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Birth-24 Work Group 1 – Infancy: Period of Sole Nutrient Source Feeding (0-6 Months)

Each B-24 work group developed a set of topics and specific questions that might be the focus of future NEL systematic reviews, identified priority data needs (to be derived either from existing data sets, e.g., NHANES, or met with new data/surveillance) and described research priorities. 

Work Group 1 discussed infant formula and infant nutrition, including bioactive components of human milk and implications for composition of infant formulas.  Below is the list of topics and systematic review questions identified by Work Group 1 as well as the related systematic review questions. The full topic brief for Work Group 1 includes the data needs and research priorities for the topics as well as a reference list for each topic.

  • Duration of exclusive breastfeeding

    • What is the optimal duration of exclusive breastfeeding for promoting appropriate nutritional status?

    • What is the optimal duration of exclusive breastfeeding for promoting appropriate growth and development?

    • What is the optimal duration of exclusive breastfeeding for promoting appropriate cognitive, behavioral and neuromotor development?

    • What is the optimal duration of exclusive breastfeeding for preventing food allergies and asthma?

    • What is the optimal duration of exclusive breastfeeding for promoting long-term health outcomes (e.g., cardiovascular disease, hypertension, diabetes--Type I and II, obesity and inflammatory bowel disease)?

  • Relationship between breast milk composition and infant health outcomes

    • What factors in human milk affect infant growth, body composition and physical development?

    • What factors in human milk affect infant cognitive, behavioral and neuromotor development?

    • What factors in human milk affect infant’s intake self-regulation?

    • What factors in human milk affect infant’s immune function (morbidity/mortality)?

  • Delivery mechanism for human milk

    • What is the effect of human milk consumed via the breast versus bottle on infant growth and development?

    • What is the effect of human milk consumed via the breast versus bottle on infant cognitive, behavioral and neuromotor development?

    • What is the effect of human milk consumed via the breast versus bottle on infant oral health?

    • What is the effect of human milk consumed via the breast versus bottle on long-term outcomes (e.g., cardiovascular disease, hypertension, Type I and II diabetes, obesity and inflammatory bowel disease)?

  • Micronutrient supplements for breastfed infants

    • What is the impact of specific micronutrient supplements (iron, zinc, vitamin D and fluoride) for breast-fed infants on: 1) physical growth; 2) cognitive, behavioral and neuromotor development and 3) relevant health outcomes (e.g., iron and anemia)?

  • Maternal diet and allergy risk

    • What is the relationship between maternal diet during pregnancy on risk of infant allergy and asthma, celiac disease, milk “sensitivities” and infant colic?

    • What is the relationship between maternal diet during lactation on risk of infant allergy and asthma, celiac disease, milk “sensitivities” and infant colic?

  • Introduction of complementary and transitional foods into the diets of infants/toddlers in those at high risk for allergic disease

    • What is the relationship between timing of introduction of complementary foods and the development of 1) food allergies and asthma, 2) immune system, infection or inflammation, 3) atopic dermatitis 4) obesity, 5) Type I and II diabetes and 6) celiac disease among infants and toddlers?

    • What is the relationship between consuming highly allergenic complementary foods and the development of 1) food allergies and asthma, 2) immune system, infection or inflammation, 3) atopic dermatitis 4) obesity, 5) Type I and II diabetes and 6) celiac disease among infants and toddlers?

  • Infant formula

    • Which type of infant formula results in similar risk of food allergies and asthma between formula-fed infants and breastfed infants?

    • Which type of infant formula results in similar risk of diabetes mellitus between formula-fed infants and breastfed infants?

    • Which type of infant formula results in similar diet quality between formula-fed infants and breastfed infants?

  • Health outcomes in formula versus breastfed infants

    • What is the relationship between infant feeding practices (i.e., exclusive breastfeeding, exclusive formula feeding) and cognitive, behavioral or neuromotor development?

    • What is the relationship between infant feeding practices (i.e., exclusive breastfeeding, exclusive formula feeding) and immune system development, infection or inflammation?

    • What is the relationship between infant feeding practices (i.e., exclusive breastfeeding, exclusive formula feeding) and overweight/obesity?

  • Type of human milk consumed

    • Insufficient data exist to support any systematic reviews at this time.

  • How is infant appetite regulated?

    • What infant cues of development readiness for complementary foods should be used to determine timing of introduction of complementary foods?

    • What factors in the infant diet and environment impact appetite regulation in infants?

    • What is the impact of appetite regulation on infant health, including growth and physical development, and cognitive, behavioral or neuromotor development?

Additional topics considered by this work group related to factors influencing infant appetite and the infant microbiome. However, questions were not drafted due to insufficient data to support any systematic reviews at this time.