New paper about sugar in infant formula is fake news

Woman with long nose. Liar concept.

Much of what passes for contemporary breastfeeding “research” is meant to demonize formula, not to accurately assess the risks and or tote up the trivial benefits of breastfeeding.

Consider a new paper is published in a journal of dentistry(?!). A cross-country exploratory study to investigate the labelling, energy, carbohydrate and sugar content of formula milk products marketed for infants is a perfect example of fake news.

What’s the difference between real news and fake news?

The authors present NO evidence the sugar content of infant formula dramatically exceeds that of breastmilk.

Real news attempts to inform while fake news attempts to manipulate people by playing on their emotions and often resorts to mistruths, half truths and outright lies to do so.

The lead researcher, graduate student Gemma Bridge, claims on The Conversation Some infant formula milks contain more sugar than soda drinks:

Some formula milks have double the sugar per serving than a glass of soda. That was the key finding of our global investigation into the sugar content of infant formula and follow-on milks…

The “key finding” is a bald faced lie!

Bridge breathlessly writes:

Our findings revealed that over half of the products contained more than 5g of sugar per 100ml.

I should hope so! The average sugar content of breastmilk is 7 gm for 100 ml. Any product that contains substantially less sugar is inadequate and possibly deadly for babies.

In support of their claims, the authors offer a chart in their paper. I’ve taken the liberty of adding the typical sugar content of both breast milk and soda to the author’s chart.

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The red line represents the sugar content of soda and the purple bar represents the range of sugar content in breastmilk. Not only is there no evidence that the sugar content of formula dramatically exceeds the sugar content of breastmilk, there is no evidence that ANY formula has double the sugar content of soda.

So how did the authors come up with their “findings”?

1. The authors are not entirely honest about the sugar content of breastmilk.

According to a 2013 paper in the Pediatric Clinics of North America:

The macronutrient composition of human milk varies within mothers and across lactation but is remarkably conserved across populations despite variations in maternal nutritional status… [T]he mean macronutrient composition of mature, term milk is estimated to be approximately 0.9 to 1.2 g/dL for protein, 3.2 to 3.6 g/dL for fat, and 6.7 to 7.8 g/dL for lactose…

So the sugar content of breastmilk varies across mothers and time and ranges from 6.7-7.8 g/dL (100ml).

2. The authors are not honest about the sugar content of soda.

There are 39 gm of sugar in a can of Coca-Cola. That works out to 11 gm/dL. The authors, however, use the misleading comparison of an iteration of Fanta Orange that has been specifically redesigned to remove sugar.

As part of our commitment to reduce the calories in some of our most popular drinks Coca-Cola European Partners changed the recipe for Fanta Orange in 2006 – it now contains 33% less sugar and calories than the previous recipe.

3. The authors are not honest about standards for infant formula.

According to Global Standard for the Composition of Infant Formula:

Data on the composition of human milk of healthy, well-nourished women can provide some guidance for the composition of infant formulae, but gross composi- tional similarity is not an adequate determinant or indicator of the safety and nutritional adequacy of infant formulae.

Instead:

…[T]he adequacy of infant formula composition should be determined by a comparison of its effects on physiological (e.g. growth patterns), bio- chemical (e.g. plasma markers) and functional (e.g. immune responses) outcomes in infants fed formulae with those found in populations of healthy, exclusively breast-fed infants.

The authors have IGNORED the fact that international experts determine the optimal composition of formula based on outcomes, NOT slavish recapitulation of breastmilk averages.

4. The authors pretend products marketed to preschoolers are “infant” formulas.

They deliberately mislead by including milks that are NOT for infants.

Total carbohydrate (g/100 ml) ranged from 4.7 (ready-to-drink milk formula for 1–3 years, UK) to 13.5 (milk formula powder for 2–3 years, Cambodia)… Across product categories, the highest average total carbohydrate content, in this sample, was in powdered milk formula products aimed at infants aged 2–3 years (8.84 g/100 ml).

NO formulas for infants dramatically exceed the sugar content of breastmilk and NO formulas for infants have double the sugar content of soda.

The paper is just fake news designed to demonize formula … which probably explains why the authors couldn’t get it published anywhere besides a journal of dentistry.

  • Gene

    OT: this poor woman. She was encouraged to kill her son, but those who “supported” her face no consequences.

    https://www.reddit.com/r/news/comments/f7s5n4/i_brainwashed_myself_with_the_internet_nearly_45/?utm_source=share&utm_medium=ios_app&utm_name=iossmf

    • Mel

      That’s absolutely heartbreaking. The “no mentioning seeking medical advice” rules on free-birthing sites are chilling. If I had trusted my body when I felt really off at 26 weeks gestation instead of calling my OB – although I had no idea what to say besides “I keep having gas-like stomach pains and I’m scared” – my son and I would have died.

      Instead, medical science saved my life and the life of my 1 pound 12 oz son after we had a ‘forced eviction’ through a C-section. That term made me giggle in spite of myself because we’ve joked that my son’s wails after being resussed after birth were about how mad he was that he was illegally evicted while he had 14 weeks left on his lease! And he was planning on using the two-week optional extension! He hadn’t violated any terms of the lease! There were no illegal puppies! His parties were sedate and no police had been called! We’d be hearing from his lawyer!

      • JDM

        Bet he lost his damage deposit, too.

        • Mel

          That hole was created by someone on the outside! The walls were in pristine shape while he occupied it!

          • rational thinker

            At least he wasn’t being a squatter at 44+ weeks.

      • swbarnes2

        Though in a sense, you did trust your body. Not in the “my body will do absolutely everything right”, but in the sense of “if my body doesn’t feel right, it’s because something is wrong”.

        • The Bofa on the Sofa

          But see, that’s not allowed. You can only trust your body to do good things, you cannot trust your body when it tells you something is wrong.

  • Sue

    Thanks for taking the time to demolish this. The article on The Conversation did their cause more harm than good, and makes the motives clear.

    If they really want to campaign against a significant cause of obesity and dental decay, sugar-sweetened beverages and the soda industry would be a much better place to go. The fact that they are saying infant milk formula has more sugar than a low-sugar soda really means that one brand of soda has reduced its sugar content.

  • rational thinker

    OT I just found a series called babies on netflix it is a 6 episode documentary and judging by the description on the 2nd episode it looks like it may be more woo infested crap. Has anyone seen it?

    • Sarah

      A lactivist from The Guardian enthused that it portrayed breast milk as near magic, so I’m gonna say there’s some woo.

    • Laura Miles

      If it’s the one I’m thinking of, there’s a lovely episode where Gisele Bundchen states that women who don’t breastfeed for at least 2 years should go to jail.

      • Sarah

        She’s one of the best examples of why we need to stop paying attention to people’s views on things just because they’re pretty.

    • MaineJen

      Yeah, I got to the 2nd episode and had to stop…there is a breast milk scientist who gets starry eyed about how “a mother makes specific milk for her specific child” and such. And a doctor who states that better nutrition (read: breast milk) could change the collective IQ by 10 points.

      The babies are cute, though.

      • rational thinker

        “a mother makes specific milk for her specific child”Yeah I can’t stand that crap. These people say that then they also tell formula feeding parents to use donor milk instead of formula. I thought the milk was made specific for each baby, they never have an answer ready for that question.

        The IQ thing probably has more to do with how much calories a baby is getting early on for optimal brain growth.

      • Mel

        In fairness to the doctor re: nutrition, I’m pretty sure that was a bad cut that made the doctor sound way more woo-ish than was deserved. The levels of malnutrition described by that doctor are very unusual in developed nations and are treated medically when they do occur. The fact that getting proper levels of micronutrients to children leads to better growth and development is extensively proven.

        • MaineJen

          Yeah, juxtaposing that quote from the doctor with the gushing from the breast milk researcher about “tailored nutrition” was bad form, for sure.

  • rational thinker

    This should not have even been published in an opinion piece let alone a journal of dentistry. When a babys teeth start coming in most parents are warned about the dangers of bottle rot. This crap is just going to be used to say formula will cause bottle rot so there is another reason to exclusively breastfeed.

    On a personal note, I had to have a massive amount of dental work done when I was a toddler because I ended up having bottle rot. They really need to call it something else because I was exclusively breastfed!

    This “paper” will no doubt be circulating on all the AP sites and mommy blogs.

    • Laura Miles

      There is a myth that breastfeeding somehow prevents cavities. I wonder how many parents forgo tooth brushing due to this.

      • FormerPhysicist

        I didn’t forgo tooth brushing, but I didn’t forgo night/sleep feeding and my toddler ended up with a bad case of bottle rot – from exclusively breastfeeding.

        Oh, and I was working in a chem lab when I had her. For kicks, we did an analysis of my breast milk. The sugar was amazingly high! I wish I still had the results.

  • fiftyfifty1

    Yes, this is a terrible paper. Which is too bad because infant feeding research should be of interest to dentists, and should be published in dental journals. There is some research out there about the relative cariogenicity of various sugars, but it is far from conclusive and not well publicized. For example a few studies suggest that cariogenic bacteria greatly prefer sucrose to lactose, so the total sugar grams may matter less than what type of sugar it is. Plain milk (whether human or cow) may not be cariogenic at all, or hardly at all, if these studies turn out to be correct.

    • Sue

      Cariogenic oral bacteria (Strep mutans) apparently likes sucrose (= fructose + glucose) best. But most milk formulas, as others have pointed out, contain Lactose (from cows’ milk).

      I found this statement interesting and well-balanced:
      “A dynamic relation exists between sugars and oral health. Diet affects the integrity of the teeth; quantity, pH, and composition of the saliva; and plaque pH. Sugars and other fermentable carbohydrates, after being hydrolyzed by salivary amylase, provide substrate for the actions of oral bacteria, which in turn lower plaque and salivary pH. The resultant action is the beginning of tooth demineralization. Consumed sugars are naturally occurring or are added. Many factors in addition to sugars affect the caries process, including the form of food or fluid, the duration of exposure, nutrient composition, sequence of eating, salivary flow, presence of buffers, and oral hygiene. Studies have confirmed the direct relation between intake of dietary sugars and dental caries across the life span. Since the introduction of fluoride, the incidence of caries worldwide has decreased, despite increases in sugars consumption. Other dietary factors (eg, the presence of buffers in dairy products; the use of sugarless chewing gum, particularly gum containing xylitol; and the consumption of sugars as part of meals rather than between meals) may reduce the risk of caries. The primary public health measures for reducing caries risk, from a nutrition perspective, are the consumption of a balanced diet and adherence to dietary guidelines and the dietary reference intakes; from a dental perspective, the primary public health measures are the use of topical fluorides and consumption of fluoridated water.”

      (Source: American Journal of Clinical Nutrition 2003 – Sugars and dental caries)

      • fiftyfifty1

        Sugarless gum is a great trick to make parenting easier and I recommend it to all my patients. Once a child can safely chew gum, you just give them a piece in situations where they need dental hygiene but where brushing is impractical or impossible. Everything from Grandma gave you a caramel in the car to oops you’re about to miss the bus and haven’t brushed yet!

    • AlexisRT

      Right. For example, it might be worth studying whether nonstandard versions of formula that use other sweeteners are more likely to cause caries than standard infant formula sweetened with lactose. But this study is terrible.