Optimal nutrition in lactating women and its effect on later health of offspring: A systematic review of current evidence and recommendations (EarlyNutrition project)

Abstract

Background: EarlyNutrition (www.project-earlynutrition.eu) is an international research consortium investigating the effects of early nutrition on metabolic programming. Objective: To summarize current evidence and standards, recommendations, guidelines, and regulations on nutrition or supplements in lactating women with emphasis placed on long-term health effects in offspring, including cardiovascular disease, hypertension, overweight/obesity, metabolic syndrome, diabetes, or glucose intolerance. Methods: Medline, Embase, selected databases and websites were searched for documents published between 2010 and 2015.Results: Thirteen documents met the inclusion criteria. Effects of maternal long-chain polyunsaturated fatty acid (LC-PUFA) supplementation on overweight/obesity or hypertension in offspring were assessed in 10 studies. One study described the effect of maternal vitamin D supplementation on overweight/obesity, and the remaining 2 studies assessed the effects of maternal probiotic/synbiotic supplementation during lactation on overweight/obesity or metabolic syndrome in their infants. Forty-one documents contained dietary recommendations on various macro-and micronutrients for lactating women, but without consideration of our long-term health outcomes in infants. Conclusion: Literature on nutrition of lactating women and its effect on their infants' later health with respect to metabolic programming outcomes appeared to be scarce, and focused mostly on supplementation of LC-PUFA's. No recent guidelines or recommendations were available, highlighting the significant research gaps regarding this topic.

Nutrition During Pregnancy, Lactation and Early Childhood and its Implications for Maternal and Long-Term Child Health: The Early Nutrition Project Recommendations

“…The RDP discussed and prioritised the questions, which was then supported by the assembly of all project partners. Systematic reviews were performed on published dietary guidelines, standards and recommendations during pregnancy (in preparation), in lactation [10] and in children up to the age of 3 years [11], with special attention to recommendations addressing long-term health consequences. In addition, systematic reviews of published data were performed on the impact of paternal and maternal body mass index (BMI) on offspring obesity risk [12], on effects of dietary and lifestyle interventions in pregnant women with a normal BMI [13] and on effects of protein concentration in infant formula on growth and later obesity risk [14].…”

“…Effects of the maternal diet during lactation on long-term health in breastfed infants have been reported, but literature on the effects of nutrition of lactating women on their infants' later health is scarce [10,88,89]. Most studies focus on the maternal supply of LC-PUFA where there is evidence of a link between fish consumption and higher DHA in breast milk, but no conclusive evidence on effects on infant growth, later body composition or other outcomes [10,40]. The provision of vitamin D and of live bacteria (so called "probiotics") did not affect the infant's later risk of overweight or obesity [10].…”

“…Most studies focus on the maternal supply of LC-PUFA where there is evidence of a link between fish consumption and higher DHA in breast milk, but no conclusive evidence on effects on infant growth, later body composition or other outcomes [10,40]. The provision of vitamin D and of live bacteria (so called "probiotics") did not affect the infant's later risk of overweight or obesity [10].…”

“…Balanced maternal nutrition before and during the breastfeeding period can affect maternal nutrient status and healthy body weight, as well as the infant supply of some nutrients with breastmilk [87]. Effects of the maternal diet during lactation on long-term health in breastfed infants have been reported, but literature on the effects of nutrition of lactating women on their infants' later health is scarce [10,88,89]. Most studies focus on the maternal supply of LC-PUFA where there is evidence of a link between fish consumption and higher DHA in breast milk, but no conclusive evidence on effects on infant growth, later body composition or other outcomes [10,40].…”

Long-Term Health Impact of Early Nutrition: The Power of Programming

“…Other stakeholders have been specifically addressed with targeted communication. Evidence-based recommendations on optimized practice of nutrition before and during pregnancy, during the breast feeding period and the early life of infants, have been developed based on the project results and on systematic reviews of available evidence [35,36,37,38,39,40,41,42], in close collaboration with a broad group of stakeholders (prepared for publication). These recommendations are of considerable importance because most of the current guidance for pregnant women, particularly obese women, and for young children does not take into account the long-term programming consequences of early nutrition.…”