Human Milk Micronutrients and Child Growth and Body Composition in the First 2 years: A Systematic Review

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

Human milk (HM) provides a plethora of nutritional and non-nutritional compounds that support infant development. For many compounds, concentrations vary substantially among mothers and across lactation, and their impact on infant growth is poorly 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 infants. Outcomes included weight-for-length, length-for-age, weight-for-age, body mass index (in kg/m2)–for–age, and growth velocity. From 9992 abstracts screened, 144 articles were included and categorized based on their reporting of HM micronutrients, macronutrients, or bioactive components. Micronutrients (vitamins and minerals) are reported here, based on 28 articles involving 2526 mother-infant dyads. Studies varied markedly in their designs, sampling times, geographic and socioeconomic settings, reporting practices, and the HM analytes and infant anthropometrics measured. Meta-analysis was not possible because data were sparse for most micronutrients. The most-studied minerals were zinc (15 articles, 1423 dyads) and calcium (7 articles, 714 dyads). HM iodine, manganese, calcium, and zinc concentrations were positively associated with several outcomes (each in ≥2 studies), whereas magnesium (in a single study) was negatively associated with linear growth during early lactation. However, few studies measured HM intake, adjusted for confounders, provided adequate information about complementary and formula feeding, or adequately described HM collection protocols. Only 4 studies (17%) had high overall quality scores. The biological functions of individual HM micronutrients are likely influenced by other HM components; yet, only 1 study analyzed data from multiple micronutrients simultaneously, and few addressed other HM components. Thus, available evidence on this topic is largely inconclusive and fails to address the complex composition of HM. High-quality research employing chronobiology and systems biology approaches is required to understand how HM components work independently and together to influence infant growth and to identify new avenues for future maternal, newborn, or infant nutritional interventions.

OriginalsprogEngelsk
Artikelnummer100082
TidsskriftAdvances in Nutrition
Vol/bind15
Udgave nummer1
Antal sider17
ISSN2161-8313
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
SMR, MB, and MBA have contributed to online courses on breast milk and the infant microbiome produced by Microbiome Courses. SMR is a former employee of Prolacta Bioscience and has also served as the scientific advisor for SimpliFed and a consultant for TraverseScience. Her contribution to this review occurred prior to these engagements. 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. DTG 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 Canadian Institute for Advanced Research (CIFAR) Fellow in the Humans and the Microbiome Program; she has consulted for DSM and is a scientific advisor to TinyHealth. All other authors report no conflicts of interest.

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

Publisher Copyright:
© 2023 The Authors

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