Nutritional Content and Ingredients of Commercial Infant and Toddler Food Pouches Compared With Other Packages Available in the United States

Abstract

The ingredients and nutrients of infant and toddler foods (ITFs) sold in pouches were compared with products available in other packages, such as jars/packs and other containers. Company websites (n = 21) and in-store shelf inventory (n = 3) were used to create a database of commercial ITFs containing vegetables (n = 548) sold in the United States. Results indicated that ITFs containing vegetables were most commonly packaged in pouches (50%), followed by “other” packages (25%) and jars/packs (25%). Infant and toddler food pouches contained significantly more sugars per serving and per Reference Amount Customarily Consumed, as well as a greater percentage of calories from sugars, compared with both jars/packs and “other” packages. Pouches were also more likely to contain vegetable/fruit blends, whereas jars/packs were more likely to contain single-vegetable or multivegetable blends, and “other” packages were more likely to contain vegetable/other ingredient combinations (eg, grains and/or dairy). Pouches are popular, widely available, and convenient but may not represent the vegetable profiles and nutritional qualities that parents believe they are buying for their children.

Energy, Sugars, Iron, and Vitamin B12 Content of Commercial Infant Food Pouches and Other Commercial Infant Foods on the New Zealand Market

“…Koletzko et al [ 18 ] reported that pouches available in Germany contained predominantly sweet, puréed fruit preparations, which were typically the source of the majority (or even all) of their sugars content. Moding et al [ 8 ] reported that the high sugars content of pouches available in the USA is driven by the presence of fruits and vegetables that are naturally higher in sugars, as has been reported for commercial infant foods in general in the UK [ 37 ]. Moreover, a recent study of commercially available complementary foods in New Zealand reported that “relatively sweet” vegetables were used more frequently than “bitter” vegetables [ 6 ].…”

“…This is the first study to report the “free sugars” and “added sugars” content of commercial infant foods. The finding that pouches, on average, did not contain any free or added sugars was surprising, particularly given the widespread concern about high sugars content in pouches, and the emphasis being placed on the sugars content of commercial infant foods in the literature [ 8 , 28 , 43 ]. The WHO Regional Office for Europe made a call in 2019 to ban added sugars and “sweetening agents” (including fruit juices and fruit juice concentrates) in commercially available complementary foods [ 27 ].…”

“…Complementary foods are also now sold in diverse forms, and the majority are sold in innovative, single-use squeeze food pouches with plastic nozzles (i.e., “pouches”). It has been reported that more than half of infant and toddler foods in the United States of America (USA) are packaged in pouches [ 8 ]. The potential benefits of complementary feeding with pouches include shorter meal times and convenience [ 9 , 10 ] particularly when feeding takes place outside of the home, because the foods are ready-to-eat and can be fed to infants without the need for eating utensils such as spoons.…”

“…Research examining the nutritional quality of pouches compared to other forms of commercial infant foods has not been undertaken in New Zealand, and little has been published about the nutritional quality of pouches internationally. Although previous studies have reported the total sugars content [ 8 , 18 , 19 ] and the percentage of energy from total sugars [ 8 , 18 ] in pouch foods, none have reported their free or added sugars content. Given the popularity and wide availability of pouches on the commercial infant food market, it is important to examine their nutritional quality.…”

Is the low pH of infant and toddler foods a concern?

“…1,2 Furthermore, epithelial injury and dysfunction [3][4][5] has recently become a focus of allergic disease of the skin, airways, and esophagus. [11][12][13][14] The incidence of food allergy is increasing 6 in both the western and eastern world, and new allergic enteropathic conditions such as eosinophilic esophagitis and GORD. 7,8 Diet histories taken at an allergy clinic showed an observed increasing trend in the use of commercial infant/toddler foods by parents of infant and toddlers diagnosed with eosinophilic esophagitis (EoE) and gastro-esophageal reflux disease (GORD).…”