A chance event in which a parent drank infant formula — and discovered how sweet it tasted — has resulted in a research project that found many such foods sold in the UAE have high sugar content.
The work by paediatric dentists at the Mohammed Bin Rashid University of Medicine and Health Sciences found that almost one-third of infant formulas available in UAE retailers contained detectable sugar levels.
Yet, in many cases, this was not clearly indicated on the label, so parents may be giving children foods with high sugar content without realising it.
The research came about when a two-year-old boy was brought to Dubai Dental Hospital at the university’s Hamdan Bin Mohammed College of Dental Medicine with severe early childhood caries, meaning his teeth had numerous cavities.
The child’s mother mentioned she had been feeding her son infant formula, but had become concerned after drinking the formula herself at an airport because she was unable to take the liquid onto a flight. She was struck by how sweet it tasted.
“She discovered that it was too sweet for her,” said Dr Rawan Awad, first author of the study.
“She said maybe that’s the reason causing his cavities. That was actually our inspiration to start the research.
“We did expect some sugar in the infant formula. We just wanted to prove it by laboratory analysis.”
The researchers purchased 71 brands of infant formula, aimed at children aged from one to three years old and available in supermarkets in the UAE, and determined the levels of three sugars — glucose, fructose and sucrose.
Their study, recently published in the International Journal of Paediatric Dentistry, revealed that they found at least some sugar in 23 samples.
The World Health Organisation recommends that sugar should provide less than 10 per cent of a person’s energy intake, and says that there are additional health benefits if the figure is below five per cent.
Infant formula may, the researchers said, be contributing to a high rate of tooth decay in young children in the region.
Dr Awad said that research at MBRU indicated a prevalence of childhood caries as high as 74 per cent in the UAE and 80 per cent in the GCC.
Sugars may also increase the risk of other health conditions, such as diabetes and obesity.
Sugars are often added to infant formula to make the product more attractive, potentially leading the child to develop a preference for the formula.
“This is alarming because it’s widely known that human milk and breastfeeding are considered the ideal form of infant feeding, especially during the first six months of life, as it provides many benefits for the child’s well-being,” said Dr Awad, who was based at MBRU but is now an assistant professor of paediatric dentistry at Tufts University, Massachusetts, US.
A concern of the researchers is that infant formula labels often state the carbohydrate content, but do not reveal that some of this is sugar. Dr Awad said tighter labelling regulations would be welcome.
Even when sugars are mentioned, complex names that parents may not recognise are often used. For example, fructose is sometimes written on packaging as oligofructose and fructooligosaccharides.
“When you call a sugar a big, scientific name, no one knows about it, except those who are in chemistry and science. That would definitely lead to some parents being misled,” said Prof Manal Al Halabi, dean of MBRU’s Hamdan bin Mohammed College of Dental Medicine.
Parents are advised to maintain good oral hygiene by using a fluoride toothpaste to clean their children’s teeth twice daily, including last thing at night. The child should visit a dentist for the first time no later than his or her first birthday, dentists recommend.
“Avoid giving the baby a bottle to sleep with at night. From what we see with our patients, this is one of the things that can be very, very harmful,” Prof Al Halabi said.
“Giving a baby a bottle with formula with sugar in it, to keep nibbling on all night long, will just be soaking the teeth with sugar.”
Production of saliva, which has a protective effect, is reduced at night, so potential harm to the teeth from infant formula will probably be increased.
Prof Al Halabi said she sympathised with parents who used infant formula, as typically they were unaware of the potential effects on their child’s teeth.
“A lot of time you deal with parents who find out the hard way, when it’s too late, that the use of formula has caused many cavities for the child,” she said. “It’s very touching and sad. Parents are always trying to do the best for their children.”