Nutrition for babies from preterm up to 1000 days is a vital issue for anyone involved in infant nutrition, so the Infant Nutrition Council was delighted to be able to assemble some of the best brains on the topic to its recent annual conference, chief executive Jan Carey says. MY SAY www.foodtechnology.co.nz 13 Having the aim of excellence in infant nutrition requires a dedication to detail that’s hard to find elsewhere because of what we are dealing with – the nutrition of babies in those first vital days, weeks and months. The challenge is always to match as closely as possible the goodness found in breast milk, recognising that breast milk is always preferred, where it’s possible. Matching breast milk is a likely impossible target, but we continue to strive for it, and that means keeping an open mind to new ideas. Speakers at the conference covered a variety of subjects around infant nutrition, but it was the subjects of nutrition for preterm babies and the importance of gut microbiota and omega-3 DHA in early childhood nutrition that stood out for me. We heard from two experts in preterm nutrition - Dr Jane Alsweiler and Distinguished Professor Jane Harding, both of the Liggins Institute at Auckland University. Alsweiler pointed to concerns around lack of data on the best way to feed babies born moderate to late preterm, which make up a surprising 6% of babies in New Zealand. They are at increased risk of developing hypoglycaemia and poor growth, and it was recently determined they are also at increased risk of poor neurodevelopment and metabolic outcomes later in life. Alsweiler said that when there is insufficient breast milk available, providing optimal nutrition to them would not only prevent hypoglycaemia and allow them to grow to their full potential, but would also improve their long-term outcomes. Her sobering conclusion was that the outcome for preterms is not as good as it is for full-term babies and that we need more research into ways forward. Harding said inadequate growth that results from preterm birth is associated with poor neurodevelopmental outcomes. She said there may be a trade-off between later, better, developmental and worse metabolic outcomes, although nutritional approaches that could improve this trade-off are poorly understood. New developments include recommendations to increase protein supply, improve formulations of parenteral lipids, and provide mineral supplements while encouraging human milk feeding. However, high-quality evidence of the risks and benefits of these approaches are lacking, and nor is there reliable evidence about how to best feed moderate-to-late preterm babies. She said there was evidence that indicated preterm girls and boys have different needs, and a new trial could eventually lead to the need for different infant formula for boys and girls. There’s little doubt nutrition in early life has a huge influence on long-term health, and as research progresses it’s becoming increasingly clear that gut microbiota and omega-3 DHA intake has a huge impact on that. Paula Smith-Brown of Queensland University revealed that around 20% of mothers are unable to produce in their breast milk the human milk oligosaccharides (HMOs) thought to play an important role in nourishing the developing gut microbiota, whose presence is important for good gut health. She said this can have a lasting effect on a child’s health, and further work is required to establish whether intervention via formula would be warranted. Likewise, with omega 3 DHA…Professor Barbara Meyer of Wollongong University talked about the importance of omega-3 docosahexaenoic acid (DHA) in very early pregnancy to aid neural tube closure and the accruing of brain issue, and how supplementation in infants for the first 12 months of life results in increased mental development index and language at 18 months of age. She said maternal diets have changed considerably over the past four decades, with much lower intakes of DHA than is optimal, resulting in a 50% reduction of DHA in breast milk. Pregnant and lactating women need to increase their intake, and DHA should be regarded as a semi-essential ingredient. This was particularly important in very early pregnancy. The conference was also treated to latest findings on an increasingly popular trend – baby-led weaning, where infants are expected to feed themselves all of their foods from the start of the complementary feeding period. Associate Professor Anne-Louise Heath of Otago University pointed out that though health professionals have expressed concern that infants following baby-led weaning may be at increased risk of growth faltering, iron deficiency and choking, this has not yet been investigated. She expressed some frustration at how little research there is on baby-led weaning. If there was a single learning from the conference it would be that there is a lot of research going on in the world of baby nutrition – and that we need to be continually updating our information so we can produce ever-better nutritional outcomes for our babies. MOUTHS OF BABES Jan Carey INC is the association for the infant formula industry in Australia and New Zealand. INC represents manufacturers, marketers and brand owners, and represents more than 95% of the volume of infant formula manufactured and sold in Australia and New Zealand.
To see the actual publication please follow the link above