Why is there sugar in baby formula? Can you find baby formula without sugar? What about corn syrup in baby formula – is that something to avoid? This article will discuss everything you need to know about sugar in baby formula – from comparing the sugar content of breast milk VS. baby formula to the difference in various sugars used by leading formula brands so that you can always choose the most nutritious option for your baby if you are formula feeding.
In this article:
- Why is there sugar in baby formula?
- Sugar in breast milk
- Sugar content in baby formula
- Summary: Sugar in breast milk VS. formula
Why is there sugar in baby formula?
Babies need sugar! As crazy as it may sound, sugar is an important macronutrient and a vital energy source that babies need for proper growth and development.
Babies grow rapidly in the first year, typically tripling their birth weight by the time they are 1 year old, all while gaining about 10 inches in length, which requires a LOT OF energy! That’s where sugar comes in. Sugars are carbohydrates, and carbs provide that much needed fuel source.
Does breast milk contain sugar? Absolutely! Nearly half the total calories from breast milk come from carbohydrates alone. Because baby formula is made to closely mimic the macronutrient composition of breast milk, it must inevitably contain carbs, in other words sugar, as well.
The problem is… sugars are not created equal.
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There are many different types of sugars in the foods we eat. You have simple sugars with only one or two molecules (monosaccharides and disaccharides) – glucose, fructose, galactose, lactose, sucrose, or maltose, and more complex sugars that contain a variety of molecules (like polysaccharides and oligosaccharides).
When it comes to breast milk, Mother Nature is very specific about the type of sugar that babies receive.
Sugar in breast milk
The primary source of sugar in breast milk is lactose, making up about 84-95% of the total carbohydrate content of breast milk. [1] Lactose is a disaccharide that’s composed of the monosaccharides glucose and galactose.
Lactose is present in the milk of all mammals, but the concentration in human milk is among the highest of all mammalian milk – about 7.5 g/100 mL (VS. 5g/100 mL that cow milk contains on average). [2,3]
Another significant carbohydrate source in breast milk is a variety of the complex sugars oligosaccharides (HMOs), some of which are exclusive to human milk only. [3] Oligosaccharides function as prebiotics, meaning they encourage the growth of beneficial bacteria in baby’s intestines. Oligosaccharides (HMOs) in breast milk average 1.2-1.4 g/100 mL. [4]
Breast milk also naturally contains very low amounts of free glucose and galactose, but at such low levels their nutritional significance is negligible. [5]
Sugar content in baby formula
Gram for gram, baby formulas contain very similar amounts of sugar – about 10-12 g/150 mL of prepared formula. (This is comparable to breast milk which contains 7.5 g of sugar per 100 mL on average, or 11.25 g/150 mL).
Unlike breast milk where the chief carb source is lactose, various types of sugars are used to make baby formula.
Baby formula can contain one or more of the following sugars:
- lactose
- corn syrup
- corn syrup solids
- glucose syrup
- glucose syrup solids
- brown syrup
- maltodextrin
- sucrose
All of these sugars have a similar energy value (4 kcal/g) but different qualities.
Firstly, they vary in the sweetness level – if you were to taste a teaspoon of each sugar listed, some would taste much sweeter than others.
This is how different sugars in baby formula compare in sweetness:
Besides varying sweetness level, the commonly used sugars in baby formula also vary in the rate of digestion and absorption which determines how your baby processes each sugar type. Some have a very high glycemic index and can cause rapid spikes in blood sugar.
The glycemic index & why it matters
The glycemic index (GI) is a ranking system that measures the impact each type of sugar has on raising blood sugar levels.
When you ingest sugar, it’s absorbed from your gut into the bloodstream. This signals your pancreas to release insulin, a hormone that helps blood sugar move into the cells so that it can be used as energy or stored. Too much sugar in the bloodstream all at once on a regular basis can put too much stress on the pancreas which can, over time, lead to serious health issues.
The higher the GI of a sugar, the faster the increase in the blood sugar and the more insulin the body needs to produce to return blood sugar levels to normal.
Carbohydrates with a low glycemic index (GI) are metabolized more slowly and don’t lead to the same blood sugar spikes.
| Sweetener | Glycemic Index (Lower is healthier) |
|---|---|
| Maltodextrin | 110 |
| Glucose | 100 |
| Brown Rice Syrup | 98 |
| Glucose Syrup + Corn Syrup | (glucose-based) |
| Sucrose (Table Sugar) | 65 |
| Lactose | 45 |
Let’s break down the individual sugars used in baby formula and see how they compare.
Lactose
Lactose, the primary sugar in breast milk, is a natural and optimal carbohydrate source for babies. Several physiological benefits have been attributed to lactose besides simply being an energy source:
- Lactose plays a role in promoting healthy gut bacteria in infants and may improve calcium absorption. [7]
- Lactose plays a part in dental health, too – it’s the least cariogenic of all mono- and disaccharides, meaning out of all other types of sugars used in baby formulas, lactose is the least likely to contribute to dental caries. [6]
- In addition, lactose scores very low on the glycemic index scale (the GI of lactose is 45), which means it’s slow to metabolize and doesn’t increase blood sugar levels nearly as fast as other sugars commonly used in baby formulas.
Most standard baby formulas in the U.S. are made with lactose as the carbohydrate source. (See a list of examples below.)
U.S.-made baby formulas with lactose
- Bobbie
- Burt’s Bees Infant Formula
- Earth’s Best Organic Formula
- Enfamil Infant
- Enfamil NeuroPro Infant
- Enfamil Enspire
- Enfamil Premium A2
- Gerber Good Start Gentle Supreme A2
- Happy Baby Organic Formula
- Mama Bear Infant Formula
- Mama Bear Advantage Formula
- Similac Advance
- Similac Pro-Advance
- Similac 360 Total Care
- Similac Organic
- Similac Organic A2 Milk
- Similac Pure Bliss
- UP & UP Infant (Target)
- UP & UP Advantage (Target)
Popular European-made baby formulas with 100% lactose
Lactose is broken down into its constituents glucose and galactose by lactase, an enzyme which the vast majority of babies produce from birth.
Most babies are able to digest and utilize lactose easily, but babies who were born premature can have difficulty producing enough lactase initially over the first few days after birth and may do better with a lactose-reduced formula at first. Additionally, babies with an irritated digestive tract (such as when recovering from diarrhea) may also temporarily produce less lactase and may prefer a lactose-reduced formula for the time being (but many do just fine with standard formula nonetheless). [7]
“Sensitive” baby formulas in the U.S. typically contain no lactose, while European “sensitive” formulas mostly just contain less lactose. “Sensitive” formulas, generally marketed for babies with colic, constipation, bloating, and gas, should never be the first choice just based on being labeled as “more sensitive” on baby’s stomach. (The protein source or oil blend are more likely to cause a reaction than lactose for the average baby!!)
Some babies cannot tolerate lactose. Babies with galactosemia (a rare genetic metabolic disorder that prevents babies from properly metabolizing the sugar galactose in lactose) and congenital lactase deficiency (a rare metabolic deficiency that makes babies unable to digest the milk sugar lactose) cannot consume lactose (both from baby formula and breast milk) and must be fed a lactose-free dairy-free (soy-based) formula.
Corn syrup solids + corn syrup in baby formula
Corn syrup is a sweet syrup derived from cornstarch, while corn syrup solids are a further processed corn syrup – dehydrated corn syrup. Depending on the grade and processing method, corn syrup can contain varying amounts of glucose, fructose, or maltose, but pure corn syrup is essentially all glucose. [8,9]
In the U.S., corn syrup is a very common lactose substitute in baby formula. It’s cheap to produce and abundant, which makes it an attractive choice for baby formula manufacturers.
Corn syrup vs. lactose in baby formula:
There are two potential red flags when it comes to corn syrup solids and corn syrup in baby formula.
One has to do with the high likelihood of being sourced from GMO corn, but if you prefer to stay away from GMOs, there are several options for a non-GMO baby formula these days.
Another concern is that corn syrup is glucose which has a high glycemic index (GI). Baby formula containing corn syrup or corn syrup solids will increase blood sugar much more quickly than a lactose-based baby formula would. Babies may be able to handle the increased glycemic load for the time being, but that doesn’t mean there are no consequences whatsoever, given that glucose is not the type of carbohydrate that babies are physiologically intended to receive as the primary carbohydrate source.
Glucose syrup + glucose syrup solids in baby formula
Some baby formulas use glucose syrup or glucose syrup solids as a carbohydrate source.
Glucose syrup is essentially the same thing as corn syrup – a sweet syrup with a high glucose content. The only difference is that it may have been sourced from a plant other than corn. However, while glucose syrup can be produced from a variety of plants, in the U.S. it is most commonly made from corn. [8]
Baby formula that contains glucose syrup or glucose syrup solids (dehydrated glucose syrup) presents the same red flags as baby formula made with corn syrup/corn syrup solids (see above).
Brown rice syrup in baby formula
Brown rice syrup is another type of liquid sugar, this time derived from the obvious – brown rice, that behaves in the body similar to how glucose does. It’s made up of three sugars – glucose (3%), maltose (45%), and maltotriose (52%).
Even though the amount of pure glucose in brown rice syrup is very small, when broken down, the rest is essentially also all glucose – maltose is a disaccharide formed by two glucose molecules, and maltotriose is an oligosaccharide that consists of three molecules of glucose. The two will just take a bit longer to break down, so the sugar won’t reach the blood stream all at once.
Nonetheless, brown rice syrup is metabolized much faster than lactose, the primary sugar in breast milk. Brown rice syrup has a glycemic index of 98 (very similar to glucose which is at 100), whereas the glycemic index of lactose is 45.
In addition, brown rice syrup is known to contain high levels of arsenic. Unless the manufacturer uses a filtration process that eliminates arsenic in brown rice syrup, it may contain unsafe levels.
You won’t find brown rice syrup in any infant formula today, but a formula marketed for toddlers may contain it. Baby’s Only organic formula for toddlers, made by Nature’s One, is the only formula I found that currently contains brown rice syrup. The company uses an organic-compliant filtration technology that reduces inorganic arsenic from their products to below the standards for drinking water established by the EPA.
Maltodextrin in baby formula
Maltodextrin, typically derived from corn, is made by a process similar to how corn syrup solids are made. The one notable difference between the two, however, is in the sugar content. Compared with other sweeteners like corn syrup or brown rice syrup, maltodextrin is only very mildly sweet.
Due to its low sweetness, maltodextrin is typically used in baby formulas as a supplemental carbohydrate source, and/or as an additive – it gives formula a foamier and thicker texture while also functioning as a preservative.
Despite the low sugar content, however, maltodextrin is at the top of the glycemic index, which means it is rapidly absorbed shortly after ingestion, causing blood sugar spikes.
Maltodextrin is a polysaccharide sugar – a polymer of glucose molecules. While it is technically a complex sugar based on the number of molecules in its structure, the individual glucose molecules break down easily, so maltodextrin essentially absorbs almost at the same rate as pure glucose upon arrival in the small intestine. [10]
When used in small amounts (this isn’t always the case – in some formulas, 50-80% of carbs come from maltodextrin), maltodextrin is unlikely to cause adverse health outcomes due to its high glycemic index. There is, however, some evidence suggesting that maltodextrin may affect the balance of bacteria in the gut. [11]
Sucrose in baby formula
Some baby formula is made with sucrose, the fancy name for ordinary table sugar or white sugar. Sucrose is made by crystallizing sugar cane or beet juice. It’s a disaccharide made up of the monosaccharides glucose and fructose.
Sucrose is used in baby formula together with maltodextrin or glucose-based sugars as a substitute for lactose.
Sucrose has a lower glycemic index than glucose or other sugar syrups on this list, but still higher than lactose. The glycemic index (GI) of sucrose is 65, whereas the GI of lactose is 45.
In the glycemic index scheme of things, sucrose is the most relatable sugar among lactose substitutes, metabolized more closely to lactose than other sugars in baby formulas. This is due to the fructose content which breaks down differently than other sugars and doesn’t trigger an insulin release.
On the other hand, sucrose is very sweet. All carbohydrates have varying degrees of sweetness on a relative scale, with fructose being the sweetest (sucrose = glucose + fructose). Gram for gram, sucrose is the sweetest sugar you can find in baby formula.
Sucrose has about five times the sweetness of lactose, which is near the bottom of the sweetness value scale. This means that a baby formula with sucrose may add unnecessary sweetness and get your baby hooked to that sweet sugary taste from a very early age.
Thirdly, fructose, one of the constituents of sucrose, is not a carbohydrate naturally found in breast milk. (In a fair comparison of sugar in breast milk vs. formula, fructose can pass through breast milk if the mother consumes processed foods/drinks high in fructose, but fructose does NOT naturally occur in breast milk.)
Studies have shown that excessive consumption of fructose from processed foods and drinks can be hard on the liver and can contribute to liver fat which is linked to health issues like diabetes and heart disease. [12] (Natural fructose in fruit does not pose the same health risks because it comes with a variety of other nutrients including fiber which slows down the absorption of fructose.)
Standard baby formulas aren’t formulated with fructose or high fructose corn syrup, nor is sucrose pure fructose, so baby formula containing sucrose will not have the same effects that fructose alone would. There is, however, a study from a few years ago that points out that even extremely small amounts of fructose in breast milk can lead to higher body weight, muscle, and bone mineral content in babies, at least temporarily (no additional follows-ups took place in this study). [13]
Sugar in breast milk VS. formula: Summary
The ideal carbohydrate source for infants is the type of sugar naturally occurring in breast milk – lactose! (Except in the case of rare metabolic conditions that make babies unable to digest or utilize lactose.) Lactose is the perfect source of energy for most infants and is easy to digest for babies.
Here is where lactose stands in both the glycemic index and sweetness level, compared with a variety of other sugars used in baby formulas:
When it comes to the content of sugar in breast milk VS. formula, lactose is the closest match to breast milk.
The benefits of lactose in baby formula compared with breast milk are somewhat diminished given that baby formula lacks the complexity of breast milk, but lactose is still the best and most natural carbohydrate source for most babies.
Related: Is Palm Oil in Baby Formula Safe for Babies?
Most standard infant formulas are made with lactose. Carbs are listed among the first few ingredients in the ingredient list, so you can easily check the carbohydrate source in any baby formula that you are considering. (Scroll up to “Lactose” to see examples of baby formulas with lactose – 100% of energy from carbs in these formulas comes from lactose.)
If a fully lactose-based formula is not an option due to dietary restrictions, the most likely carb choices you will encounter will be corn syrup, glucose syrup, sucrose, and maltodextrin. I personally don’t think there is a clear winner here. Either the glycemic index is very high, or you have a much sweeter taste as a tradeoff for gentler effects on blood sugar.
However, considering that sucrose is part fructose which doesn’t naturally occur in breast milk, sucrose would be my least recommended option as a carbohydrate source in baby formula if your baby does not tolerate lactose well. I consider glucose-based carbs and maltodextrin in small amounts safer over sucrose, but ultimately, it’s a personal choice and a matter of how well your baby tolerates formula.
If your baby has specific dietary needs, make sure to discuss with your health care provider which formula is the most appropriate for your baby.
I hope this article helped you learn about the sugar content in breast milk VS. formula and that you have a better understanding about the substitutes for lactose that formula companies use.
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References:
- The carbohydrate composition of human milk; S M Kunizhev, I P Chepurnoĭ, K S Ladodo, S G Gribakin, N A Khodzhibekova; Vopr Pitan. Jul-Aug 1985;(4):69-71. [PubMed]
- Lactose intolerance and gastrointestinal cow’s milk allergy in infants and children – common misconceptions revisited; Ralf G. Heine, Fawaz AlRefaee, Prashant Bachina, Julie C. De Leon, Lanlan Geng, Sitang Gong, José Armando Madrazo, Jarungchit Ngamphaiboon, Christina Ong, Jossie M. Rogacion; World Allergy Organ J. 2017; 10(1): 41. [NCBI]
- Human Milk Composition: Nutrients and Bioactive Factors; Olivia Ballard, Ardythe L. Morrow; Pediatr Clin North Am. 2013 Feb; 60(1): 49–74. [NCBI]
- Human Milk Oligosaccharides: Health Benefits, Potential Applications in Infant Formulas, and Pharmacology; Michał Wiciński, Ewelina Sawicka, Jakub Gębalski, Karol Kubiak, Bartosz Malinowski; Nutrients. 2020 Jan; 12(1): 266. [NCBI]
- Components of human breast milk: from macronutrient to microbiome and microRNA; Su Yeong Kim, Dae Yong Yi; Clin Exp Pediatr; Volume 63(8); 2020. [CEP]
- Dietary advice in dental practice; P J Moynihan; British Dental Journal; Volume 193, pages 563–568 (2002). [Nature]
- The Importance of Lactose in the Human Diet: Outcomes of a Mexican Consensus Meeting; Enrique Romero-Velarde, Dagoberto Delgado-Franco, Mariana García-Gutiérrez, Carmen Gurrola-Díaz, Alfredo Larrosa-Haro, Ericka Montijo-Barrios, Frits A. J. Muskiet, Belinda Vargas-Guerrero, Jan Geurts; Nutrients 2019, 11(11), 2737. [MDPI]
- Corn Syrup, New World Encyclopedia. [NWE]
- Glucose/Dextrose; Chemistry LibreTexts. [LibreTexts]
- Nutrition, Health, and Regulatory Aspects of Digestible Maltodextrins; Denise L. Hofman, Vincent J. van Buul, Fred J. P. H. Brouns; Crit Rev Food Sci Nutr. 2016 Sep 9; 56(12): 2091–2100. [NCBI]
- Deregulation of intestinal anti-microbial defense by the dietary additive, maltodextrin; Kourtney P Nickerson, Rachael Chanin, Christine McDonald; Gut Microbes. 2015; 6(1): 78–83. [NCBI]
- The Gut Shields the Liver from Fructose-Induced Damage; Penn Medicine. [Penn Today]
- Fructose in Breast Milk Is Positively Associated with Infant Body Composition at 6 Months of Age; Michael I. Goran, Ashley A. Martin, Tanya L. Alderete, Hideji Fujiwara, David A. Fields; Nutrients. 2017 Feb; 9(2): 146. [NCBI]
