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If you want to make a paediatric dietitian’s eyes roll, just say ‘toddler milk’.

“It can displace food because it’s so easy for toddlers to fill up with a drink and because it’s sweet it helps drive a preference for sweet foods. About half of all three year olds now have formula or other sweet drinks,” says Evelyn Voiders, senior lecturer at Monash University’s Department of Nutrition, Dietetics and Food, and lead author of the DAA and Dental Health Services Australia Joint Position Statement on Oral Health and Nutrition.

 Toddler milk - or ‘growing up milk’-  is also a smart way for formula manufacturers to promote their brand without breaking their industry’s voluntary agreement (the Marketing of Infant Formulas in Australia agreement) which prohibits print and TV advertising of formula for babies under 12 months, she adds.

 “Toddler formula, which was introduced after the agreement, is a way around this -it increases their customer base and sends a message that formula provides good nutrition for young children,” she says.

Ads for toddler milk may act as de facto ads for infant formula according to 2010 research from the University of Wollongong which suggests that because the packaging of these two products is so similar, some consumers may assume that messages promoting toddler formula apply to infant formula as well.  

Australia’s breastfeeding rates need a boost (only around 15 per cent of babies are breastfed until the age of six months). But encouraging women to keep breastfeeding instead of switching to formula needs more than support at an individual level, says Evelyn Volder: the evidence points to a broader public health approach that normalises breastfeeding - and reduces the reach of the formula industry.   

It’s not just babies who benefit from breastfeeding either, she says. Current breastfeeding rates prevent around 20,000 breast cancers globally each year, a number that could be doubled if breastfeeding could be increased, according to the World Health Organisation. 

“Yet the message that babies thrive on formula is now probably louder than the message that breastfeeding helps protect women from breast cancer - not to mention the advantages for babies and the environment,” she points out.

 “Dietitians are in a good place to support women to breastfeed if they work with pregnant women and new mothers or if they’re in public health and able to influence policy. Dietitians in hospitals can also support mothers of sick babies to breastfeed -I’ve worked in hospitals myself and there were times when doctors recommended mothers give their babies formula instead of breastmilk because it’s easier to measure,” says Evelyn, the  course convener for the Master of Dietetics at Monash.  

Still, breastfeeding can be a tricky topic for dietitians to navigate at a time when stressing the value of breastmilk can be seen as ‘guilting’ women who have difficulty breastfeeding or who choose not to.

“The guilt argument is pervasive but maybe we should change the viewpoint. Is it bad to say we should wear seat belts, for instance? Would parents who drove kids around 40 years ago feel guilty about not using them?

“Guilt about not succeeding at breastfeeding shouldn’t fall on individual women but on the policies and health systems that fail them,” she says.   

Along with toddler milk, there’s now a fortified milk drink to ‘support normal growth and development’ for four to 12-year-olds with zinc and iron ‘for cognitive and immune function’ - which means that once a three year old has outgrown toddler milk she can graduate to drinking another product.   

Fussy eaters and anxious parents can create fertile ground for products like these to thrive, Evelyn says.  

“Family food can provide all the nutrients children need but I think parents have lost confidence with feeding children. One reason may be that we don’t grow up in large extended families where we learn about these things through observation. There’s also so much conflicting information online and with social media there’s a lot of pressure to be a perfect parent,” she says.

Toddler milks aren’t the only products that can distance children from eating real food - there are food pouches too. They might be an easy way to feed a baby or toddler but they don’t familiarise them with the smell and texture of real food - or teach them how to chew, she says.  

 “There’s a place for the occasional food pouch but if you’ve only eaten spinach and peas from a pouch you might not want to eat green food off a plate.

“Dietitians take on a variety of roles in their working lives - and being an advocate for breastfeeding followed by family meals is one of the most important.”