Early Life Feeding Research Articles

Associations of Feeding Practices in Early Life and Dietary Intake at School Age with Obesity in 10- to 12-Year-Old Arab Children.

Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age as determinants of obesity in children aged 10–12 years. In an earlier study of 233 healthy infants in two Arab towns in northern Israel, neonatal history, feeding practices, and health information were obtained up to age 18 months. This follow-up study assessed dietary intake and anthropometric measurements at age 10–12 years using the 24 h recall method. Overall, 174 children participated in this study. Almost all (98%) the children were breastfed. The prevalence of obesity at school age was 42%. A multivariable model adjusted for energy intake and socioeconomic status showed positive associations of total fat intake and of weight-for-height z score, but not feeding practices in infancy, with obesity. Higher gestational age at birth was associated with lower odds of obesity at age 10–12 years. In conclusion, in a population with near universal breastfeeding, gestational age at birth, weight indicators but not feeding practices in infancy, and total fat intake at school age were associated with increased likelihood of obesity.

Impact of early-life feeding on local intestinal microbiota and digestive system development in piglets

Early-life gut microbial colonisation is known to influence host physiology and development, shaping its phenotype. The developing gastro-intestinal tract of neonatal piglets provides a “window of opportunity” for programming their intestinal microbiota composition and corresponding intestinal development. Here, we investigated the impact of early feeding on jejunum and colon microbiota composition, and intestinal maturation in suckling piglets. From two days of age, early-fed (EF; n = 6 litters) piglets had access to solid feed containing a mixture of fibres till weaning (day29) in addition to sow’s milk, whereas the control (CON; n = 6 litters) piglets exclusively fed on sow’s milk. Early feeding elicited a significant impact on the colon microbiota, whereas no such effect was seen in the jejunal and ileal microbiota. Quantified eating behavioural scores could significantly explain the variation in microbiota composition of EF piglets and support their classification into good, moderate, and bad eaters. Members of the Lachnospiraceae family, and the genera Eubacterium, Prevotella, and Ruminococcus were quantitatively associated with eating scores. EF piglets were found to have a decreased pH in caecum and colon, which coincided with increased short-chain fatty acid (SCFA) concentrations. Moreover, they also had increased weights and lengths of several intestinal tract segments, as well as a decreased villus-crypt ratio in jejunal mucosa and an increased abundance of proliferative cells in colon mucosa. The approaches in this study indicate that early feeding of a mixed-fibre (pre-weaning) diet changes the microbiota composition, pH, and fermentation products in the distal gut of piglets, while it also alters both macroscopic and microscopic intestinal measurements. These results exemplify the potential of early feeding to modulate intestinal development in young piglets.

Long-Chain Polyunsaturated Fatty Acids (LCPUFAs) and the Developing Immune System: A Narrative Review.

The immune system is complex: it involves many cell types and numerous chemical mediators. An immature immune response increases susceptibility to infection, whilst imbalances amongst immune components leading to loss of tolerance can result in immune-mediated diseases including food allergies. Babies are born with an immature immune response. The immune system develops in early life and breast feeding promotes immune maturation and protects against infections and may protect against allergies. The long-chain polyunsaturated fatty acids (LCPUFAs) arachidonic acid (AA) and docosahexaenoic acid (DHA) are considered to be important components of breast milk. AA, eicosapentaenoic acid (EPA) and DHA are also present in the membranes of cells of the immune system and act through multiple interacting mechanisms to influence immune function. The effects of AA and of mediators derived from AA are often different from the effects of the n-3 LCPUFAs (i.e., EPA and DHA) and of mediators derived from them. Studies of supplemental n-3 LCPUFAs in pregnant women show some effects on cord blood immune cells and their responses. These studies also demonstrate reduced sensitisation of infants to egg, reduced risk and severity of atopic dermatitis in the first year of life, and reduced persistent wheeze and asthma at ages 3 to 5 years, especially in children of mothers with low habitual intake of n-3 LCPUFAs. Immune markers in preterm and term infants fed formula with AA and DHA were similar to those in infants fed human milk, whereas those in infants fed formula without LCPUFAs were not. Infants who received formula plus LCPUFAs (both AA and DHA) showed a reduced risk of allergic disease and respiratory illness than infants who received standard formula. Studies in which infants received n-3 LCPUFAs report immune differences from controls that suggest better immune maturation and they show lower risk of allergic disease and respiratory illness over the first years of life. Taken together, these findings suggest that LCPUFAs play a role in immune development that is of clinical significance, particularly with regard to allergic sensitisation and allergic manifestations including wheeze and asthma.

Integrating genetics with newborn metabolomics in infantile hypertrophic pyloric stenosis

IntroductionInfantile hypertrophic pyloric stenosis (IHPS) is caused by hypertrophy of the pyloric sphincter muscle.ObjectivesSince previous reports have implicated lipid metabolism, we aimed to (1) investigate associations between IHPS and a wide array of lipid-related metabolites in newborns, and (2) address whether detected differences in metabolite levels were likely to be driven by genetic differences between IHPS cases and controls or by differences in early life feeding patterns.MethodsWe used population-based random selection of IHPS cases and controls born in Denmark between 1997 and 2014. We randomly took dried blood spots of newborns from 267 pairs of IHPS cases and controls matched by sex and day of birth. We used a mixed-effects linear regression model to evaluate associations between 148 metabolites and IHPS in a matched case–control design.ResultsThe phosphatidylcholine PC(38:4) showed significantly lower levels in IHPS cases (P = 4.68 × 10−8) as did six other correlated metabolites (four phosphatidylcholines, acylcarnitine AC(2:0), and histidine). Associations were driven by 98 case–control pairs born before 2009, when median age at sampling was 6 days. No association was seen in 169 pairs born in 2009 or later, when median age at sampling was 2 days. More IHPS cases than controls had a diagnosis for neonatal difficulty in feeding at breast (P = 6.15 × 10−3). Genetic variants known to be associated with PC(38:4) levels did not associate with IHPS.ConclusionsWe detected lower levels of certain metabolites in IHPS, possibly reflecting different feeding patterns in the first days of life.

Long-term growth patterns in children born with cleft lip and/or palate. A systematic review.

Introduction: in children with cleft lip and/or palate nutritional status and growth may be impaired due to early life feeding difficulties. Objective: to review the existing literature on the nutritional prognosis during childhood of patients undergoing surgery for cleft lip and/or palate (CLP), their body composition and growth patterns from 2 to 10 years of age, and the possible effects of their early nutritional status on the long-term onset of overweight. Methods: a systematic search of growth and body composition parameters in 2-10 year-old CLP children, including cross-sectional and longitudinal studies, and using the Pubmed and Scopus databases. From the 2,983 retrieved articles, 6 were finally included. Results: two studies out of 6 were longitudinal and the other 4 were cross-sectional, including very heterogeneous samples. Weight and height were used as growth parameters in 2 studies; 2 studies used body mass index (BMI); and the remaining 2 used indexes of nutritional status derived from anthropometric measures. The studies showed discrepancies among results: 3 of them found growth differences between children with CLP and their counterparts, whereas the other 3 did not. The two longitudinal studies did not show any significant differences between the mean BMI z-scores or growth curves of cleft patients and their counterparts. When differences existed, the most affected group was that under 5 years, syndromic children, and adopted children with CL/P. Conclusions: the literature is scarce comparing growth patterns between children with CLP and controls, and results cannot confirm that children with CLP aged 2-10 years, excluding those with syndromes or belonging to vulnerable populations, have different growth patterns or a worse nutritional status than their counterparts.

Effects of early nutrition and sanitary conditions on antibody levels in early and later life of broiler chickens

Immune maturation of broiler chickens may be affected by management, such as early life feeding strategy (early versus delayed nutrition) or by low or high sanitary conditions (LSC versus HSC). We compared systemic maternal (MAb), natural (NAb), natural auto- (NAAb), and antigen specific antibody (SpAb) levels (IgM, IgY) between broilers (n = 48 per treatment) that received early (EN) or delayed nutrition for 72 h (DN) housed in either low (LSC) or high sanitary conditions (HSC) between 7 and 35 d of age. We found minimal interactions between feeding strategy and sanitary conditions. At 7 d of age, broilers receiving EN compared with DN, had elevated levels of IgM binding keyhole limpet hemocyanin (KLH), phosphoryl-conjugated ovalbumin (PC-OVA), and muramyl dipeptide (MDP), whereas effects of feeding strategy diminished at later ages. In LSC compared with HSC broilers, levels of NAb agglutinating RRBC and sheep red blood cells (SRBC) were already elevated from 14 d of age onwards. At 33 d of age, antibody levels (NAb, NAAb, anti-LPS, anti-MDP) were all elevated in LSC, compared with HSC broilers, for both IgM and IgY, but not IgM against KLH. Western blotting revealed different binding patterns of NAAb against chicken liver homogenate, which may indicate that the NAAb repertoire is affected by antigenic pressure. Our data suggest that antibody levels are affected for an important part by environmental conditions (feeding strategy and sanitary conditions), but minimally by their interaction. However, it remains to be further studied whether the enhanced levels of antibodies as initiated by EN and LSC contribute to enhanced resistance to infectious diseases.

Phenotypic and genetic correlations of beef replacement heifer feeding behaviour, feed intake and feed efficiency with cow performance and lifetime productivity.

Objectives were to quantify the phenotypic (rp ) and genetic (rg ) correlations between early-life feeding behaviours, dry matter intake, and feed efficiency and measures of cow performance and lifetime productivity traits. Traits were measured on 1,145 crossbred replacement beef heifers and then on cows over parities one to four. Feeding event duration (FD) was phenotypically correlated with cow prebreeding body weight (PBWT; rp 0.29-0.45), cow prebreeding back fat thickness (PBBF; rp 0.35-0.49), progeny weaning weight (WW; rp 0.09-0.31) and progeny birthweight (BW; rp -0.06 to 0.17). Feeding event frequency (FF) was phenotypically correlated with PBBF (rp 0.16-0.30). Dry matter intake (DMI) was phenotypically correlated with PBWT (rp 0.16-0.20) and PBBF (rp -0.22 to -0.05). Feeding event duration was genetically correlated with PBWT (rg 0.38-0.41). Feeding event frequency was genetically correlated with PBWT (rg -0.43 to -0.39). Dry matter intake was genetically correlated with PBWT (rg -0.27 to 0.14). Days in herd (DIH) was phenotypically correlated with FD and DMI (rp =0.12, 0.20, respectively). Lifetime productivity was phenotypically correlated with FD and FF (rg =0.25, 0.22, respectively). Calving interval was phenotypically correlated with FD and FF (rp =-0.12, -0.14, respectively) and genetically correlated with FF (rg =-0.41). Due to moderate positive correlations with cow weight, caution would be required in selection to prevent an increase in mature cow size. Use of FF, FD, DMI and a measure of feed efficiency such as residual feed intake adjusted for back fat (RFIFAT ) in a balanced selection index is recommended.

Infant Feeding Practices and Subsequent Dietary Patterns of School-Aged Children in a US Birth Cohort

BackgroundInfant feeding practices are thought to shape food acceptance and preferences. However, few studies have evaluated whether these affect child diet later in life. ObjectiveThe study objective was to examine the association between infant feeding practices and dietary patterns (DPs) in school-aged children. DesignA secondary analysis of data from a diverse prospective birth cohort with 10 years of follow-up (WHEALS [Wayne County Health Environment Allergy and Asthma Longitudinal Study]) was conducted. Participants/settingChildren from the WHEALS (Detroit, MI, born 2003 through 2007) who completed a food screener at age 10 years were included (471 of 1,258 original participants). Main outcome measuresThe main outcome was DPs at age 10 years, identified using the Block Kids Food Screener. Statistical analysis performedLatent class analysis was applied for DP identification. Breastfeeding and age at solid food introduction were associated with DPs using a 3-step approach for latent class modeling based on multinomial logistic regression models. ResultsThe following childhood DPs were identified: processed/energy-dense food (35%), variety plus high intake (41%), and healthy (24%). After weighting for loss to follow-up and covariate adjustment, compared with formula-fed children at 1 month, breastfed children had 0.41 times lower odds of the processed/energy-dense food DP vs the healthy DP (95% CI 0.14 to 1.25) and 0.53 times lower odds of the variety plus high intake DP (95% CI 0.17 to 1.61), neither of which were statistically significant. Results were similar, but more imprecise, for breastfeeding at 6 months. In addition, the association between age at solid food introduction and DP was nonsignificant, with each 1-month increase in age at solid food introduction associated with 0.81 times lower odds of the processed/energy-dense food DP relative to the healthy DP (95% CI 0.64 to 1.02). ConclusionsA significant association between early life feeding practices and dietary patterns at school age was not detected. Large studies with follow-up beyond early childhood that can also adjust for the multitude of potential confounders associated with breastfeeding are needed.

Soy-Based Infant Formula is Associated with an Increased Prevalence of Comorbidities in Fragile X Syndrome.

A large number of adults and children consume soy in various forms, but little information is available regarding potential neurological side effects. Prior work indicates an association between the consumption of soy-based diets and seizure prevalence in mouse models of neurological disease and in children with autism. Herein, we sought to evaluate potential associations between the consumption of soy-based formula during infancy and disease comorbidities in persons with fragile X syndrome (FXS), while controlling for potentially confounding issues, through a retrospective case-control survey study of participants with FXS enrolled in the Fragile X Online Registry with Accessible Research Database (FORWARD). There was a 25% usage rate of soy-based infant formula in the study population. We found significant associations between the consumption of soy-based infant formula and the comorbidity of autism, gastrointestinal problems (GI) and allergies. Specifically, there was a 1.5-fold higher prevalence of autism, 1.9-fold GI problems and 1.7-fold allergies in participants reporting the use of soy-based infant formula. The major reason for starting soy-based infant formula was GI problems. The average age of seizure and allergy onset occurred long after the use of soy-based infant formula. We conclude that early-life feeding with soy-based infant formula is associated with the development of several disease comorbidities in FXS.

Childhood growth prior to screen-detected celiac disease: prospective follow-up of an at-risk birth cohort

Objectives To determine the association between childhood growth prior to the development of celiac disease (CD) and CD autoimmunity (CDA) identified by periodic serological screening. Study design The Diabetes Autoimmunity Study in the Young cohort includes 1979 genetically at-risk children from Denver, Colorado, with annual growth measurements from age nine months until ten years. Between 1993 and February 2019, 120 children developed CDA defined by persistent positive tissue transglutaminase autoantibodies (TGA); among these, 71 met our criteria for CD based on histopathological findings or high TGA levels. Age- and sex-specific z-scores of weight, body mass index (BMI), and height prior to seroconversion were derived using US reference charts as standards. Joint modeling of serial growth measurements was used to estimate adjusted hazard ratios (aHRs) accounting for celiac-associated human leukocyte antigens, early-life feeding practices, and socio-demographics. Results In the first 10 years of life, there were no significant associations between the child’s current weight, BMI and height and the risk of screening-detected CDA or CD, neither was the weight nor BMI velocity associated with CDA or CD as identified by screening (all aHRs approximated 1). Increased height velocity was associated with later CD, but not CDA, development (aHR per 0.01-z score/year, 1.28; 95% confidence interval [CI] 1.18–1.38 and 1.03; 0.97–1.09, respectively). Conclusions In the first 10 years of life, from prospectively collected serial growth measurements, we found no evidence of impaired childhood growth before CD and CDA development as identified through early and periodic screening.

12q14.3 microdeletion involving HMGA2 gene cause a Silver-Russell syndrome-like phenotype: a case report and review of the literature

BackgroundSilver-Russell Syndrome (SRS) is a genetic disorder characterized by intrauterine and postnatal growth restriction and normal head circumference with consequent relative macrocephaly. Addictional findings are protruding forehead in early life, body asymmetry (of upper and lower limbs) and substantial feeding difficulties. Although several genetic mechanisms that cause the syndrome are known, more than 40% of patients with a SRS-like phenotype remain without an etiological diagnosis. In the last few years, different clinical reports have suggested that mutations or deletions of the HMGA2 gene can be responsible for a SRS-like phenotype in patients with negative results of the common diagnostic tests for this syndrome.Case presentationWe present a 3-year-old male patient with clinical diagnosis of Silver-Russell Syndrome (SRS) associated with a de novo heterozygous deletion of the long arm of the chromosome 12 (12q14.3) encompassing the HMGA2 gene.ConclusionsOur report confirms the etiological role of HMGA2 as a disease gene in the development of a SRS-like phenotype.

1263-P: Nutritional Reprogramming of Hepatic Metabolism by Feeding a Diet Containing Large, Phospholipid-Coated Lipid Droplets in Early Life Protects against Western Style Diet–Induced Insulin Resistance in Adult Mice

Early life nutrition possibly influences long-term metabolic outcomes. Previous studies in mice showed that adult obesity and energy metabolism can be improved by early life exposure to an infant milk formula (IMF) with large (3-5μm), (milk)-phospholipid coated lipid droplets (Concept diet, Nuturis®). This study examined the effects of the Concept diet on (adult) fasting insulin sensitivity and hepatic mitochondrial capacity. From postnatal day (PN) 16 to PN42, male C57BL/6j mice were exposed to a semisynthetic rodent diet containing Concept or Control (CTRL)-IMF. Subsequently, mice were fed either Western-style (WSD) or standard rodent diet (AIN) from PN42 to PN98 and sacrificed after 3 hours fasting, at PN98. Homeostasis model assessment insulin resistance index (HOMA-IR) was calculated from fasting insulin and glucose levels. Mitochondrial function was assessed by high-resolution respirometry in liver tissue at PN98 using substrates stimulating β-oxidation (β-OX) and tricarboxylic acid cycle (TCA) flux. Plasma thiobarbituric acid reactive substances (TBARS), a marker of lipid peroxidation, were measured fluorometrically. At PN98, WSD induced insulin resistance in CTRL, but not in Concept fed mice (p<0.05). Furthermore, Concept mice on WSD had a lower liver weight (p<0.05) and 69% higher maximal β-OX compared to CTRL (p<0.05). Liver fat content increased with WSD independent of initial diet (p<0.05) and was not different between CTRL and Concept groups. Yet, plasma TBARS were 23% lower in Concept compared to CTRL mice fed WSD (p<0.05). In conclusion, early life feeding of the Concept diet improved hepatic oxidative capacity and protected adult mice against diet-induced insulin resistance. These results suggest that early postnatal metabolic priming may decrease systemic oxidative damage which can help to maintain liver health in an obesogenic environment. Disclosure T. Jelenik: Employee; Self; Boehringer Ingelheim Pharmaceuticals, Inc. A. Kodde: Employee; Self; Danone Nutricia Research. D. Pesta: None. E. Rohbeck: None. B. Dewidar: None. E. Phielix: None. A. Oosting: Employee; Self; Danone Nutricia Research. E.M. van der Beek: Employee; Self; Danone Nutricia Research. M. Roden: Advisory Panel; Self; Servier. Board Member; Self; Poxel SA. Consultant; Self; Eli Lilly and Company, Gilead Sciences, Inc., ProSciento, TARGET PharmaSolutions. Research Support; Self; Boehringer Ingelheim International GmbH, Novartis Pharma K.K., Sanofi US. Speaker’s Bureau; Self; Novo Nordisk A/S. Funding Danone Nutricia Research

Newborn feeding recommendations and practices increase the risk of development of overweight and obesity

BackgroundThe prevalence of obesity among infants less than 2 years of age has increased by more than 60% over the last three decades. Obese infants and toddlers are at an increased risk for staying overweight into adolescence and adulthood. Metabolic programming has been demonstrated in animal models whereby early life feeding habits result in life-long changes in hormone balance and metabolism. Our study explores if newborn over-nutrition on the first day of life (DOL1) is associated with risk for future overweight and obesity in childhood.MethodsRetrospective chart data was collected for full term formula-fed infants born between January 2008 and December 2012 who continued care at the same institution. Data included the volume of formula (ml) consumed on DOL1 as well, as subsequent yearly BMI measures from well child checkups (WCC). Overfeeding was categorized as any feed greater than or equal to 30 ml on any of the first seven feeds while controlling for birth weight.ResultsThe final data set included 1106 infants (547 male; 559 female). 1023 of the 1106 newborns (93%) were overfed at least once during DOL1, while 789 of 1106 (71%) were overfed 3 or more times during their first 7 feeds. After adjusting for birth weight, infants who were overfed 5 of the first 7 feeds were 5 times as likely to be overweight or obese at their 4th year well child check-up (p < 0.05) compared to children not overfed. Infants who were overfed on all 7 of their first 7 feeds were 7 times more likely to be overweight or obese at their 4th year WCC (p = 0.017).ConclusionsInfants overfed on DOL1 were significantly more likely to be overweight or obese at their 4th year WCC, compared to infants not overfed on their first day of life. Newborn families may benefit from counseling regarding age-appropriate volumes of formula during this critical time period. Future studies will aim to look at effect of implementation of smaller feeding bottle size on reducing overfeeding practices and future risk of overweight and obesity.

Complementary feeding: new styles versus old myths.

Early life feeding habits may potentially alter future metabolic programming and body composition. Complementary feeding is the period of time when infants introduce food different from milk in their diet, together with a gradual reduction of the intake of milk (either breast milk or formula), to finally acquire the diet model of their family. This period is important in the transition of the infant from milk feeding to family foods, and is necessary for both nutritional and developmental reasons. The timing for introducing complementary foods and the method of feeding have changed over time. Available literature data show increasing interest and concerns about the impact of complementary feeding timing and modality on the onset of later non-communicable disorders, such as overweight and obesity, allergic diseases, celiac disease, or diabetes. While international scientific guidelines on complementary feeding have been published, many baby food companies' websites, blogs, and books, in most European countries exist. The aim of this manuscript is to look over current recommendations, and to revise "old myths." The adoption of an adequate weaning method is a cornerstone in the development of life-long health status. A correct strategy could reduce the risk of feeding disorders and other health problems later in life.

Early feeding profiles based on breastfeeding, infant formula and introduction of solid foods

Abstract Background As early feeding practices may be related with allergy at older age, we aimed to investigate infant-feeding profiles in the first year of life and their determinants in the PARIS (Pollution and Asthma Risk: an Infant Study) cohort. Methods This study included 3446 infants. Feeding data was collected using standardized questionnaires at 1, 3, 6, 9 and 12 months. At each time, we considered 6 variables such as (i) breastfeeding (no, mixed, exclusive), consumption of formula (no, yes): (ii) regular formula, (iii) hypoallergenic, (iv) with pre-/probiotics, or (v) extensively hydrolyzed/soya, as well as (vi) solid foods introduction (no, yes: 0, 1, ≥2 allergenic foods). Children with similar feeding profiles over the first year of life were grouped together using multidimensional longitudinal cluster analysis. Socio-demographic and health determinants of these profiles were examined using multinomial logistic regression models. Results Five distinct profiles were identified. Profile 1 (45%) included children mainly fed with regular formula. Children from Profile 2 (27%) were exclusively breastfed during the first 3 months. Children from the other three profiles were moderately breastfed and differed regarding the type of formula consumed: pre-/probiotics for Profile 3 (17%), hypoallergenic for Profile 4 (7%), or extensively hydrolyzed/soya for Profile 5 (4%). Profiles did not seem to differ regarding timing of solid foods introduction, except Profile 5 starting later. Compared to Profile 1, children from Profiles 2 to 5 were more likely to have parental history of allergy and higher family socioeconomic status (SES). Profile 5 appeared to be influenced by early health outcomes such as eczema or food reactions. Conclusions We identified different early feeding profiles. Parental history of allergy, SES and early health outcomes seem to be important determinants of these profiles. Associations of these profiles with the development of allergic disease will be studied. Key messages These results are important to better understand early-life feeding practices and their contributors. Their possible role in helping to prevent allergic diseases in later life will be further studied.

Early life feeding and current dietary patterns are associated with biomarkers of glucose and lipid metabolism in young women from the Nutritionist's Health Study.

We investigated if breastfeeding duration and current dietary patterns (DP) were associated with glucose and lipid metabolism biomarkers in women from the Nutritionist's Health Study. This is a cross-sectional analysis of 200 healthy undergraduates and nutrition graduates aged ≤45 years. Total [<6; ≥6 months] and predominant [<3; ≥3 months] breastfeeding were recalled using questionnaires. Diet were assessed using a food frequency questionnaire. DP obtained by factor analysis by principal component were categorized into tertiles of adherence (T1 = reference). Glucose and lipid biomarkers were categorized into tertiles (T1 + T2 = reference). Logistic regression was applied considering minimal sufficient adjustment recommended by directed acyclic graphs. Median (interquartile range) age and BMI were 23.0 (20.0; 28.5) years and 22.6 (20.7; 25.4) kg/m2, respectively. Mean ± SD values of glucose, LDL-c and HDL-c were 82.0 ± 9.0, 101.1 ± 29.6 and 54.4 ± 12.4 mg/dL, respectively. Women breastfed for <6 months had higher chance of being classified into T3 of insulin (OR = 2.87; 95%CI = 1.28-6.40). Predominant breastfeeding < 3 months was associated with insulin levels (OR = 2.27; 95%CI = 1.02-5.02) and HOMA-IR (OR = 2.36; 95%CI = 1.06-5.26). Breastfeeding was not associated with lipids. The Processed pattern was directly associated with LDL-c (T3: OR 6.08; 95%CI 1.80-20.58; P-trend = 0.004), while the Prudent pattern was inversely associated with LDL-c (T3: OR 0.26; 95%CI 0.08-0.87; P-trend = 0.029) and LDL-c/HDL-c ratio (T3: OR 0.28; 95%CI 0.08-0.97; P-trend = 0.046). Early feeding could be a protective factor against insulin resistance development, while current DP were associated with lipid profile. This evidence indicates that from early life until early adulthood, dietary habits might influence women's cardiometabolic risk profile.

Factors affecting exclusive breastfeeding in the first month of life among Amazonian children.

Early life feeding practices can directly affect the growth, development, and survival of a child. This study aimed to estimate the frequency of and factors associated with exclusive breastfeeding (EBF) in the first month of life among Amazonian infants. We used data of 1,523 mother-child pairs of the MINA-Brazil birth cohort study. Mothers were interviewed soon after delivery at baseline and by telephone at 30–45 days postpartum (n = 962, 63.2% of those eligible). Kaplan-Meier survival analysis and accelerated failure-time (AFT) models were used to estimate the probability of EBF and the factors associated with EBF duration in the first month. At 30 days of age, 36.7% of the studied population (95% confidence interval [CI] 33.6–39.8) were exclusively breastfed, with a median duration of 16 days. Considering all eligible children for follow-up, the probability of EBF in the first month was 43.7% (95% CI 40.4–46.8), and the median duration was 30 days. The duration of EBF (time-ratio, TR) was 28% longer among multiparous mothers (TR 1.28; 95% CI 1.11–1.48). The use of a pacifier and the occurrence of wheezing were associated with a reduced EBF duration by 33% (TR 0.67; 95% CI 0.58–0.77) and 19% (TR 0.80; 95% CI 0.70–0.93), respectively. These results highlight that EBF among children in the Brazilian Amazon is considerably below international recommendations, and indicate the immediate need to plan and implement actions to promote and support breastfeeding early in life.

Maternal nicotinamide supplementation during the perinatal period modifies the small intestine morphology and antioxidative status of offspring kids

Nicotinamide (NAM) was evidenced to have the capacity to improve energy metabolism and attenuate oxidative stress during the perinatal period. As there is an association between maternal nutrition and the developmental outcomes of offspring, the aim was to investigate the effect of maternal NAM supplementation on small intestine morphology and some antioxidative parameters of offspring kids. Fifteen multiparous does were paired and allocated into 3 treatments: control (C), postpartum (P, supplemented post-kidding), and entire-perinatal (EP, supplemented from d -21 to 28 around kidding). NAM was drenched to does at 5 g/d and at 0700 h every day. After kidding, the kids were named LC, LP, and LEP, respectively, and fed milk from their mothers until d 28 of life. For the offspring kids, BW and ADG were not affected. The villus height in the duodenum was higher in LP than in LC, and that in the ileum was higher in LEP. The ratio of villus height to crypt depth of intestine was increased in LEP. The serum IgG was tended to elevate by maternal NAM supplementation, and the total antioxidant capacity was decreased in both LP and LEP. The does supplemented with NAM had an improved antioxidative status, and lower level of milk IL-1β was found in EP. The MDA of the mammary tissue was also decreased by NAM. Moreover, the milk metabolomics profile showed that glycerol was decreased while citramalic acid and sucrose were elevated with NAM supplementation. Glycerolipid metabolism, galactose metabolism, and starch and sucrose metabolism were enriched. Thus, these data indicated that maternal NAM supplementation improved the small intestinal development of offspring kids partially by affecting the antioxidative status and milk metabolites of the does. This knowledge further suggested that the development of a nutritional strategy from prepartum period and milk feeding in early life are important for offspring kids.

Scientific Evidence for Breastfeeding.

The global drive to promote breastfeeding targeted at all 134 million infants born/year on the planet is one of the most pervasive public health interventions. It is, therefore, critical that the breastfeeding field is rooted in sound evidence. Three important scientific pillars of breastfeeding have been: (1) that human milk (HM) is the product of 200 million years of mammalian evolution; (2) that HM composition should be seen as the gold standard for infant nutritional requirements; and (3) that HM has numerous clinical benefits for the infant. I shall look carefully at these areas to help pave the way to a more solid basis for modern breastfeeding medicine. Firstly, I shall look at evolutionary theory for human breastfeeding and consider in general terms the implications for optimal nutritional care of breastfed infants. Secondly, I shall show how HM composition has been incorrectly translated into dietary intake in a large body of past flawed work that resulted in misleading data. Implementing such data as a model for infant formula appears to have increased the risk of obesity and cardiovascular disease (CVD) in formula-fed infants. Finally, most studies that examine the benefits of HM are observational and potentially confounded. So, this body of data needs to be backed by experimental evidence. Here, I shall use preterm infants as a model, since numerous RCTs and physiological studies over 40 years have compared exclusive HM feeding versus cow's milk exposure. Unexpectedly diverse immediate beneficial effects span the field of neonatology, and long-term programmed effects have been shown for cognition, brain structure, risk factors for CVD, structural development of the heart and lungs, bone health, and atopy. These data add much weight to the evidence, obtained in full-term infants using observational study designs, that HM feeding in early life may fundamentally and permanently change the biology of the organism. Breastfeeding is emerging as a major evidence-based field of medical and public health practice.

223 Are we raising “normal” cows? Effects of early life diet, feeding plan, and housing on the natural behavior of dairy cattle.

223 Are we raising “normal” cows? Effects of early life diet, feeding plan, and housing on the natural behavior of dairy cattle.