The Nutrition Association of Thailand and the Early Nutrition Academy on Composition of Follow-up Formula

Early Nutrition Academy on Composition of Follow-up Formula

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Countries may adapt compositional requirements, considering recommended nutrient intakes, habitual diets, nutritional status and existence of micronutrient programs to ensure adequacy while preventing excessive intakes.

Proposed recommendations from the Nutrition Association of Thailand (NAT) in collaboration with Early Nutrition Academy (ENA) and the Federation of International Societies on Pediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN) on follow-up formula for young children (FUF-YC) aged 1 – 3 years.

Recommendations were devised based on a detailed literature review (23 publications from 19 countries) of nutrient intakes and unmet needs in children aged 12 – 36 months.

Key Findings:

  • The following nutrients were often limited in the diet of young children and across various regions:
    • Vitamins A, D, B12, C ,folate, calcium, iodine, iron, zinc , DHA
  • Average intake of some nutrients were low compared to recommended intakes:
    • Alpha-linolenic acid (ALA), DHA, iron, vitamin D and iodine in some European countries
    • Intakes of dietary fiber in young children
  • Dietary intake of protein, sodium and potassium are generally high in young children across Europe


  • The use of adequately composed FUF-YC is one of the several options that can contribute to improving nutrient supply to young children up to the age of 3 years
  • FUF-YC should not the exclusive source of nutrients but will be fed along with appropriate meals and at time also along with partial breast-feeding
  • The recommended number of daily serving is 1 – 2 cups (total 200 – 400 ml) of FUF-YC, equivalent to ~15% of total energy intake in young children
  • When children do not achieve adequate nutrient intake from eating normal foods
    • Fortified foods and nutrient supplements including formula products should be considered to complement locally available foods for satisfying nutritional requirement

Other Information:
Selected nutrient levels recommendations in this literature:

Nutrients Recommended levels
Protein (from cow’s milk based formula) 1.6 – 2.7 g/100 kcal
Fat 4.4 – 6 g/100 kcal
DHA Minimum content is 15 mg/100 kcal (equivalent to 0.3% of total fat)
Carbohydrate 9 – 14 g/100 kcal (with >50% from lactose)
Calcium 200 mg/100 kcal
Other micronutrient contents /100 kcal should reach 15% of the WHO/FAO recommended nutrient intake values




Suthutvoravut U, Abiodun PO, Chomtho S, Chongviriyaphan N, Cruchet S, Davies PS, Fuchs GJ, Gopalan S, van Goudoever JB, Nel Ede L, Scheimann A, Spolidoro JV, Tontisirin K, Wang W, Winichagoon P, Koletzko B. Composition of Follow-Up Formula for Young Children Aged 12-36 Months: Recommendations of an international Expert Group Coordinated by the Nutrition Association of Thailand and the Early Nutrition Academy. Ann Nutr Metab. 2015 Sep 12;67(2):119-132. [Epub ahead of print]. Link to PubMed