Young Child Formula: The latest recommendations & Practical Implications

Young child formulas (YCFs) were first introduced in France by the Nestlé Group in 1991, followed by the Danone Group in 1993. Although they were possibly developed to extend the formula market beyond one year of age, their composition was specifically designed to prevent nutritional deficiencies in toddlers. Indeed, compared with cow’s milk, YCFs are enriched in iron, essential fatty acids (EFA), vitamin D, and sometimes docosahexaenoic acid (DHA).
In 2013, the European Food Safety Authority (EFSA) recommended the use of YCFs to improve iron status in toddlers, a position that was supported in 2014 by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). In 2017, the French Pediatric Society (SFP) confirmed that YCF consumption is the most convenient way to meet the dietary reference values for iron after one year of age. However, in 2018, ESPGHAN revised its position and no longer recommended the routine use of YCFs, a stance later endorsed by the World Health Organization (WHO) in 2023.
These recently revised positions are concerning, as it is difficult to meet iron requirements after one year of age without YCF consumption. For example, when consuming one 250 mL bottle of YCF per day, only 45 g of meat per day are needed to meet the recommended intake of absorbed iron. In contrast, without YCF, approximately 125 g of meat per day are required to achieve the same absorbed iron intake. Moreover, numerous studies have demonstrated that serum ferritin and, in some cases, hemoglobin levels are significantly higher in toddlers consuming YCF compared with those receiving unenriched cow’s milk.
The French Pediatric Society considers that YCFs should be recommended from one year of age to facilitate the achievement of iron requirements, and that their use should be maintained until the child is able to consume 100–150 g of meat per day, i.e., approximately between 3 and 6 years of age. It is important to emphasize that iron deficiency remains common in toddlers and may lead to irreversible neurocognitive impairment at this critical stage of development.
In addition, YCFs can contribute to meeting EFA and DHA requirements. However, vegetable oils, particularly rapeseed oil, for EFA intake, and fish, especially fatty fish such as mackerel, salmon, sardine, herring, or trout, for DHA intake, are often still necessary to fully cover daily needs. Finally, since the primary role of YCFs after one year of age is to ensure adequate iron intake, a potentially cost-effective alternative could be the use of cow’s milk fortified with iron only.