Infant Formula and Dietary Supplement Use Among Infants and Toddlers, Aged 0 to 23 Months, NHANES, 2019 to March 2020

Infant formula (IF) is crucial for meeting the nutrient needs of some infants and toddlers, underscoring the need for continued monitoring of their use, composition, and contribution to nutrient intakes in this group. The objectives were to estimate among infants and toddlers aged 0 to 23 months: (1) percentage using IF, (2) mean IF nutrient content per 100 kcal, (3) percentage using IF with selected bioactives, (4) percentage using frequently reported product brands, and (5) percentage consuming both IF and dietary supplements (DSs). Data from a sample of infants and toddlers aged 0 to 23 months (n = 389) from the 2019 to March 2020 National Health and Nutrition Examination Survey were analyzed. Nearly half (45.7%) of infants and toddlers consumed IF within the past 14 days. Most IF users were infants aged 0 to 11 months: 47.7% were 0 to 5 months, 42.1% were 6 to 11 months, and about 10% were toddlers 12 to 23 months. On average, the reported IFs contained the US Food and Drug Administration-specified required nutrients in quantities within the US Food and Drug Administration standards. Some IF users (8.5%) used more than one IF product within the 2-week period. About 68% of infants and 10% of toddlers consumed an IF with docosahexaenoic acid. Additionally, 7% and 19% of infants consumed a product with probiotics or prebiotics, respectively; less than 5% used a product with both. Enfamil^® RT products were used by 40.9% of IF users, Similac^® RT by 38.6%, and Gerber^® RT by 9.1%. Overall, 20.6% of infants and toddlers used DSs. Among IF users, 13.1% also used DSs: 16.7% aged 0 to 5 months, 10.8% aged 6 to 11 months, and 5.6% aged 12 to 23 months. Among infant IF users, the majority used products with docosahexaenoic acid, smaller percentages used products with probiotics/prebiotics, and more than one-tenth used DSs. Comprehensive dietary assessments for this age group are needed to capture accurate nutrient and bioactive intakes.