Breastfeeding: early influences on later health

Abstract

The theme of this year's ISRHML conference was early influences on later health, including the contribution of intrauterine factors to early 'programming' and the effect of post-natal factors, particularly breastfeeding, on disease in later life. The event was aptly held in the UK, where work in this field has been championed by many leading investigators including McCance and Widdowson at Cambridge University and more recently by Barker and his team in Southampton. The conference attracted delegates from 32 different countries and included speakers from five continents. As well as prize lectures from eminent researchers in the field, workshops, multidisciplinary poster sessions and an update symposium on HIV and breastfeeding, the scientific programme highlighted three main topics: the biology of early life development, how breast milk and breastfeeding might 'programme' these processes and the epidemiological evidence that long-term effects exist. This report provides a summary of the talks provided within these three sessions.

Associations Between Breastfeeding Practices and Young Children's Language and Motor Skill Development

“…Children who are not breastfed are at increased risk of respiratory tract infection, otitis media, diarrhea, necrotizing enterocolitis, undernutrition, and childhood overweight. [1][2][3][4][5][6] Maternal health risks associated with not breastfeeding include increased risk of postpartum blood loss, premenopausal breast cancer, and ovarian cancer. [7][8][9] Many medical and professional groups such as the World Health Organization, the United Nations Children's Fund, the American Academy of Obstetricians and Gynecologists, the American Academy of Pediatrics (AAP), and others advocate human milk as the gold standard for infant feeding.…”

Role of human milk components in gastrointestinal development: Current knowledge and future NEEDS

“…136 In 2004, the Institute of Medicine Committee on the Evaluation of the Addition of New Ingredients to Infant Formula summarized that "infancy is a uniquely vulnerable period of rapid growth and development and as such, feeding changes have the potential to impart benefit or harm in the short term, into early childhood, and even later into adulthood." 137 Breastfeeding imparts nutritional and developmental advantages 138,139 ; thus, there is precedent for developing formulas that mimic the composition of HM as closely as possible. 140 A better understanding of the biology of HM 38 and the physiology of normal postnatal intestinal growth 114 are prerequisites to enable the selection of possible targets for formula improvement or therapies for intestinal compromise.…”

“…To fully appreciate the full potential functionality of bioactive agents within HM, we will need to assess their quantitative patterns and physical distribution in milk, whether their physical structures and functions are modified within the gastrointestinal tract, 39 their precise anatomic, cellular, and molecular targets, 141,142 and the short-and long-term biological consequences of their actions. 138,139 There is a critical need to develop and validate "relatively" non-invasive methods for assessing the impact of nutritive and non-nutritive components on the intestinal development of healthy, term human infants. Sensitive and reproducible methods also would provide the necessary tools to determine whether components added to an infant formula were efficacious in promoting neonatal intestinal development.…”

Mothers who Formula Feed: Their Practices, Support Needs and Factors Influencing their Infant Feeding Decision

“…Associations between early infant feeding method and long term health outcomes via a potential early 'programming' mechanism are well established (Stanner and Smith, 2005;Rudnicka et al, 2007). According to recent research, higher protein intakes in infant formula per kilogram (kg) of body weight, in excess of metabolic requirements, have been hypothesised to enhance weight gain in infancy and potentially contribute to increased risks for later obesity (Koletzko et al, 2009).…”