(P27-086-25) The Effects of the Baby-Act Trial on Infant’s Diet

Objectives: The Baby-Act Trial was a cluster-randomized controlled trial for preventing excessive infant weight gain among mothers/infants from the Puerto Rico WIC program. Participants were randomly assigned to the intervention group or the control group (WIC usual care) from the last trimester of pregnancy until the infant was 12 months. The theory-based intervention included responsive feeding, infant activation, healthy sleep, and limiting sedentary behaviors, delivered through weekly online lessons, weekly text messages, and monthly calls.

Methods: This is an analysis of the effects of the intervention on the infant’s diet using a validated infant food frequency questionnaire (FFQ) completed at 0-2 months and at 6-8 months. The FFQ was analyzed for the infant diet quality index score (IDQIS) and for feeding type (breastfeeding and formula). The total IDQIS (0-55 points) was categorized as Excellent (≥45), Good (35-44), Needs improvement (25-34), and Poor ( < 25). Diet was compared between groups (intervention vs usual care) and between visits using two-sample and paired t-test, Pearson’s and McNemar’s chi-square, mixed logistic and linear regression models.

Results: 270 infants had complete data. The IDQIS at each time point and the change in IDQIS between time was similar by group. When IDQIS was categorized, results were also similar by group, but overall, there was a significant decline in the proportion of infants with Excellent diets at 0-2 months (98.5%) compared to 6-8 months (27.4%; p< 0.01). Type of feeding was also similar between groups but there was a significant decline in the proportion of infants exclusively breastfed at 0-2 months (38.2%) compared to 6-8 months (32.2%; p=0.02) and a significant increase in those fed exclusively infant formula (15.6% at 0-2 months vs 52.2% at 6-8 months; p< 0.0001). There were no differences in dietary patterns between the groups; results were similar when controlling for compliance level and after excluding 14 participants with < 70% of the lessons completed.

Conclusions: The intervention had no significant effects on diet. However, we found a significant decline in diet quality and a significant increase in formula feeding at the time of the introduction of complementary feeding.

Funding Sources: U54 MD007600 and U54GM133807 (National Institute on Minority Health and Health Disparities, NIH).