Sugar in Balamrutham Sparks Nutrition Debate

Hyderabad: As parents become increasingly cautious about sugar in children’s diets and paediatricians advise avoiding added sugars before the age of two, many infant foods marketed as healthy still contain sweeteners or calorie‑boosting ingredients under different names. For low‑income families who depend on government nutrition programmes, the choices are even fewer.

The issue has brought attention to Telangana government’s Balamrutham, the fortified supplementary food supplied through anganwadi centres to children aged seven months to three years. According to government specifications, Balamrutham contains roasted wheat, Bengal gram, skimmed milk powder, oil and sugar. Every 100 grams provides about 414 kilocalories of energy and 11 grams of protein. Of the 100 grams, 20 grams is sugar.

The product reaches around 10.7 lakh children through more than 35,000 anganwadi centres across the state. Beneficiary families receive a 2.5 kg packet every month along with eggs under the supplementary nutrition programme.

For many experts, the debate is not about whether Balamrutham has helped improve child nutrition but about whether nutrition programmes designed when calorie deficiency was the primary concern should be reviewed in light of current infant feeding recommendations.

Dr Sivaranjani Santosh, paediatrician, said parents often assumed that the only alternative to sweetened products was expensive premium baby food. “That is not necessarily true. The question is whether calories currently coming from sugar could instead come from ingredients that provide additional nutritional value. We should be looking at protein, micronutrients and overall nutritional quality, not just calories.”

She said consumers should also be cautious when reading labels. “Many parents look only for the word sugar. Some products contain ingredients such as maltodextrin to increase calories. Others contain fructooligosaccharides, which are prebiotics and not sugars. Parents need to understand what they are actually buying.”

Rohit Reddy, a senior nutritionist specialising in paediatric nutrition, said infant nutrition science had changed considerably over the years and public programmes should periodically be reviewed. “The question is not whether supplementary nutrition should continue. The question is whether formulations developed years ago should evolve as nutrition science evolves.”

While sweetness is often cited as a reason children accept supplementary foods, he said taste preferences were shaped over time. “We should not assume babies are born craving highly sweet foods. Early feeding practices influence what children become accustomed to eating.” The discussion also exposes a wider inequality in infant nutrition.

Parents with greater financial resources increasingly buy baby cereals and complementary foods marketed as containing no added sugar. Yet many such products cost several hundred rupees for a few hundred grams and remain unaffordable for large sections of the population. Products promoted as healthier alternatives often use ingredients such as dates powder or jaggery, which can further increase costs.

Dr Santosh cautioned against viewing commercial products as the answer. “There is a growing fear of missing out among parents. Families are encouraged to buy specialised milk mixes, gummies and nutritional products when wholesome family foods may often be a better option. Marketing should not replace common sense.”

For mothers, the issue is not always straightforward. Priyanka Reddy, mother of a 15‑month‑old child in Hyderabad, said she became more conscious about sugar after reading about infant nutrition online. “If there is a way to reduce sugar without affecting nutrition, I think most parents would support it. But affordable alternatives are limited, and many parents trust what is already being supplied through the health system.”

An anganwadi worker from Medchal‑Malkajgiri district said most mothers focussed on whether their children were eating and gaining weight. “Families trust Balamrutham because it has been distributed for years. Mothers are mainly worried about their children staying healthy and putting on weight,” Sukanya B. told Deccan Chronicle.

The state has previously modified its supplementary nutrition interventions, introducing Balamrutham Plus for children with severe and moderate acute malnutrition in collaboration with the National Institute of Nutrition (NIN). This could mean that experience shows formulations can be revised when required.

Officials from the women development and child welfare department did not comment on whether lower‑sugar alternatives have been evaluated, and whether reformulation is under consideration.