June 10, 2010 -- Parents and nutritionists are up in arms about a line of designer toddler drinks containing mostly milk and sugar that are aimed at children as young as 1 year old.
They say the health claims of Mead Johnson's Enfagrow Premium -- a "toddler formula" for children 12 to 36 months old -- are unproven. The products contain more than 25 additives to boost growth, brain development and immunity for the kids, but some say the dollops of added sugar for flavoring may contribute to the childhood obesity epidemic.
The company responded to the firestorm of criticism by dropping its new chocolate-flavored product, which critics have considered the worst offender with 19 grams of sugar.
The chocolate version was discontinued after four months because of "the whole emotional evocative nature of chocolate," said Mead Johnson spokesman Chris Perille. "It's more associated with candy and sweets and things potentially not as beneficial. Flavor was more in conflict with a nutritious product."
In a prepared statement Wednesday, Mead Johnson said there had been "some misunderstanding and mischaracterization regarding the intended consumer" of the product. "The resulting debate has distracted attention from the overall benefits of the brand."
But the company still intends to sell its vanilla-flavored Enfagrow, which has 16 to 17 grams of sugar overall, and three other unflavored versions with 10 to 11 grams, targeting so-called "picky eaters" who could use a nutritional supplement.
The company introduced an unflavored product, "Next Step," in 1994. Later it was rebranded as Enfagrow. Last July the company launched its vanilla flavor and chocolate was added in February, according to Perille.
Mead Johnson sells all these products as "science-based" and is marketing Enfagrow for children ages 1 to 3, who have been weaned off breast milk or infant formula and "still need nutritional support."
Its main ingredients are, in this order: whole milk, nonfat milk and sugar. Product labeling indicates the formula is fortified with vitamins "for healthy growth;" Omega-3 DHA and iron, "building blocks of the brain;" and prebiotics and antioxidants to "support the immune system."
It's not cheap: $18.99 for 29 ounces. The can makes 22 servings (one-quarter cup of powder mixed with six ounces water) -- about 86 cents for a glass of fortified milk, sugar and flavoring.
In its advertising, the company notes that "85 percent of brain growth" happens before age 3. The poster child for the advertising, a chunky toddler in red Converses, seems to echo that claim as he points to a nutritional list with a saw cutting a log over his head.
"It's got three health claims and if somebody looks at it, they'll think, 'Oh if I feed my child this product he will be smart, immune and grow. My kid is a picky eater, he'll love this,'" said Marion Nestle, professor of food studies and public health at New York University, who has launched a campaign to get the U.S. Food and Drug Administration (FDA) to stop Mead Johnson's health claims.
"This is a completely unnecessary product," she said. "It's expensive and the first two ingredients are milk and the third is sugar. They could just add a teaspoon of sugar to the milk and get the same thing."
Nutritionists Worry About Sugar Drink and Diabetes
"You don't have to train kids to like candy," said Nestle. "What I hear is that mothers find it hard to get kids to eat. Of course they aren't hungry because they have been fed so much and kids get used to eating sweet things."
Nestle also said the company's health claims are not backed up by definitive proof. Some research has lined DHA to visual and cognitive benefits in young infants, though long-term studies are lacking.
A recent report by the Institute of Medicine called for tighter standards on nutrition claims in light of the obesity epidemic and rising rates of type 2 diabetes among children.
Nestle, author of "What to Eat," said that when companies add "functioning ingredients" like lutein, lycopene and beta carotene to formulas, it increases cost.
These ingredients are "about marketing, not health," she writes on her blog, Food Politics.
Other companies have already been called to task for their health claims.
In December of 2009, the FDA forbid manufacturer Nestle from marketing Juicy Juice with DHA to help with "brain development." Under federal regulations, no products can make nutrient content claims if it is marketed for children under the age of 2.
"Her brain will triple in size by the time she's two," the company claimed in its marketing material.
General Mills Cheerios and Kellogg's Rice Krispies were also warned by the FDA about false health claims in their packaging.
"I am very surprised the FDA hasn't taken any action on this," said professor Nestle. "I don't see any difference between juice and this or an immunity claim on a cereal box."
ABCNews.com was unable to reach a spokesman at the FDA Enfagrow's health claims.
Perille said the company made no "inappropriate" health claims.
He defended the vanilla-flavored Enfagrow -- "a sippy cup product" -- which has the same calorie count and nutritional profile as the chocolate version, but is lower in sugar. Most of its 16 to 17 grams of sugar are from lactose, the natural sugar found in milk; 4 to 5 grams are added sugar.
"It's been on the market a year and is doing well with great testimonials," Perille said.
"It's positioned as a product as part of a balanced nutrition diet for toddlers, particularly beneficial when the toddler has an undiversified palate and narrow range of food and doesn't always get everything they might need," he said. "It's another choice or tool to potentially round out nutrition."
When infants are ready to be weaned, sometime after 12 months old, they are ready for nutritious table food, not formula, according to nutritionists, who encourage parents to expose toddlers to a wide-range of foods.
Dr. Keith Ayoob, director of the nutrition clinic at the Rose R. Kennedy Center at Albert Einstein College of Medicine, said products like Emfagrow are fine when used therapeutically for children with special medical needs and wasting conditions who have high caloric needs.
"At times we recommend them," he said, but warns against giving it to the "average picky eater.
"For a toddler, I would try everything else first," said Ayoob.
Parents Don't Like Added Sugar for Their Toddlers
Food like eggs, milk, fruits and vegetables also support the immune system, according to Ayoob. "This is all about variety, and helping kids learn to eat and accept a variety of food. No one food can do everything."
If a child is not getting enough nutrition, "what are they eating instead?" he asked. "When they are toddlers it's a perfect opportunity to start changing the diet. You make a big mistake by offering a kid a new food two or three times then stopping. It takes 10, 12 or 15 occasions."
Geniene Pernotto, the mother of a 3-year-old from Youngstown, Ohio, said she worries about added sugar.
"First and foremost, with any product I look for information regarding organic ingredients," said Pernotto, 44, and a former marketing director for beauty companies. "Second, I worry about sugar and fat content. Third, I think about long-term food habits I will be forming for my child."
Pernotto's daughter RoseMarie has grown up on fresh fruits and vegetables and is now beginning to taste new foods. She said she would never give her Enfagrow.
"I truly believe that their tastes should evolve around the true flavor of foods," she said. "I have only just begun adding butter or salt to some of her vegetables. I wouldn't want her to associate chocolate or vanilla with her milk or a daily drink. I feel it sets a standard for flavor cravings."
Pernotto has nothing against added DHAs and omega 3, but finds them in gummy vitamins, organic miles and yogurts, rather than a "toddler formula."
"I believe that children should receive their nutrients from real fruits and vegetables at this age," she said.. "There are plenty of fruits and vegetables to pick and choose among to get your child's intake of vitamins…Believe me, she has tasted cake, candy and ice cream but it isn't in the guise of being a real food or nutrition but a special treat for an event or dessert."
Natalya Murakhver, a 38-year-old New Yorker who expecting a daughter in two weeks, is distressed by Mead Johnson's marketing, especially its nutrition additives, which it has trademarked, "Triple Health Guard."
"It sounds like a pet food product," said Murakhver. "And where are all the studies? They are just selling it to use and you can't ask babies how they feel on it and they guinea pigs really."
Murakhver, who has a degree in food studies, worries about the lack of government oversight. As for her expectant baby, she is learning to read labels and look for more organic foods.
"Companies are selling us products not only that we don't need, but we should be avoiding at all costs," Murakhver said. "They are steering us toward processed food manufactured in labs, rather than whole food grown as close to nature as possible. It's appalling they try to sell these products to toddlers.
"I can't image starting 12-month-old in a sugared formula," she said. "It seems so anti-nature."