Thumbs down for baby food pouches

Parents are unaware of the risks of using commercial baby food pouches as a main source of nutrition.

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Regular use of baby food pouches poses nutritional and developmental risks for babies and toddlers, especially if the food is sucked straight from the pouch and used as a main source of nutrition, experts have warned.

Parents of children under two years need to be aware of the importance of a varied, iron-rich diet once solids are part of the child’s diet.

“GPs are at the coalface and are often the people parents turn to for nutrition advice,” Professor Tim Green said.

“If parents were aware of potentially what harms they [food pouches] were doing, I think most would stop using them.”

Speaking at the Infant and Nutrition Council Australia & New Zealand meeting in Wellington this month, Professor Tim Green and Dr Netting, of the South Australian Health and Medical Research Institute, presented findings of the 2021 Australian Feed Infants and Toddlers Study (OzFITS), the first nationwide survey of the feeding practices of children under two years of age.

The research was also published this month in the journal Nutrients.

Researchers compared nutritional and textural properties of commercial infant and toddler foods available in Australia with established infant feeding guidelines and found many of the purees in squeeze pouches they looked at were inconsistent with guidelines – being sweet, smooth and low in iron.

Pouches comprised half of the 414 products they looked at, while one-third were discretionary foods. Dietary guidelines recommend “first foods” be rich in iron with no added sugars and that nutrient-poor discretionary foods are to be avoided.

Dr Netting said the commercial baby food market had changed dramatically in the past decade.

“Very little is available in jars now, the majority of baby foods are in pouches,” she said.

“Eighty per cent were fruit-based, even the savoury ones had some fruit in them. And most of them were really low in iron,” she told The Medical Republic.

“I think I think parents probably think that because they’re sitting next to the baby formula [on the supermarket shelf], which is really highly regulated, they might think that the baby foods are highly regulated in the same way, which they’re not – they come under a totally different section in the Food Standards Code.”

The survey also found that 90% of older infants and 25% of toddlers had inadequate iron intakes. Dr Netting said pouches were generally low in iron, but there were other health concerns with using them as a main source of nutrition.

“The aim of starting solid foods is actually to get the children used to eating the foods that the rest of the family eat,” said Dr Merryn Netting.

“They need to get used to eating, they need to transition to lumpy foods, they need to get used to eating some iron rich foods, including meat, and they need to get used to eating vegetables even though they taste bitter and they might prefer to eat fruit.”

She said the development of feeding skills and oral musculature could not be optimal if a child was sucking most of their food from a pouch. Using a spoon, picking up food and putting it in the mouth, chewing and moving food around the mouth was an integral part of early development and contributed to speech and fine motor development.

“I think there’s also an obesity risk because drinks are dealt with differently by the gastric emptying system compared to chewing and eating food,” she said.

“With the pouch you are not getting the satiety signals that you would get if you were chewing on a food.”

Dr Netting said the survey found about half of the people that were using pouches were allowing their kids to suck them directly from the spout. While most of the baby food pouches have written instructions recommending the food be served in with a spoon and not consumed directly from the pouch, some did not.

Professor Green said GPs  needed more up-to-date guidelines that took changes to commercial baby and toddler food into account if they were going to educate parents about infant and toddler nutrition.

“The problem is if we wait for the NHMRC to do it, it could be another two or three years and by then they’ll be outdated,” he said.

“Somebody else needs to step in and come up with some practical advice for GPs. [Currently], we’re being driven by data from 2012 which are the dietary guidelines.

“I didn’t see pouches until I moved to Australia in about 2015 which doesn’t mean that weren’t there, I just wasn’t looking for them. But now I hear from people around the world that these things are everywhere.

“I saw a mother [in a supermarket’ buy about 200 or these things [pouches]. At $1.25 they’re so cheap, and they were all the custards which are the worst of the lot.”