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The Role of Feeding Practice and Early Nutrition in Infant Growth, Metabolism and Body Composition

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: closed (15 November 2022) | Viewed by 16640

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Special Issue Editors

Prof. Dr. Ferdinand Haschke

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Guest Editor

Visiting Professor, Dept Pediatrics, Paracelsus Medical University, Salzburg, Austria
Interests: early nutrition; growth; body composition; human milk; maternal health; nutritional supplements; probiotics

Prof. Dr. Nadja Haiden

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Guest Editor

Department of Clinical Pharmacology, Medical University of Vienna, Wien, Austria
Interests: preterm infants; parenteral nutrition; body composition; human milk composition; donor milk; necrotizing enterocolitis; microbiota; micrombiome
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Special Issue Information

Dear Colleagues,

The purpose of this issue is to evaluate long-term effects of early nutrition on quantitative and qualitative growth and metabolic outcome. Early malnutrition (e.g., stunting, obesity) can be associated with many adverse health outcomes, such as cardiovascular and metabolic-disease-related comorbidities later in life. Genome, epigenome, microbiome, and environmental conditions interact with nutrition and growth. Extremely, very, and low-birthweight infants are a heterogenous and vulnerable group, and long-term studies on the effect of parenteral and enteral nutrition during the first months on body composition, metabolic outcome, and micronutrient status are still scarce. In particular, those preterm infants who are initially fed fortified (banked) human milk and subsequently breastfed according to the recommendations need to be followed up on. Term infants should be offered for taste development a variety of weaning foods starting at 4 to 6 months of age, but recent studies indicate that high animal (cow’s milk) protein intake and frequent exposure to ultra-processed foods and sugary drinks during the first 2 years is associated with higher BMI and % body fat during later childhood and adolescence. We invite authors to contribute to this issue by submitting their original work, systematic analyses, and reviews related to the topic.

Prof. Dr. Ferdinand Haschke
Prof. Dr. Nadja Haiden
Guest Editors

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Keywords

early nutrition
growth
body composition
malnutrition
gut
microbiome
preterm infants
immunity
obesity
micronutrients
stunting
human milk
breastfeeding

Published Papers (7 papers)

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Editorial

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4 pages, 186 KiB

Open AccessEditorial

Early Nutrition Must Be Safe and Should Have Positive Impacts on Long-Term Health

by Nadja Haiden and Ferdinand Haschke

Nutrients 2023, 15(12), 2645; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15122645 - 06 Jun 2023

Cited by 2 | Viewed by 937

Abstract

The Special Issue entitled ‘The Role of Feeding Practice and Early Nutrition in Infant Growth, Metabolism and Body Composition’ examines the long-term outcomes of early nutrition in both preterm and term infants [...] Full article

(This article belongs to the Special Issue The Role of Feeding Practice and Early Nutrition in Infant Growth, Metabolism and Body Composition)

Research

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11 pages, 628 KiB

Open AccessArticle

Effect of Docosahexaenoic Acid (DHA) Supplementation of Preterm Infants on Growth, Body Composition, and Blood Pressure at 7-Years Corrected Age: Follow-Up of a Randomized Controlled Trial

by Karen P. Best, Thomas R. Sullivan, Anoja W. Gunaratne, Jacqueline F. Gould, Robert A. Gibson, Carmel T. Collins, Maria Makrides and Tim J. Green

Nutrients 2023, 15(2), 335; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15020335 - 10 Jan 2023

Cited by 3 | Viewed by 3205

Abstract

Aim: To determine if supplementation of infants born <33 weeks’ gestation with higher dose docosahexaenoic acid (DHA) affects growth, body composition, and blood pressure at 7 y corrected age (CA) and if treatment effects differed by infant sex at birth and birth weight strata (<1250 and ≥1250 g). Methods: Seven-year follow-up of an Australian multicenter randomized controlled trial in which 657 infants were fed high-DHA (≈1% total fatty acids) enteral feeds or standard-DHA (≈0.3% total fatty acids) from age 2–4 d until term CA. Seven-year CA outcomes were growth (weight, height), body composition (lean body mass, fat mass, waist, and hip circumference), and blood pressure. Results: There was no effect of high-DHA enteral feeds compared with standard-DHA on growth, body composition, and blood pressure at 7-year CA either overall or in subgroup analysis by sex. There was a significant interaction between high-DHA and birthweight strata on height at 7-y CA (p = 0.03). However, the post-hoc analyses by birthweight strata did not reach significance (p > 0.1). High-DHA group infants were more likely to be classified as obese (relative risk 1.6 (95% CI 1.0, 2.6); p = 0.05). Conclusions: DHA supplementation of premature infants did not affect growth, body composition, or blood pressure at 7-year CA overall by sex and birthweight strata. The finding of a higher risk of obesity in children who receive high-DHA needs to be interpreted with caution due to the small number of children classified as obese. Full article

(This article belongs to the Special Issue The Role of Feeding Practice and Early Nutrition in Infant Growth, Metabolism and Body Composition)

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9 pages, 263 KiB

Open AccessArticle

Neonatal Morbidities and Feeding Tolerance Outcomes in Very Preterm Infants, before and after Introduction of Probiotic Supplementation

by Ayoub Mitha, Sofia Söderquist Kruth, Sara Bjurman, Alexander Rakow and Stefan Johansson

Nutrients 2022, 14(17), 3646; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14173646 - 03 Sep 2022

Cited by 6 | Viewed by 3522

Abstract

While probiotics are reported to reduce the risks of neonatal morbidities, less is known about probiotics and feeding tolerance. With this retrospective cohort study, we investigate whether introduction of probiotic supplementation as the standard of care was associated with fewer neonatal morbidities and improved feeding tolerance in very preterm infants. Using the Swedish Neonatal Quality Register, 345 live-born very preterm infants (28–31 weeks’ gestation), from January 2019–August 2021, in NICUs in Stockholm, Sweden, either received probiotic supplementation (Bifidobacterium infantis, Bifidobacterium lactis, Streptococcusthermophilus) (139) or no supplementation (206); they were compared regarding a primary composite outcome of death, sepsis, and/or necrotising enterocolitis and secondary outcomes: time to full enteral feeding and antibiotics use. Probiotics seemed associated with a reduced risk of the composite outcome (4.3% versus 9.2%, p = 0.08). In the subgroup of 320 infants without the primary outcome, probiotics were associated with shorter time to full enteral feeding (6.6 days versus 7.2 days) and less use of antibiotics (5.2 days versus 6.1 days). Our findings suggest that probiotics improve feeding tolerance and further support that very preterm infants may benefit from probiotic supplementation. Full article

(This article belongs to the Special Issue The Role of Feeding Practice and Early Nutrition in Infant Growth, Metabolism and Body Composition)

9 pages, 477 KiB

Open AccessArticle

Preterm Infants on Early Solid Foods and Vitamin D Status in the First Year of Life—A Secondary Outcome Analysis of a Randomized Controlled Trial

by Margarita Thanhaeuser, Fabian Eibensteiner, Margit Kornsteiner-Krenn, Melanie Gsoellpointner, Sophia Brandstetter, Ursula Koeller, Wolfgang Huf, Mercedes Huber-Dangl, Christoph Binder, Alexandra Thajer, Bernd Jilma, Angelika Berger and Nadja Haiden

Nutrients 2022, 14(15), 3105; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14153105 - 28 Jul 2022

Cited by 2 | Viewed by 1359

Abstract

Preterm birth places infants at high risk for mineral and micronutrient deficiencies important for bone health. The aim of this study was to examine whether two timepoints for the introduction of solid foods in preterm infants have an impact on vitamin D status in the first year of life. This is a secondary outcome analysis of a prospective, randomized trial on very low birth weight (VLBW) infants, randomized to an early (10–12th week corrected age) or a late (16–18th week corrected age) complementary-feeding group. Vitamin D status was assessed by blood samples taken at 6 weeks, 6, and 12 months corrected age. In total, 177 infants were randomized (early group: n = 89, late group: n = 88). There was a tendency toward lower levels of serum 25-OH-vitamin D in the early group throughout the first year of life (p = not significant (n.s.)); no differences were detected in the other parameters. At 6 months corrected age, infants of the early group had a significantly higher incidence of vitamin D deficiency. The timepoint of the introduction of solid foods had no impact on the serum 25-OH-vitamin D levels and other parameters important for bone health but showed a tendency toward lower levels in the early-feeding group. Full article

(This article belongs to the Special Issue The Role of Feeding Practice and Early Nutrition in Infant Growth, Metabolism and Body Composition)

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11 pages, 629 KiB

Open AccessArticle

Preterm Infants on Early Solid Foods and Iron Status in the First Year of Life—A Secondary Outcome Analysis of a Randomized Controlled Trial

by Margarita Thanhaeuser, Fabian Eibensteiner, Margit Kornsteiner-Krenn, Melanie Gsoellpointner, Sophia Brandstetter, Renate Fuiko, Ursula Koeller, Wolfgang Huf, Mercedes Huber-Dangl, Christoph Binder, Alexandra Thajer, Bernd Jilma, Angelika Berger and Nadja Haiden

Nutrients 2022, 14(13), 2732; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14132732 - 30 Jun 2022

Cited by 2 | Viewed by 1712

Abstract

Introduction of solid foods and iron status in the first year of life of preterm infants are highly discussed topics. The aim of this study was to examine whether two timepoints of introduction of standardized solid foods in preterm infants have an impact on ferritin and other hematologic parameters important for iron status in the first year of life. This is a secondary outcome analysis of a prospective, randomized intervention trial in very low birth weight (VLBW) infants randomized to an early (10–12th week corrected age) or a late (16–18th week corrected age) complementary feeding group. Iron status was assessed with blood samples taken at 6 weeks, 6 months, and 12 months corrected age. In total, 177 infants were randomized (early group: n = 89, late group: n = 88). Ferritin showed no differences between study groups throughout the first year of life, as did all other parameters associated with iron status. At 12 months corrected age, the incidence of iron deficiency was significantly higher in the early feeding group. There is room for improvement of iron status in VLBW preterm infants, regular blood checks should be introduced, and current recommendations may need to be a reconsidered. Full article

(This article belongs to the Special Issue The Role of Feeding Practice and Early Nutrition in Infant Growth, Metabolism and Body Composition)

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13 pages, 346 KiB

Open AccessArticle

IQ Was Not Improved by Post-Discharge Fortification of Breastmilk in Very Preterm Infants

by Anja Klamer, Line H. Toftlund, Kristjan Grimsson, Susanne Halken and Gitte Zachariassen

Nutrients 2022, 14(13), 2709; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14132709 - 29 Jun 2022

Cited by 3 | Viewed by 2403

Abstract

(1) Very preterm infants are at increased risk of cognitive deficits, motor impairments, and behavioural problems. Studies have tied insufficient nutrition and growth to an increased risk of neurodevelopmental impairment; (2) Methods: Follow-up study on cognitive and neuropsychological development at 6 years corrected age (CA) in 214 very preterm infants, including 141 breastfed infants randomised to mother’s own milk (MOM) with (F-MOM) or without (U-MOM) fortification and 73 infants fed a preterm formula (PF-group), from shortly before discharge to 4 months CA. Infants with serious congenital anomalies or major neonatal morbidities were excluded prior to intervention. The Wechsler Intelligence Scale for Children IV was used for cognitive testing, and the children’s parents completed the Five to Fifteen Questionnaire (FTF); (3) Results: Post-discharge fortification of MOM did not improve either full-scale intelligence quotient (FSIQ) with a median of 104 vs. 105.5 (p = 0.29), subdomain scores, or any domain score on the FTF questionnaire. Compared to the PF group, the MOM group had significantly better verbal comprehension score with a median of 110 vs. 106 (p = 0.03) and significantly better motor skills scores on the FTF questionnaire (p = 0.01); (4) Conclusions: The study supports breastfeeding without fortification as post-discharge nutrition in very preterm infants, and it seems superior to preterm formula. Full article

(This article belongs to the Special Issue The Role of Feeding Practice and Early Nutrition in Infant Growth, Metabolism and Body Composition)

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Review

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25 pages, 1530 KiB

Open AccessReview

Effect of Fortified Formula on Growth and Nutritional Status in Young Children: A Systematic Review and Meta-Analysis

by Paige G. Brooker, Megan A. Rebuli, Gemma Williams and Beverly S. Muhlhausler

Nutrients 2022, 14(23), 5060; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14235060 - 28 Nov 2022

Cited by 4 | Viewed by 2696

Abstract

Previous reviews of the effect of young child formulas on health outcomes in infants and toddlers have been inconclusive. In this study, we undertook a contemporary synthesis of studies investigating the effects of consuming fortified milk beverages (compared to cow’s milk or unfortified comparator formula) on growth and/or nutritional status in children 1–3 years of age. Five electronic databases were searched (PubMed, Web of Science, Scopus, ProQuest, and Cochrane Library) for randomised controlled trials comparing fortified milk against control milk in young children (9–48 months), published between January 1990 and June 2022. Outcomes were growth, body composition, biochemical markers, and/or nutritional status. Mean differences (MD) were pooled using random-effects meta-analysis where there were ≥3 studies. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Nineteen articles (12 studies; n = 4795) met the inclusion criteria. Heterogeneity was substantial, likely attributable to considerable variation in study characteristics. Fortified milk was associated with increased weight gain (MD = 0.14 kg [95% CI 0.06, 021], p = 0.0003) compared with control milk. Subgroup analyses demonstrated increases in weight in lower-income countries, and in studies with intervention periods > 6 months. There were no effects of fortified milks on other anthropometric measures. Haemoglobin (MD = 3.76 g/L [95% CI 0.17, 7.34], p = 0.04) and ferritin (MD = 0.01 nmol/L [95% CI 0.00, 0.02], p = 0.02) concentrations were increased in infants consuming fortified milks. Fortified milk beverages appear to offer a safe and acceptable source of complementary nutrition as a short-term strategy for addressing nutritional deficits and may modestly promote weight gain in vulnerable populations when provided for periods > 6 months. This study was prospectively registered with PROSPERO (CRD42022339920) and funded by the Infant Nutrition Council. Full article

(This article belongs to the Special Issue The Role of Feeding Practice and Early Nutrition in Infant Growth, Metabolism and Body Composition)

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