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Human Milk Macronutrients and Child Growth and Body Composition in the First Two Years: A Systematic Review
Meredith Merilee Brockway1, Allison I Daniel2, Sarah M Reyes3
1Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Canada; Faculty of Nursing, University of Calgary, Canada.
Human milk (HM) macronutrients like carbohydrates and protein are linked to infant growth, impacting weight and length. However, HM fat associations with growth are inconsistent, highlighting research needs for better infant nutrition understanding.
Area of Science:
- Human nutrition
- Pediatric growth and development
- Infant health
Background:
- Human milk (HM) is vital for infant nutrition, but the precise relationship between its macronutrients and early life growth requires further clarification.
- While HM macronutrients are studied, their specific impact on infant anthropometry remains incompletely understood.
- Existing research presents heterogeneity in methodologies, limiting definitive conclusions on HM components and infant growth.
Purpose of the Study:
- To systematically synthesize evidence on human milk macronutrients and infant anthropometry up to two years of age.
- To identify associations between digestible carbohydrates, proteins, fats, and fatty acids in HM and infant growth metrics.
- To highlight limitations in current research and propose future directions for studying HM-infant growth relationships.
Main Methods:
- Systematic literature search of major databases (Medline, EMBASE, Cochrane Library, Scopus, Web of Science) for studies from 1980-2022.
- Inclusion of 57 articles from 5979 dyads focusing on HM macronutrients and infant growth outcomes.
- Categorization of studies based on reported HM macronutrients and infant growth, noting substantial heterogeneity preventing meta-analysis.
Main Results:
- Digestible carbohydrates in HM showed a positive association with infant weight.
- HM protein was positively associated with infant length but not weight.
- HM fat lacked consistent associations with growth metrics, while fatty acids generally correlated positively with head circumference, with exceptions like docosahexaenoic acid.
Conclusions:
- Human milk carbohydrates and proteins demonstrate specific associations with infant weight and length, respectively.
- The relationship between HM fat intake and infant growth metrics is inconsistent and requires further investigation.
- Future research should standardize milk collection, anthropometric measurements, and analytical methods for robust HM-infant growth studies.
