Research Article| Volume 53, ISSUE 8, P643-653, August 2021

Caregiver's Provision of Non-Recommended Commercially Prepared Milk-Based Drinks to Infants and Toddlers

  • Author Footnotes
    † Dr Romo-Palafox was affiliated with the Rudd Center for Food Policy & Obesity, University of Connecticut at the time this study was completed.
    Maria J. Romo-Palafox
    Address for correspondence: Maria J. Romo-Palafox, PhD, RD, Department of Nutrition and Dietetics, Doisy College of Health Sciences, Saint Louis University, 3437 Caroline St, 3076 St Louis, MO 63104
    † Dr Romo-Palafox was affiliated with the Rudd Center for Food Policy & Obesity, University of Connecticut at the time this study was completed.
    Department of Nutrition and Dietetics, Doisy College of Health Sciences, Saint Louis University, St Louis, MO
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  • Jennifer L. Harris
    Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, CT
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  • Author Footnotes
    † Dr Romo-Palafox was affiliated with the Rudd Center for Food Policy & Obesity, University of Connecticut at the time this study was completed.



      Assess milk type provision (commercially prepared infant and toddler formula, cow's milk, and plant milk) to infants and toddlers, accounting for sociodemographic characteristics and marketing claims.


      Caregivers (N = 1,645) of children (aged 6–36 months) recruited through online panels in 2017.


      Cross-sectional survey analysis (system of probit equations) estimated associations between sociodemographics and agreement with marketing claims (independent variables) with milk type provision in the past month (binary dependent variable).


      Most caregivers (63%) of infants (aged 6–11 months) provided only breastmilk and/or commercially prepared infant formula. Sixty-five percent of caregivers of 12-month-old infants provided commercially prepared infant formula, and 47% provided cow's milk. Most caregivers (64%) of toddlers (aged 13–36 months) provided cow's milk; some also provided other non-recommended milk types (51%).Associations between milk types suggested milk-based drink provision should be evaluated as a pattern and not as independent behaviors (all Ps < 0.048). Milk type provision was significantly associated with a child's age (months), household income, and race (all Ps < 0.049). Including agreement with marketing claims reduced the significance of associations between milk type provision and some sociodemographic characteristics.

      Conclusions and Implications

      These findings suggest the need for additional expert guidance to discourage inappropriate and unnecessary milk for young children, provide strategies to transition from breastmilk (or commercially prepared infant formula) to cow's milk, and conduct outreach to communities at risk for health disparities about the dangers of serving milk that is not recommended for their child's age. Research is needed to understand how diverse populations interpret product claims and how marketing may perpetuate health disparities.

      Key Words

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