Challenges of infant nutrition research: a commentary.

Alan S Ryan,William W Hay

doi:10.1186/s12937-016-0162-0

Abstract

Considerable advances have been made in the field of infant feeding research. The last few decades have witnessed the expansion in the number of studies on the composition and benefits of human milk. The practice of breastfeeding and use of human milk represent today’s reference standards for infant feeding and nutrition. Additional research regarding the benefits of breastfeeding is needed to determine which factors in human milk and in the act of breastfeeding itself, singly or in combination, are most important for producing the beneficial effects on infant growth, body composition, and neurodevelopmental outcome. We examine evidence that breastfeeding confers health benefits and offer suggestions on how best to interpret the data and present it to the public. We also describe some examples of well-designed infant nutrition studies that provide useful and clinically meaningful data regarding infant feeding, growth, and development. Because not all mothers choose to breastfeed or can breastfeed, other appropriate feeding options should be subjected to critical review to help establish how infant formula and bottle feeding can confer benefits similar to those of human milk and the act of breastfeeding. We conclude with the overarching point that the goal of infant feeding research is to promote optimal infant growth and development. Since parents/families may take different paths to feeding their infants, it is fundamental that health professionals understand how best to interpret research studies and their findings to support optimal infant growth and development.

Highlights

In 2020, the U.S Dietary Guidelines for Americans will for the first time include recommendations for nutrition of healthy infants and young children, as mandated by the Agricultural Act of 2014 [1]
We examine the weight of evidence linking human milk and the act of breastfeeding to specific health benefits, and describe some of the inherent limitations of infant feeding research involving both human milk and infant formulas
A different human milk-fed group is used for comparison as a control, not all studies are careful to select a different comparison group to be as close to the study group as possible in all other factors

Summary

Introduction

In 2020, the U.S Dietary Guidelines for Americans will for the first time include recommendations for nutrition of healthy infants and young children, as mandated by the Agricultural Act of 2014 [1]. The most obvious problem in neonatal nutrition is that while the randomized clinical trial (RCT) is the most scientific and rigorous method to evaluate the efficacy of human milk feeding and the act of breastfeeding on selected outcomes (neurodevelopment, body composition, etc.), it is impossible to conduct an RCT comparing human milk-fed vs formula-fed infants, because it is unethical to randomly assign infants to a breast-fed or formula-fed treatment group.

Results

Conclusion