TY - JOUR

T1 - Human Milk Macronutrients and Child Growth and Body Composition in the First Two Years

T2 - A Systematic Review

AU - Brockway, Meredith (Merilee)

AU - Daniel, Allison I.

AU - Reyes, Sarah M.

AU - Granger, Matthew

AU - McDermid, Joann M.

AU - Chan, Deborah

AU - Refvik, Rebecca

AU - Sidhu, Karanbir K.

AU - Musse, Suad

AU - Patel, Pooja P.

AU - Monnin, Caroline

AU - Lotoski, Larisa

AU - Geddes, Donna

AU - Jehan, Fyezah

AU - Kolsteren, Patrick

AU - Allen, Lindsay H.

AU - Hampel, Daniela

AU - Eriksen, Kamilla G.

AU - Rodriguez, Natalie

AU - Azad, Meghan B.

N1 - Publisher Copyright: © 2023 The Authors

PY - 2024

Y1 - 2024

N2 - Among exclusively breastfed infants, human milk (HM) provides complete nutrition in the first mo of life and remains an important energy source as long as breastfeeding continues. Consisting of digestible carbohydrates, proteins, and amino acids, as well as fats and fatty acids, macronutrients in human milk have been well studied; however, many aspects related to their relationship to growth in early life are still not well understood. We systematically searched Medline, EMBASE, the Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born healthy infants. From 9992 abstracts screened, 57 articles reporting observations from 5979 dyads were included and categorized based on their reporting of HM macronutrients and infant growth. There was substantial heterogeneity in anthropometric outcome measurement, milk collection timelines, and HM sampling strategies; thus, meta-analysis was not possible. In general, digestible carbohydrates were positively associated with infant weight outcomes. Protein was positively associated with infant length, but no associations were reported for infant weight. Finally, HM fat was not consistently associated with any infant growth metrics, though various associations were reported in single studies. Fatty acid intakes were generally positively associated with head circumference, except for docosahexaenoic acid. Our synthesis of the literature was limited by differences in milk collection strategies, heterogeneity in anthropometric outcomes and analytical methodologies, and by insufficient reporting of results. Moving forward, HM researchers should accurately record and account for breastfeeding exclusivity, use consistent sampling protocols that account for the temporal variation in HM macronutrients, and use reliable, sensitive, and accurate techniques for HM macronutrient analysis.

AB - Among exclusively breastfed infants, human milk (HM) provides complete nutrition in the first mo of life and remains an important energy source as long as breastfeeding continues. Consisting of digestible carbohydrates, proteins, and amino acids, as well as fats and fatty acids, macronutrients in human milk have been well studied; however, many aspects related to their relationship to growth in early life are still not well understood. We systematically searched Medline, EMBASE, the Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born healthy infants. From 9992 abstracts screened, 57 articles reporting observations from 5979 dyads were included and categorized based on their reporting of HM macronutrients and infant growth. There was substantial heterogeneity in anthropometric outcome measurement, milk collection timelines, and HM sampling strategies; thus, meta-analysis was not possible. In general, digestible carbohydrates were positively associated with infant weight outcomes. Protein was positively associated with infant length, but no associations were reported for infant weight. Finally, HM fat was not consistently associated with any infant growth metrics, though various associations were reported in single studies. Fatty acid intakes were generally positively associated with head circumference, except for docosahexaenoic acid. Our synthesis of the literature was limited by differences in milk collection strategies, heterogeneity in anthropometric outcomes and analytical methodologies, and by insufficient reporting of results. Moving forward, HM researchers should accurately record and account for breastfeeding exclusivity, use consistent sampling protocols that account for the temporal variation in HM macronutrients, and use reliable, sensitive, and accurate techniques for HM macronutrient analysis.

KW - amino acids

KW - anthropometry

KW - body composition

KW - breastfeeding

KW - breastmilk

KW - carbohydrates

KW - fat

KW - fatty acids

KW - glucose

KW - growth

KW - human milk

KW - infant

KW - lactation

KW - lactose

KW - macronutrients

KW - protein

U2 - 10.1016/j.advnut.2023.100149

DO - 10.1016/j.advnut.2023.100149

M3 - Review

C2 - 37981047

AN - SCOPUS:85180295704

VL - 15

JO - Advances in Nutrition

JF - Advances in Nutrition

SN - 2161-8313

IS - 1

M1 - 100149

ER -