An analysis suggests that baby food pouches with spouts are more like sugary drinks or milkshakes than nutritious food

This study measures, for the first time, the texture and composition of around 300 baby food jars and pouches (the little sachets with spouts found in supermarkets) sold in the UK and provides, for the first time, an objective assessment of texture, going beyond the descriptions on the packaging of these products. They have observed that, depending on the product, nutritional quality can vary – something already highlighted by nutritionists and paediatricians, who have long warned that many commercial baby foods contain too much sugar and are low in nutritional density.

The practical implication is, above all, regulatory. The authors suggest that many pouches are more similar, in texture and composition, to a fruit purée than to a complementary food, and argue that regulations and labelling should distinguish more clearly between ‘food’ and ‘drink’.

That said, this is a cross-sectional and descriptive study with its limitations: the products were selected from large supermarkets in the UK (so the findings cannot be extrapolated to other countries) and nutritional data are scarce, comprising little more than what is stated on the product label. Another important point is that the study has not demonstrated that pouches cause tooth decay, overweight or a reluctance to eat solids.

For families, the message and recommendation are that pouches should be used only occasionally, particularly in the early stages of life, when children are learning to eat solids and chew.

It is an interesting study, but it is very surprising – as is often the case with many scientific studies – that the title does not specify the location where the fieldwork was carried out and the study sample was selected: the United Kingdom.

The study’s title should, without fail, include the country in which the research was carried out, particularly in this piece of work, which calls for legislative regulation of the products analysed. This is a major shortcoming which the reviewers, during the peer-review and approval process, should have highlighted as a major comment.

In the case of the European Union, there is legislation on this matter (Regulation (EU) No 609/2013 of the European Parliament and of the Council concerning specific compositional and labelling requirements for infant formulae and follow-on formulae, as well as labelling requirements for foods intended for infants and young children); moreover, in Spain we have Royal Decree 490/1998 of 27 March, which approves the specific technical and health regulations for cereal-based foods and infant foods for infants and young children; this covers aspects not included in the EU Regulation, where Article 4(2)(1) states: “The age from which the product may be consumed, taking into account its composition, texture and other specific properties. The age indicated shall be at least four months for any product. For products recommended from four months of age, it may be stated that they are suitable from that age, unless otherwise indicated by an independent and competent person in medicine, nutrition or pharmacy, or another professional providing care for mothers and children”.

Therefore, depending on their fruit and cereal composition, they are recommended for ages +4 months, +6 months, +8 months and +12 months. Another aspect, to prevent choking hazards—just as when preparing food at home—is the texture; generally speaking, it should be as fine as possible for foods consumed before 12 months of age. They contain no added sugars; this information should be mandatory on labelling in the EU but is not yet required for all food products.

The sugar content comes from the fruit, cereals or dairy products that make up these foods; as they are puréed, these are no longer intrinsic sugars but are free sugars. However, just as when food is made or prepared at home, the balance between puréed and whole forms must be considered; for the target consumer, the food must be puréed. Nor is it reasonable, within the context of sugar content limits, to compare those found in fruit or cereals with those present in milk; lactose has nothing in common with fructose, glucose and/or sucrose, either in terms of digestibility or composition, This is the case, but as with any food product introduced at that age, the introduction of these foods from 4 months onwards – known as complementary feeding or ‘beikost’ – must be done gradually in order to detect any possible allergies or intolerances in the infant, and this process must be supervised by a paediatrician.

In conclusion, this is a study that, in terms of content and legislation, applies exclusively to the United Kingdom; and when weighing up the risks and benefits, one must consider the process of introducing complementary feeding from four months onwards, with texture being critical. The food must be intended as a complement to, and not a substitute for, breast milk or infant formula, as well as the infant’s other foods, particularly if it is introduced between four and six months of age.