Abstract
Added sugar consumption is contraindicated for infants <2 years old; however added sugars are present in many US infant formulas. We examined whether US formulas contain primarily added sugars, or whether formulas contain primarily naturally occurring lactose (the sugar in human milk). Data were obtained from the Nutrition Data System for Research and included formulas available on the US market in 2022 (N=73). Formulas were categorized as: standard (n=31), gentle (n=27), and lactose-free (n=15). Differences across formulas were examined using Bayesian modeling. The median percent added sugars were high in standard (M=59.7%; IQR=22.0), gentle (M=85.0%; IQR=39.5), and lactose-free formulas (M=90.0%; IQR=54.3). Gentle formulas had significantly lower proportional lactose (OR=0.22, 95% HDI=[0.11,0.44], pd=99.3%) and >2 fold higher proportional added sugars compared to standard formulas (ORs=2.11 to 2.57, HDI>0, pd=99.1-99.99%). Lactose-free formulas had 4-8 times higher proportional sucrose (OR=8.92, HDI=[3.86,20.8], pd=100%) and maltose (OR=4.91, HDI=[2.51,9.56], pd=100%) relative to standard and gentle formulas. Five formulas contained primarily (70-90%) naturally occurring lactose. In conclusion, most US infant formulas contain primarily added sugars. However, the presence of five formulas containing primarily naturally occurring lactose demonstrates that such formulations are feasible to produce; such formulas should be made more widely available to help promote infant health.