Human Milk Macronutrients and Child Growth and Body Composition in the First Two Years: A Systematic Review

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  • Meredith (Merilee) Brockway
  • Allison I. Daniel
  • Sarah M. Reyes
  • Matthew Granger
  • Joann M. McDermid
  • Deborah Chan
  • Rebecca Refvik
  • Karanbir K. Sidhu
  • Suad Musse
  • Pooja P. Patel
  • Caroline Monnin
  • Larisa Lotoski
  • Donna Geddes
  • Fyezah Jehan
  • Patrick Kolsteren
  • Lindsay H. Allen
  • Daniela Hampel
  • Kamilla G. Eriksen
  • Natalie Rodriguez
  • Meghan B. Azad

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.

OriginalsprogEngelsk
Artikelnummer100149
TidsskriftAdvances in Nutrition
Vol/bind15
Udgave nummer1
Antal sider29
ISSN2161-8313
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
This review was undertaken as part of the International Milk Composition Consortium, funded by the Bill & Melinda Gates Foundation (INV-001734).

Funding Information:
MB has contributed to online courses on breast milk and the infant microbiome produced by Microbiome Courses. SMR has contributed to online courses on breast milk and the infant microbiome produced by Microbiome Courses, serves as the scientific adviser for SimpliFed, and has served as a consultant for TraverseScience. She is a former employee of Prolacta Bioscience; her contribution to this review occurred prior to this employment. JMM has received support from the Bill & Melinda Gates Foundation and serves on the Council on Research for the American Academy of Nutrition and Dietetics. DC is supported by a Canadian Nurses Foundation Scholarship. DG is funded by an unrestricted research grant from Medela AG . She is also currently funded by Telethon Child Health Grants and the Australian National Health and Medical Research Council . LHA has research grants from the Bill & Melinda Gates Foundation . MBA is supported by a Canada Research Chair and is a CIFAR Fellow in the Humans and the Microbiome Program; she has consulted for DSM and is a scientific adviser to TinyHealth. MG, RR, KKS, SM, CM, FJ, PK, DH, LL, and KGE have no conflicts of interest.

Publisher Copyright:
© 2023 The Authors

ID: 388948599