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Am J Clin Nutr. 2019 Sep 01;110(3):769-779. doi: 10.1093/ajcn/nqz123.

NIH workshop on human milk composition: summary and visions.

The American journal of clinical nutrition

Kellie O Casavale, Jaspreet K C Ahuja, Xianli Wu, Ying Li, Julia Quam, Richard Olson, Pamela Pehrsson, Lindsay Allen, Douglas Balentine, Manjit Hanspal, Deborah Hayward, Erin Pias Hines, James P McClung, Cria G Perrine, Mandy Brown Belfort, David Dallas, Bruce German, Jae Kim, Mark McGuire, Michelle McGuire, Ardythe L Morrow, Margaret Neville, Laurie Nommsen-Rivers, Kathleen M Rasmussen, Janos Zempleni, Christopher J Lynch

Affiliations

  1. Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD, USA.
  2. Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA.
  3. Western Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Davis, CA, USA.
  4. Center for Food Safety and Applied Nutrition, US Food and Drug Administration, US Department of Health and Human Services, College Park, MD, USA.
  5. Environmental influences on Child Health Outcomes (ECHO) program, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA.
  6. Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada.
  7. National Center for Environmental Assessment, US Environmental Protection Agency, Research Triangle Park, NC, USA.
  8. US Army Research Institute of Environmental Medicine, Natick, MA, USA.
  9. Centers for Disease Control and Prevention; US Department of Health and Human Services, Atlanta, GA, USA.
  10. Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  11. School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
  12. Department of Food Science and Technology, University of California, Davis, Davis, CA, USA.
  13. Divisions of Neonatology and Pediatric Gastroenterology, University of California, San Diego, San Diego, CA, USA.
  14. College of Agricultural and Life Sciences, University of Idaho, Moscow, ID, USA.
  15. School of Biological Sciences, Washington State University, Pullman, WA, USA.
  16. Center for Interdisciplinary Research in Human Milk and Lactation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
  17. Department of Physiology and Biophysics, University of Colorado, Denver, Denver, CO, USA.
  18. College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA.
  19. Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
  20. Nebraska Center for the Prevention of Obesity Diseases, University of Nebraska-Lincoln, Lincoln, NE, USA.
  21. Office of Nutrition Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA.

PMID: 31274142 PMCID: PMC6895543 DOI: 10.1093/ajcn/nqz123

Abstract

Nationally representative data from mother-child dyads that capture human milk composition (HMC) and associated health outcomes are important for advancing the evidence to inform federal nutrition and related health programs, policies, and consumer information across the governments in the United States and Canada as well as in nongovernment sectors. In response to identified gaps in knowledge, the National Institute of Diabetes and Digestive and Kidney Diseases of the NIH sponsored the "Workshop on Human Milk Composition-Biological, Environmental, Nutritional, and Methodological Considerations" held 16-17 November 2017 in Bethesda, Maryland. Through presentations and discussions, the workshop aimed to 1) share knowledge on the scientific need for data on HMC; 2) explore the current understanding of factors affecting HMC; 3) identify methodological challenges in human milk (HM) collection, storage, and analysis; and 4) develop a vision for a research program to develop an HMC data repository and database. The 4 workshop sessions included 1) perspectives from both federal agencies and nonfederal academic experts, articulating scientific needs for data on HMC that could lead to new research findings and programmatic advances to support public health; 2) information about the factors that influence lactation and/or HMC; 3) considerations for data quality, including addressing sampling strategies and the complexities in standardizing collection, storage, and analyses of HM; and 4) insights on how existing research programs and databases can inform potential visions for HMC initiatives. The general consensus from the workshop is that the limited scope of HM research initiatives has led to a lack of robust estimates of the composition and volume of HM consumed and, consequently, missed opportunities to improve maternal and infant health.

Published by Oxford University Press on behalf of the American Society for Nutrition 2019.

Keywords: bioactives; breastfeeding; food composition database; human milk microbiome; infant nutrition; lactation; maternal nutrition; milk volume; nutrient composition; nutrients

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