Early nutrition
Nutrition plays a vital role both in optimising healthy growth in infants with increasing evidence showing the impact on health later on in life. There are high quality, randomised controlled trials showing the health impact of accelerated growth rates in early years in term infants. Recent research has investigated the links with increased obesity and cardiovascular disease risk.
Breastfed infants show an optimum rate of growth and studies show that breastfed infants also have lower levels of various cardiovascular disease risk factors, including:
- Obesity
- Dyslipidaemia
- High blood pressure
- Insulin resistance
Much of this recent research has been carried out by Professors Atul Singhal and Alan Lucas (who specialise in Paediatric Nutrition at the Institute of Child Health, UCL, London)
The studies show that faster early postnatal growth adversely impacted on the following problems:
- Insulin resistance
- Endothelial dysfunction (an early stage in the atherosclerotic process)
- Higher blood pressure1
This impact is called "programming". Their hypothesis was that postnatal growth acceleration (upward centile crossing) could explain in part adverse programming of effects in term infants and have confirmed an association between faster growth in infancy and later insulin resistance, higher blood pressure and, in 3 systematic reviews, tendency to obesity. ln fact, the adverse long-term effects of faster early growth in human infants appears to be a fundamental biological phenomenon seen across many animal species.
The adverse effects of faster growth are seen in both high- and low-income countries, for both weight gain and linear growth. The magnitude of the effect may be substantial.
For example, the long-term effect of an optimum rate of growth in the first six months of life may equate to a 3-4 mmHg lowering of diastolic blood pressure. Slower growth rates in early life shown in breastfed children may have a greater impact than conventional public health interventions designed to reduce blood pressure.
This is estimated that a slower rate of growth in the early years could prevent over 100,000 cardiovascular events per year in the USA alone.1
Formula-fed infants gain weight more quickly than breastfed infants in the first year of life, and this may be due to the greater quantity of protein in infant formulas which are based in cows' milk compared with breast milk.2 A new randomised controlled study has shown that lowering protein levels in infant formula can slow infants' weight gain velocity to a rate that is closer to that of breastfed babies.3
Click here to read how this is reflected in SMA First Infant Milk.
New UK-WHO growth charts
With the introduction of the new WHO Growth charts4 and the adoption of these charts in the UK, focus is on "appropriate" growth of infants. Breastfed infants have a slower rate of growth than formula fed infants. Historically the UK1990 growth charts have plotted a child’s development based on data from predominantly formula fed babies. Using these old charts, healthcare professionals may well have seen breastfed infants who were previously thought to be growing at a slower rate than normal. The new growth UK-WHO charts are now based on predominantly breastfed infants and hence depict a slower rate of growth as being the most appropriate. In addition formula fed infants will now appear to have a faster rate of growth.