Infant Intake of Nonlactose Carbohydrates in Milk Feeding Is Associated with Lower Diet Quality Scores for Dairy and Protein from Ages 13 to 72 Months

BACKGROUND: Infant receipt of milk products with added nonlactose carbohydrates, primarily infant formula, is highly prevalent. This study was conducted to assess relationships between infant receipt of milk products with added nonlactose carbohydrates and subsequent child diet quality. METHODS: Data from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2, a national cohort study of infants born into WIC in 2013-2014 (n = 1379), were used. Child diet was assessed with 24-h dietary recalls. Intake of milk products with added nonlactose carbohydrates was determined from recalls at ages 1 and/or 3, 5, 7, 9, and 11 mo (continuous: percent of milk). Differences in subsequent Healthy Eating Index (HEI)-2020 Toddler (ages 13, 15, and 18 mo) and HEI-2020 (ages 2, 3, 4, 5, and 6 y) scores (total, individual components) were assessed using multivariable mixed effects regression models. RESULTS: Each additional 25% of infant milk product intake containing added nonlactose carbohydrates was associated with significantly lower dairy intake scores at ages 1 {difference [95% confidence interval]: [-0.12 (-0.20, -0.04)], 5 [-0.20 (-0.33, -0.08)], and 6 y [-0.24 points (-0.38, -0.11)]; lower total protein score at 1 y [-0.05 (-0.09, <0.00)]; higher fatty acid ratio score at 1 [0.13 (0.03, 0.23)] and 2 y [0.17 (0.02, 0.32)]; and with higher saturated fat score at 1 y [0.12 (0.03, 0.22)]}. CONCLUSIONS: Future research into whether caregiver-perceived lactose-sensitivity contributes to lower dairy intake in childhood among infants who consumed milk with added nonlactose carbohydrates in infancy is necessary.