Every day, scientists at Mead Johnson manage research programs that advance the science of pediatric nutrition around the world. Our team has taken research, both from projects conducted at Mead Johnson and studies in the scientific literature, and compiled a growing number of short, simple articles about common topics in infant and children’s nutrition.
The birth of a baby can be an exciting, overwhelming and life-changing time for many parents. Perhaps even more dramatic than the change experienced by a new parent is the rapid change in growth and development that is demonstrated by a newborn from birth through toddlerhood.
But changes in a baby’s growth and development are more than just exciting milestones. Growth and development are important measurements that may serve as early indicators of possible nutrition or health concerns.
Assessment of Growth
Proper growth is typically carefully monitored by a healthcare professional throughout a baby’s young life. Different factors, such as the baby’s weight, length and head circumference, are taken into consideration during healthcare visits and then used to track and assess the pattern of the child’s growth over a period time using a growth curve chart. There are two major growth curve charts used by healthcare professionals around the world, one created by the U.S. Centers for Disease Control and Prevention (CDC) and one created by the World Health Organization (WHO).
While some of the specifics in each chart may vary, in general, a consistent pattern over time tracking along the reference curves indicates healthy growth in development, while falling off or accelerating significantly beyond the child’s curve may be cause for further evaluation. If there are concerns about growth, additional tests may be recommended.
In addition to physical growth, nutrition also plays a role in other important developmental milestones, including visual, neurological and behavioral. Healthcare professionals typically perform physical exams and ask caregivers a number of questions to assess an infant's development in these areas. If there are any concerns, more comprehensive assessments may be recommended.
Helping to Promote Healthy Growth & Development
Healthy growth and development depends on a constant supply of essential nutrients in the proper amount and proportion. That’s why scientists at Mead Johnson conduct ongoing studies related to nutrient absorption, intake and feeding patterns. Congenital conditions and problems with intake, retention or absorption require consultations with healthcare specialists to determine the best nourishment options for an infant or young child.
However, in many cases, a parent has unique control over the nourishment that is offered to his or her child during the first years of life. The nourishment that is provided can be optimized in several ways. For example:
Pre-natal nutrition of a pregnant woman: The growth and development of a baby can be impacted by his or her mother’s health and nutritional status before and throughout pregnancy. For example, proper maternal consumption of folate can help decrease the risk of the neural tube defect spina bifida,i while maternal consumption of omega-3 fatty acids may help promote brain development.ii
Post-natal nutrition of a breastfeeding mother: In their first months out of the womb, newborns will grow faster than at any other time in their lives. Experts agree that breastfeeding is the best way to ensure that newborns and infants get the nourishment they need. In addition to providing a balanced source of protein, fat and carbohydrate, breast milk contains vitamins and minerals needed for healthy growth, as well as components such as immunoglobulins and oligosaccharides that help build a baby’s immune system and keep his or her digestive tract healthy. Proper maternal nutrition can help affect the composition of breast milk. Still, while breastfeeding is a preferred method of feeding, breast milk itself does not provide infants with adequate intakes of vitamin D. That’s why the American Academy of Pediatrics recommends a supplement of 400 IU per day of vitamin D for all breastfed infants beginning soon after birth.
Infant formulas: In cases where a mother cannot or chooses not to breastfeed, selecting a newborn or infant formula to meet a baby’s unique nutritional needs can play an important role in healthy growth and development. For more than a century, scientists at Mead Johnson have studied the composition of breast milk in order to design formula that provides a product as close to human milk as possible. These efforts have also led to adding other important nutrients, such as vitamin D, that may be found in lower concentrations in breast milk. Just as breast milk’s nutritional composition changes with time, a variety of newborn and infant formulas are available to meet the changing nutritional needs of a growing baby.
Concerns About Over-Nourishment
In recent years, concerns about the rising rates of obesity have led researchers to examine the role that infant nutrition plays in the risk of becoming overweight or obese later in life.
To date, the science isn’t clear about the relationship between early infant nutrition and the risk of obesity. Despite common perceptions, a comprehensive research review published in Obesity Reviews concluded that the body of scientific evidence does not support a causal association between breastfeeding and a reduced risk of overweight.iii
While more research needs to be done on the topic, one thing that’s clear is calories matter. Parents should continue to focus on nourishing their children with the proper amount of calories, based on the age, gender and individual needs of the child. A healthcare professional can help determine the appropriate calorie needs of a growing infant or child.
iCollins J.S., Atkinson K.K., Dean J.H., Best R.G., Stevenson R.E. Long term maintenance of neural tube defects prevention in a high prevalence state. J Pediatr. 2011; Feb 22; Epub ahead of print.
iiJacobson J.L., Jacobson S.W., Muckle G., Kaplan-Estrin M., Ayotte P., Dewailly E. Beneficial effects of a polyunsaturated fatty acid on infant development: evidence from the inuit of arctic Quebec. J Pediatr. 2008; 152, 3:356-364.
iiiCope, M.B., Allison, D.B. Critical review of the World Health Organization's (WHO) 2007 report on ‘evidence of the long-term effects of breastfeeding: systematic reviews and meta-analysis’ with respect to obesity. Obes Rev. 2008; 9(6):594-605.
Metabolic disorders, or inborn errors of metabolism, are inherited genetic diseases in which a baby is unable to metabolize a specific nutrient. Without appropriate dietary management, the unmetabolized nutrient and metabolic by-products will accumulate in the body, and may result in adverse effects that inhibit normal growth and development. However, many infants who start treatment early in life can grow and develop normally. Mead Johnson Nutrition is a pioneer in the field of specialized nutrition for metabolic disorders and has been a leader in the development of science-based metabolic products for more than 50 years.
Protein Metabolism Disorders
Protein is a key constituent of most foods we eat, including meat, beans, milk products and grains. Infants with protein metabolism disorders cannot drink human milk because it also contains proteins and amino acids that cannot be metabolized. Infants with protein metabolism disorders are unable to metabolize certain amino acids and require specialized formulas without the offending amino acid, allowing the baby to receive essential nutrients for growth.
Examples of protein metabolism disorders include:
A Closer Look at Phenylketonuria (PKU)
Phenylketonuria, often referred to as PKU, is one of the most common protein metabolism disorders. Normally, the human body metabolizes the essential amino acid phenylalanine into tyrosine. Infants with PKU do not have the enzyme needed to make this conversion. Consequently, their bodies have excess amounts of phenylalanine and low tyrosine levels. The following symptoms may result from untreated PKU:
Dietary management is critical for individuals with PKU to assure normal growth and development, as well as to support normal neurocognitive function. Fortunately, PKU can be diagnosed early in life through genetic disorders screenings, which are mandatory in many countries. Once diagnosed, the dietary management of PKU can start right away.
PKU management involves a highly restrictive diet that minimizes the amount of phenylalanine consumed and regular monitoring by healthcare professionals experienced in the dietary management of metabolic diseases. For infants with PKU, special phenylalanine-free formulas act as their primary source of protein. Regular clinic visits allow monitoring phenylalanine in the blood and the growth of the infant to ensure that the dietary management is successful.
In the last trimester of pregnancy, a fetus grows rapidly and stores important nutrients. Premature infants often miss much of this critical time in the womb, and as a result, face many challenges and may require specialized nutrition support.
The goals for caring for and feeding preterm infants are to promote growth and weight gain similar to that which would have occurred in utero, and to maintain relatively normal concentrations of nutrients in the blood and tissues.
Mead Johnson’s research and collaboration with neonatal intensive care units continues to result in feeding regimens and clinical nutrition products that provide premature infants with the support required to have the best start in life.
Nutrients and Growth
Because premature infants may miss some of the third trimester, they have a greater need for protein, certain fats, vitamins and minerals than full-term infants. They also have a critical need for carbohydrates, such as glucose, which act as an important energy source for the brain.
There are several key needs that occur through the third trimester that help a fetus prepare for life outside the womb, including:
Feeding Premature Infants
Meeting the necessary energy and nutrient requirements for catch-up growth and development is challenging. Among these challenges, the immature digestive systems of premature infants alter the absorption and tolerance of nutrients. Also, premature infants often have trouble performing the suck-swallow mechanism necessary for breast or bottle feeding. In these cases, the infant may need to be fed breast milk or infant formula using a nasogastric tube or orogastric tube until they develop the ability to feed orally.
Mead Johnson continues to investigate ideal forms of protein, carbohydrates and fats to feed infants with immature digestive systems. With a better understanding of these special nutritional needs, Mead Johnson continues to enhance its science-based pediatric clinical nutrition products that help provide premature infants with the best start in life.
Mead Johnson is dedicated to increasing scientific knowledge about pediatric nutrition and the important role early nutrition plays in infants and young children’s lives.
Mead Johnson’s scientists are continuously working on rigorous nonclinical and clinical studies – both independently and in collaboration with leading academic institutions – to better understand human milk and how nutrient content of the early feeding period can be optimized. Mead Johnson uses findings from such research to further enhance the quality, availability and acceptability of nutritious foods for infants and young children around the world.
Striving to Meet the Gold Standard
The American Academy of Pediatrics recommends that babies be exclusively breastfed for about the first 6 months of life. Human milk - the gold standard for infant nutrition - provides the protein, fat and carbohydrate that infants need, as well as a multitude of other important components that help an infant grow and thrive.
While scientists have long known the major components that make up human milk, research continues to reveal important functions of these components and their mechanism of action. For example, new information is emerging on the benefits of specific prebiotics and certain long-chain fatty acids when incorporated into the daily diet. Mead Johnson’s research in these and other areas contribute to health care professionals’ understanding of the elements in human milk and their affect on infant health.
Enhancing Digestion and Immunity with Prebiotics
Scientific research, conducted at Mead Johnson and at various academic institutions, has demonstrated that certain complex components in human milk – human milk oligosaccharides (HMOs) – help improve an infant’s digestive health and immunity.
HMOs generally are digestion-resistant carbohydrates, which act as prebiotics providing food for beneficial bacteria. Prebiotics are important for the growth and development of a healthy digestive tract.
Researchers have found the following connections between prebiotics and infant gastrointestinal health:
Optimizing Neurological Development with Long-chain Fatty Acids
Research has demonstrated that two types of fatty acids, called docosahexaenoic acid (DHA) and arachidonic acid (ARA), are essential for optimal neurological development.
While brain development continues well into the teen years, the majority of brain growth occurs at the beginning of life. In the last trimester of pregnancy, a fetus’ brain grows 260 percent; between birth and the first two years of life, a baby’s brain grows 175 percent.vii The building blocks for this rapid brain growth include DHA and ARA.
Researchers have found the following connections between DHA and ARA and developmental outcomes:
iZielger E., Vanderhoof J.A., Petschow B., et al. Term infants fed formula supplemented with selected blends of prebiotics grow normally and have soft stools similar to those reported for breast-fed infants. J Pediatr Gastroenterol Nutr. 2007;44:359-364.
iiMoro G., Inoli I., Mosca M., et al. Dosage-related bifidogenic effects of galacto- and fructooligosaccharides in formula-fed term infants. J Pediatr Gastroenterol Nutr. 2002;34:291-291.
iiiBakker-Zierikzee A.M., van Tol E.A.F., Kores H. Alles M.S., Kok F.J, Bindels J.G. Faecal SigA secretion in infants fed on pre- or probiotic infant formula. Pediatr Allergy Immunol. 2006;17:134-140.
ivMoro G., Arslanoglu S., Stahl B., Jelinek J. Wahn U., Boehm G. A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age. Arch Dis Child. 2006;91:814-819.
vArslanoglu S., Moro G.E., Boehm, E. Early supplementation of prebiotic oligosaccharides protects formula-fed infants against infections during the first 6 months of life. J Nutr. 2007;137:2420-2424.
viArslanoglu S. Moro G.E., Schmitt J., Tandoi L. Rizzardi S., Boehm G. Early dietary intervention with a mixture of prebiotic oligosaccharides reduces the incidence of allergic manifestations and infections during the first two years of life. J Nutr. 2008; 138:1091-1095.
viiDobbing J., Sands J. Quantitative growth and development of human brain. Arch Dis Child. 1973;48:757-767.
viiiMcCann J.C. and Ames, B.N. Is docosahexaenoic acid, an n-3 long-chain polyunsaturated fatty acid, required for development of normal brain function? An overview of evidence from cognitive and behavioral tests in humans and animals. Am J Clin Nutr 2005;82:281-295.
ixHoffman DR, Birch EE, Castaneda YS, et al. Visual function in breast-fed term infants weaned to formula with or without long-chain polyunsaturates at 4 to 6 months: a randomized clinical trial. J Pediatr. 2003;142(6):669-677.