Michael Goran, PhD, has spent more than 30 years studying the causes and consequences of childhood obesity—especially the impact of added sugars. Now, the Children’s Hospital Los Angeles researcher is shining a national spotlight on a surprising source of these sugars: infant formula.
Dr. Goran, Director of the Nutrition and Obesity Program in The Saban Research Institute of Children’s Hospital Los Angeles, is one of 13 experts on a new U.S. Food and Drug Administration working group—the first since 1998 to comprehensively review formula ingredients.
He explains how added sugars are increasingly showing up in formulas—particularly those marketed as “gentle” and “sensitive”—and the changes he hopes the FDA will make.
The only digestible carbohydrate in breast milk is lactose. Traditionally, lactose was the main carbohydrate in formula, too. But today, more than half of all formulas sold in the U.S. replace some or all lactose with other sugars—mostly corn syrup.
These formulas are often marketed as “gentle” or “sensitive,” based on the myth that many babies are lactose-intolerant. But lactose intolerance is rare in full-term babies, and even in preterm infants it is usually temporary.
Corn syrup is a different type of sugar, and it’s metabolized differently. It’s all glucose, while lactose is glucose plus galactose. Studies suggest that corn syrup formula may affect the gut microbiome or make babies fussier eaters.
But the biggest concern is obesity. In our study of more than 15,000 children in California’s Women, Infants & Children (WIC) program, we found that babies fed corn syrup-based formula were 10% more likely to be obese by age 4. That was regardless of the mother’s weight. The longer infants consumed this formula, the higher their risk.
USDA guidelines recommend no added sugars for kids under 2. And yet, many formulas contain them.
That’s what we’re studying now. Corn syrup has a higher glycemic index than lactose. Using continuous glucose monitors, our team has been comparing blood sugar levels in babies fed corn syrup formulas to those fed lactose-based formula.
Our preliminary data show that babies consuming formula with corn syrup have more erratic blood sugar patterns. Could that increase diabetes risk later on? We don’t know.
The evidence here is much more limited than what we have on obesity. It can be difficult to get good data on brain development in a baby. But in our study, we’re now using MRI to scan the brains of 6-year-old children from a cohort we’ve followed since birth. Our goal is to see how infant nutrition relates to brain structure years later.
First, non-lactose sugars, such as corn syrup and sucrose (table sugar), should be labeled as added sugars. Current regulations exempt formula from this requirement.
Second, the FDA should set limits on added sugars in formula—as the European Union does—or require a minimum amount of lactose. Right now, regulations require that formula contain carbohydrates, but they don’t specify what type.
For babies who truly can’t digest lactose, adding lactase to formula would be a better solution. This is the enzyme that helps to digest lactose and is already used in lactose-free milk for adults.
We are in the process of publishing a paper with our expanded recommendations- Opens in a new window. We plan to submit it as part of the FDA’s public comments on infant formula, which are open through Sept. 11.
My hope is that the FDA will rethink why and when lactose is replaced in formula. While we don’t know all the long-term effects yet, eliminating added sugars from a baby’s diet is the safest approach.
Reference
1) https://www.preprints.org/manuscript/202508.0225/v1
(Newswise/TL)