The foods we eat as young children help set the course for the rest of our lives. Regular doses of peanut butter and eggs before age 1 can help prevent food allergies. A baby who gnaws on spinach and soft bouquets of broccoli, with their slightly bitter flavors, is more likely to enjoy vegetables as an adult.
As for what happens when babies and toddlers grow up on ultra-processed foods — well, that’s what health experts are increasingly worried about.
The global market for baby and toddler food has exploded in recent years, more than doubling from $33.2 billion in 2010 to $67.9 billion in 2022. Offerings go well beyond the arrowroot biscuits and jars of puree that older generations may remember, with snacks and finger foods making up 20% of products in the category. Beckoning from grocery store shelves are coconut-mango melts and light-as-air sweet potato puffs; “growing-up” milks and oat bars; and squeezable pouches of fruit and vegetable mush.
Many of these are ultra-processed, meaning they’re made with industrial techniques and additives, and frequently contain high levels of sugar or sodium. One serving (or three tubes) of Yoplait’s Go-Gurt, Crayola Kids edition, contains 18 grams of added sugar, about 75% of the recommended daily limit for kids ages 2 and up. Gerber’s Mild Cheddar Lil’ Crunchies for babies 8 months and up contains ingredients like maltodextrin and mixed tocopherols — not exactly the kind of stuff grandma could whip up in her kitchen. Taken together with old standbys for the knee-high set, like Goldfish crackers and frozen chicken nuggets, it’s no wonder studies show that toddlers in places like Canada and the United Kingdom now get almost half their daily calories from ultra-processed foods.
These kinds of foods are designed to appeal both to tots still working on skills like chewing and hand-eye coordination, and to busy working parents in a culture that hardly leaves enough time for a bath and a story before bed — let alone preparing three meals a day plus snacks from scratch. But as everyone from former Food and Drug Administration chief Robert Califf to new Health and Human Services Secretary Robert F. Kennedy Jr. call for more scrutiny over the potential ties between ultra-processed foods and chronic disease, there’s been surprisingly little focus on how very young children are getting hooked on a way of eating that can have lifelong health consequences.
“It’s a very vulnerable stage in the palate development of a child, and people believe this group deserves more protection,” said Fran Fleming, director of marketing initiatives at the University of Connecticut’s Rudd Center for Food Policy and Health. “It’s tasting real food, and a variety of food, that expands our palate and sets us up for a healthy future. Having ultra-processed foods be the first thing that is a food for children does not set them up for success.”
The ‘ultra-processed food pipeline’
Ultra-processed food is a broad category, and the products encompassed by the term aren’t necessarily unhealthy. Infant formula, for example, is an ultra-processed food, but one that provides vital nutrition to babies who need it either as a substitute for, or supplement to, breast milk.
But more broadly, researchers have been raising alarms about the effects of industrial processes that break down whole foods and modify their ingredients before reconstituting them into alluring new forms, as well as the unknown long-term impacts of many additives and the fact that many ultra-processed foods are high in sugar, salt, and saturated fat in order to make them more palatable.
“Currently there is no agreed upon scientific definition of ultra-processed foods, and demonizing shelf ready foods could limit access to and cause avoidance of nutritious foods resulting in decreased diet quality, increased risk of food-borne illness and exacerbated health disparities,” Sarah Gallo, senior vice president of product policy at the Consumer Brands Association, said in a statement. “The industry is constantly innovating to meet consumer demand, as seen with the increase of the variety of products that are low in sugar, sodium and saturated fats. Families deserve choices that meet their health and lifestyle needs and parents shouldn’t be made to feel badly for making decisions on what is best for their children.”
For babies and toddlers, the added sugars found in many ultra-processed foods are a particular concern. We’re born loving sweets from the get-go: Sugar water dabbed on an infant’s tongue will help soothe the pain of a vaccine jab. But dietary guidelines recommend that children under age 2 avoid added sugar entirely, and that children 2 and up consume no more than 25 grams of added sugar, or about six teaspoons, per day.
Eating a lot of added sugars gives kids a higher sweetness preference, as Michael Moss explains in his 2013 book “Salt Sugar Fat: How the Food Giants Hooked Us,” and encourages them to keep seeking out more sweet foods — which also tend to contain fewer key macronutrients like fiber or protein. “It’s much more addictive for kids when it’s sweeter,” says Barry Popkin, a nutrition professor at the UNC Gillings School of Global Public Health.
Food companies know that sugar appeals to young children, and formulate their ingredients accordingly. One study found that sales of sugar via infant and toddler foods grew from 697 billion grams of sugar in 2010 to 1,009 billion grams in 2021.
Unlike sugar, salt isn’t naturally alluring to babies; they have to be taught to like it. Nutrition guidelines recommend avoiding added salt as much as possible for babies under 1, over concerns about their developing kidneys. Children between 1 and 3 are supposed to limit their intake to 1,000-1,500 milligrams per day — both because eating a lot of salt is linked with high blood pressure, and because nutrition experts worry they’ll develop a lifelong yen for salty foods, too.
Yet a 2015 study found that 84% of packaged toddler meals and 69% of savory snacks for infants and toddlers in the U.S. were high in sodium.
Another concern with ultra-processed foods is the processes that allow food companies to develop textures that appeal to young children, like airy puffs and crisp crackers. Breaking down grains, legumes, and other ingredients means that we’re able to digest the food more quickly, which makes us hungrier faster, Popkin explained. If you feed an infant or toddler oatmeal made from just oats and milk or water, “that would fill the kid up for the whole morning,” he said. “But if you feed them the instant stuff, it goes right through them.”
Some health effects from a diet heavy on ultra-processed foods may become apparent right away. Rapid weight gain in early childhood increases the risk of obesity and associated illnesses, like type 2 diabetes and cardiovascular disease, later on.
But even if children show no signs of problems to begin with, “you’re increasing the likelihood for those health outcomes later in life, because they’re developing preferences for these kinds of ultra-processed foods that are high in sugar and sodium and saturated fat,” said Lindsey Smith Taillie, a nutrition epidemiologist at the University of North Carolina, Chapel Hill. It wasn’t until she had a child of her own, she said, that she noticed the way babies and toddlers get shuffled into the “ultra-processed food pipeline.”
As one illustration of where that pipeline can lead, a lawsuit filed late last year against makers of food behemoths like Kraft Heinz, General Mills, Nestlé, and Coca-Cola is believed to be the first of its kind on the long-term health consequences of consuming ultra-processed foods from childhood. Plaintiff Bryce Martinez was diagnosed with type 2 diabetes and non-alcoholic fatty liver disease at age 16.
The lawsuit highlights the fact that tobacco behemoths Philip Morris and R.J. Reynolds bought food companies like General Foods, Kraft, Nabisco, and Kentucky Fried Chicken in the 1980s. The companies “used their cigarette playbook to fill our food environment with addictive substances that are aggressively marketed to children and minorities,” the lawsuit argues, via tactics like cartoon mascots and advertising that appealed to kids’ desire for play and autonomy.
Consumer Brands Association’s Sarah Gallo contested the premise of the lawsuit, saying in a statement to CBS News: “Attempting to classify foods as unhealthy simply because they are processed, or demonizing food by ignoring its full nutrient content, misleads consumers and exacerbates health disparities.”
It makes sense to think of hyper-palatable, ultra-processed foods in terms of addiction, according to Tera Fazzino, an assistant professor of psychology at the University of Kansas.
“Infants are highly sensitive to their nutritional environments, and they really are learning from every exposure, every eating occasion what food should taste like,” she said. “If they’re already consuming these hyper-palatable foods regularly, there’s a risk these foods are excessively activating their brain reward neural circuitry, and they may over time develop a really strong drive to consume hyper-palatable foods at the expense of their interest in consuming fresh whole foods like fruits and vegetables.”
The lure of ‘toddler milk’
Ask experts who study the issue to name one ultra-processed food they’re concerned about that’s aimed at young children, and toddler milk is usually first on their list. Also known as toddler drink or growing-up milk and aimed at kids between the ages of 1 and 3, the product is a triple whammy: “They’re ultra-processed, they contain added sugar, and there’s no nutritional reason why a toddler would need these types of products,” said Taillie.
But the products are shelved alongside baby formula, so it’s easy for harried parents who want to make sure their children are getting their nutritional needs met to assume that a toddler milk from Kendamil, Enfamil, or Similac is the natural next step. And because, unlike baby formula, toddler milk isn’t regulated by the Food and Drug Administration, its packaging often makes claims about providing immune support or boosting brain development. Those claims work: One recent study found that 60% of parents who were surveyed believed toddler milks offered nutrients that couldn’t otherwise be provided in their children’s diets.
Beyond toddler milk, trusted brand names that serve relatively healthy baby foods often serve to usher parents toward ultra-processed options in the baby food aisle. If you buy Gerber’s purees when the baby is younger, it’s a short leap to the brand’s cheddar crunchies or strawberry-banana grain bars, which contain 6 grams of added sugar. These snacks are often marketed as part of a young child’s healthy development: The back of the package for HappyBaby’s yogurt-strawberry snacks, for example, claims that it’s “curated for baby” and “helps develop fine motor skills,” accompanied by an image of a hand grasping the snack between the thumb and index finger.
Of course, babies can just as easily practice their pincer grasps with blueberries or toy blocks. But this kind of messaging works to convince parents that packaged snacks are necessities — a characterization nutrition experts dispute.
“The idea that we need to be feeding children snacks constantly is not necessarily driven by biology,” said Taillie. “It’s driven by the food industry essentially creating a problem which they solve, like, ‘Oh, your baby you know needs a snack, and also your baby needs this particular type of snack. It needs to be portable, because you have to have it with you all the time. It needs to dissolve in their mouth, because it’s a choking hazard otherwise.’”
The products’ packaging and marketing, Fleming added, “make the parents think this is even better than any real food.”
What’s the solution?
Researchers say that concerns over the health effects of ultra-processed foods can’t, and shouldn’t, be solved simply by educating parents about nutrition. Rather, they want better policies around the nutritional content, labeling, and marketing of those products.
“We’re all challenged for time,” said Fleming. “But the marketing messages that mislead parents are something that can be changed.”
Parents, she said, are anxious about their children’s nutrition and growth. The marketing of ultra-processed foods for babies and toddlers takes advantage of those anxieties, with packaging that touts added vitamins, whole grains, and no GMOs even as they contain ingredients like high-fructose corn syrup, synthetic dyes, or artificial flavors. “When you talk to parents, they’re not necessarily aware of what the actual ingredients are in the products,” Fleming said, “because they’re marketed as being healthy when they aren’t.”
Approaches like adding warning labels about added sugar on fruit drinks could help parents steer away from foods that seem healthy but aren’t, Taillie said. Those kinds of warning labels might also encourage companies to reformulate their products to include less sugar and salt.
Strengthening the rules around how products aimed at young children are labeled and marketed — for example, by eliminating characters on packaging and restricting health claims — would also go a long way, experts said.
It’s not possible, or even desirable, to expect parents to avoid ultra-processed foods entirely. “One of the problems is that our societal structure doesn’t support spending a lot of time on preparing home-cooked food,” Taillie said. “We don’t have a lot of paid family leave and universal health care.”
And experts agree that warning labels and marketing regulations won’t be enough if healthier foods are unaffordable. One of Taillie’s studies looked at the added budget for fruits and vegetables that the government introduced into the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during the Covid-19 pandemic. She and her co-authors found that when people had more money to put toward produce, they bought more — and more diverse varieties of produce, too, exposing kids to a wider variety of nutrients and expanding their palates.
“Purchasing power makes a difference,” said William Masters, a professor at the Friedman School of Nutrition at Tufts University who focuses on food economics. But as House Republicans look to make cuts in federal spending, SNAP and WIC may come on the chopping block. And while Kennedy and Secretary of Agriculture Brooke Rollins have both discussed banning candy and other ultra-processed foods from SNAP, nutrition experts are more focused on what can be done to make healthy alternatives accessible.
Anything the government can do to make shopping and food prep easier for parents of young children, Masters said, “will pay off in better schooling outcomes, lower health bills, and higher lifelong productivity for those children as they grow.”
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.
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