutrition Council of America. The trade group’s members are top manufacturers of formula and toddler drinks, including Abbott Nutrition, Perrigo Nutrition and Reckitt.

Families and health care providers should be better educated on toddler milks, which “have no specific role in routine care of healthy children,” the AAP said.

The group also wants requirements to ensure the products are not linked to regulated infant formula or sold next to formula. A health group petitioned the FDA in 2020 to regulate toddler milks, but the agency is still reviewing the request.

Families who want to ensure older babies and toddlers are getting the nutrition they need should rely on fortified grains and milks, protein and fruits and vegetables, Fuchs said.