It is likely that the growth rate (weight gain during the first few weeks) and the composition of this weight gain (lean body gain and body fat gain) during this key period have major long-term effects. BARKER ( 1, 2) and the formalization of the concept of DOHaD (Developmental Origin of Health and adult Diseases), it is recognized that there is a link between the conditions of development during the perinatal period and the health and adult diseases, and nutrition has a key role. The perinatal period is a period of organogenesis in the newborn (at the beginning of pregnancy), and of strong growth of the child during the first 2 years of life, but also in the establishment of the physiological mechanisms that persist throughout life. A better knowledge on how human milk could act on infant development to the mid- and long-term participating thus to nutritional programming is a challenging question for a better management of infants' nutrition, especially for preterm infants who are most fragile.ĭOHAD (Developmental Origin of Health and Adult Diseases) Context and Nutritional Programming Some biomarkers (lipids, oligosaccharides) have been identified in breast milk but their function is not always yet known. In a situation of preterm birth, mother physiology impacts partly breast milk composition and this explains how this is more difficult to correlate infant growth or neurodevelopment with milk composition. These charts reflect first the infant physiology and likely reflect the composition of human milk when infants are breastfed. Pediatricians and nutritionists use charts of infant growth (weight, size, head circumference) and neurodevelopment criteria that reflect the food that these infants receive. There is no ideal composition of human milk and also no easy way to control the complexity of its nutritional quality and the quantity received by breastfed infants. Human milk is the best food for newborn nutrition. 2EMBA (European Milk Bank Association), Milan, Italy. 1INRA, Université Nantes, Centre de Recherche en Nutrition Humaine–Ouest, IMAD, Physiopathologie des Adaptations Nutritionnelles (UMR PHAN), Nantes, France.
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