A review of dairy food intake for improving health among black infants, toddlers, and young children in the US

Adequate nutrition is paramount for proper growth and musculoskeletal, neurocognitive, and immunological development in infants, toddlers, and young children. Among breastfeeding mother–child dyads, this critical window of development, is impacted by both maternal and offspring dietary patterns. For mothers, their dietary patterns impact not only their own health and well-being, but also the nutrition of their breast milk – which is recommended as the sole source of food for the first 6 months of their infant's life, and as a complementary source of nutrition until at least 2 years of age. For infants and toddlers, the breast milk, formulas, and first foods they consume can have both short-term and long-term effects on their health and well-being – with important impacts on their taste perception, microbiome composition, and immune function. According to dietary intake data in the US, infants and young children meet a greater number of nutrient requirements than older children and adults, yet numerous disparities among socially disadvantaged racial/ethnic groups provide significant challenges to achieving adequate nutrition during these early life stages. For example, Black children are at greater risk for disparities in breastfeeding, age-inappropriate complementary feeding patterns, nutrient inadequacies, food insecurity, and obesity relative to most other racial/ethnic groups in the US. In recent years, a growing body of literature has promoted the role of breastfeeding to support infant/toddler health and improving the quality of complementary and transitional feeding by promoting adequate intake of dairy foods and their key nutritional and bioactive compounds such as prebiotic oligosaccharides, immunoglobulins, lactoferrin, and phospholipids. For infants who do not receive adequate breast milk, which includes a disproportionate number of Black infants, then dairy-based infant formulas are considered the next best option for meeting nutritional needs, however, these formulas are not able to provide the same immune or psychosocial benefits that are achieved through breastfeeding. Fermented dairy foods (e.g., yogurt, cheese) can serve as ideal first foods for complementary feeding, and cow's milk is recommended for introduction during the transitional feeding period to help meet the nutrient demands during this phase of rapid growth and development. Although lactose intolerance is generally not an issue in infancy or early childhood, upwards of 70–75% of Black populations start to lose some of their ability to digest lactose later in childhood or in adolescence and tend to have lower levels of dairy intake than most other racial/ethnic groups. Low dairy intake may put children at risk for multiple nutrient inadequacies and health disparities – some of which may have lifelong consequences on physical and mental health. A burgeoning body of research shows that in addition to breast milk, cow's milk and other dairy foods may play critical roles in supporting physical growth, neurodevelopment, immune function, and a healthy gut microbiome in early life. However, most of this research so far has been conducted in White populations and can only be extrapolated to Black infants, toddlers, and young children. Therefore, to better understand and support the health and development of this population, greater research and education efforts on the role of milk and dairy products are urgently needed. This review presents the current evidence on health disparities faced by Black children in the US from birth to four years of age, and the role that dairy foods can play in supporting the normal growth and development of this vulnerable population.