Let's Talk About Sugar! Carb Sources in Infant Formula
Do you check food labels for these three magic words-- “No added sugar”? It’s easy to understand why parents want to avoid sugar in their baby’s diet. This desire, however, sometimes leads to confusion about the importance of carbohydrates for healthy infant development.
In this article we’ll break down common misconceptions about sugar and discuss how to choose a formula with an optimal carbohydrate source.
“Sugar” is Necessary!
First and foremost: when people talk about “sugar” in infant formula, they may mean any number of compounds in a broad category of nutrients called saccharides. These compounds typically share the suffix “-ose” which makes them easily recognizable in an ingredients list! Saccharides that may be used in infant formula include fructose (fruit sugar), lactose (milk sugar), glucose (starch sugar), and sucrose (cane sugar). It’s important to know that when you read about sugar in formula, it may be referring to the formula’s carbohydrate source-- not necessarily “table sugar.”
So why does formula need a sugar component, also known as a carbohydrate source?
Infant formulas need sugar in some form in order to mimic the composition of breast milk.
More than one-third of calories in mature breast milk come from sugar in the form of lactose. As such, both the FDA and the European Commission require that infant formulas provide 40% of their calories from carbohydrates.
These calories are an important part of an infant’s diet as carbohydrates serve a vital function for energy metabolism. A baby’s body breaks down carbohydrates to provide energy for cells that support growth and development. Without carbohydrates, infants would not have the fuel they need to grow, learn and play.
Not All Carbs Are Created Equal
While all formulas are required to provide a certain amount of calories from carbs, there are few restrictions in the U.S. about the type of sugar that can be used to provide those calories. As such, there is significant debate about the best carb source, and in some cases, whether the type of sugar that is used in formula matters at all. Let’s take a look at common ingredients used to provide carbohydrates in formulas and discuss why some are better than others.
Lactose: The Ideal Sugar for Babies
The best sugar for babies is the type of sugar that’s naturally found in breast milk-- lactose! This milk sugar is the ideal carb source in a formula because babies are biologically and physiologically designed to digest it. Virtually all babies are born with the lactase enzyme which means they are born with the ability to digest lactose appropriately. Given the many benefits of breast milk as an infant’s optimal first food, the best formulas are those that mimic the composition of breast milk closely. This is why the European Commission requires that standard formulas use lactose as the primary carbohydrate source.
Corn Syrup Solids
While the European Commission bans the use of corn syrup solids in infant formulas, the United States does not. As such, many U.S. formulas use corn syrup solids as the primary carbohydrate source, which is not ideal as most corn syrup in the U.S. is made from genetically-modified corn. Corn syrup solids are made from corn syrup that has been dehydrated, thereby removing the water and concentrating the sugars. Corn syrup is widely available and cheap to produce which makes corn syrup solids an attractive choice for some conventional formula companies.
It’s important to note that corn syrup, which is glucose (starch sugar), is NOT the same as high-fructose corn syrup, which is a mixture of glucose plus fructose (fruit sugar).
While studies have shown that corn syrup solids are safe for infants and provide the calories needed for infants to grow along a healthy curve, there have been no longitudinal studies that look at the long-term effects of the use of corn syrup solids in baby formula. What is known, however, is that corn syrup (and glucose in general) is a fast-acting carbohydrate. This means that glucose is known to quickly increase blood sugar-- the exact reason that glucose tablets are recommended for those who have episodes of low blood sugar.
The Glycemic Index and Why It Matters
Fast-acting carbs like corn syrup solids have a high glycemic index value. This value is calculated by how quickly 50g of the carbohydrate increases blood sugar levels. From the Glycemic Index Foundation,
“The Glycemic Index (GI) is a relative ranking of carbohydrates in foods according to how they affect blood glucose levels. Carbohydrates with a low GI value are more slowly digested, absorbed, and metabolized and cause a lower and slower rise in blood glucose and, therefore usually, insulin levels.”
The more quickly a carbohydrate increases blood sugar levels, the more insulin the body produces to metabolize this sugar. As discussed previously, infants are biologically and physiologically equipped to metabolize lactose, which has a GI value of 46. Glucose on the other hand has a GI value of 100.
This means that glucose increases blood sugar levels at twice the rate of lactose.
The bottom line? Sugar in the form of lactose is metabolized much more slowly and can help maintain stable blood sugar and insulin levels. While babies may be able to safely handle the increased “glycemic load” that comes from corn syrup solids, we know that humans aren’t designed to consume such a fast-acting carbohydrate in infancy.
Given that we don’t yet know the long-term effects of such early exposure to glucose (and the associated blood sugar spikes and increased insulin production that goes along with it), we do not recommend corn syrup solids as a carbohydrate source in infant formula.
Sucrose
When you think about sugar, sucrose is likely what you’re thinking of. Commonly known as table sugar, sucrose is the white, grainy, or fluffy substance you use to top french toast or sprinkle on strawberries that aren’t quite sweet enough. While “table sugar” sounds awful as an ingredient in baby formula, it’s functionally a better choice than glucose (corn syrup solids).
Why? Because the GI value of sucrose is around 65-- this means the body metabolizes sucrose more similarly to how it metabolizes lactose than it does glucose.
Additionally, the European Commission does not prohibit the use of sucrose in infant formula. It does, however, provide limits for when it can be used (i.e. in specialty formulas that require reduced lactose for infants with sensitive stomachs) and how much sucrose can be used.
While lactose remains the optimal carb source for infants, sucrose is not the worst choice if a fully lactose-based formula is not an option.
A Note About Maltodextrin
Maltodextrin, which is typically derived from corn, contains broken down sugar molecules for easy digestion. This means that while it has a GI value that’s higher than glucose, it is nonetheless a good option for some babies with sensitive stomachs.
It is important to note that maltodextrin may be used in infant formula three ways:
- As a primary carbohydrate source
- As a supplemental carbohydrate source
- As a thickener or natural preservative
The use of maltodextrin as the largest source of calories from carbohydrates in infant formula is typically not recommended unless the infant is unable to tolerate carbs from more conventional sources. This is because of the increased glycemic load of maltodextrin and because much of the maltodextrin produced in the United States is made from genetically-modified crops.
The use of maltodextrin as a supplementary source of carbohydrates or as an additive, however, is considered safe. Given that the maltodextrin in European formulas is certified organic, GMO-free, and present in smaller quantities, European formulas with maltodextrin are highly preferable to those available in the U.S.
If your baby requires a hydrolyzed or broken down carb source, rest assured that choosing a European formula that offers both lactose and maltodextrin ingredients is a good choice.
Summary
All infants need sugar! Carbohydrates are an essential macronutrient for healthy infant development.
When possible, infants should get their necessary carbohydrate calories from lactose-- either via breast milk or from a lactose-based formula. If a lactose-based formula is not possible due to dietary restrictions or digestive upset, formulas made with sucrose and/or organic, non-GMO maltodextrin are preferable to those made with corn syrup solids.
If you’re looking for a high-quality formula with the right kind of sugar, we've got you covered! Our HiPP, Holle, and Lebenswert formulas all list baby’s best sugar, lactose, as the very first ingredient-- even our HiPP specialty formulas! If you have questions about ingredients or need help finding the best formula for your baby, please contact us. Our product specialists are here to help you make an informed decision about your infant’s nutrition.