@article{8bcb765154924ab4bbdd20f3556642a2,
title = "Lactation and neonatal nutrition: Defining and refining the critical questions",
abstract = "This paper resulted from a conference entitled {"}Lactation and Milk: Defining and refining the critical questions{"} held at the University of Colorado School of Medicine from January 18-20, 2012. The mission of the conference was to identify unresolved questions and set future goals for research into human milk composition, mammary development and lactation. We first outline the unanswered questions regarding the composition of human milk (Section I) and the mechanisms by which milk components affect neonatal development, growth and health and recommend models for future research. Emerging questions about how milk components affect cognitive development and behavioral phenotype of the offspring are presented in Section II. In Section III we outline the important unanswered questions about regulation of mammary gland development, the heritability of defects, the effects of maternal nutrition, disease, metabolic status, and therapeutic drugs upon the subsequent lactation. Questions surrounding breastfeeding practice are also highlighted. In Section IV we describe the specific nutritional challenges faced by three different populations, namely preterm infants, infants born to obese mothers who may or may not have gestational diabetes, and infants born to undernourished mothers. The recognition that multidisciplinary training is critical to advancing the field led us to formulate specific training recommendations in Section V. Our recommendations for research emphasis are summarized in Section VI. In sum, we present a roadmap for multidisciplinary research into all aspects of human lactation, milk and its role in infant nutrition for the next decade and beyond.",
keywords = "Breastfeeding, Human milk, Human nutrition, Infant nutrition, Lactation, Lactational programming, Mammary gland development, Milk, Obesity, Preterm birth, Undernutrition",
author = "Neville, {Margaret C.} and Anderson, {Steven M.} and McManaman, {James L.} and Badger, {Thomas M.} and Maya Bunik and Nikhat Contractor and Tessa Crume and Dana Dabelea and Donovan, {Sharon M.} and Nicole Forman and Frank, {Daniel N.} and Friedman, {Jacob E.} and German, {J. Bruce} and Armond Goldman and Darryl Hadsell and Michael Hambidge and Katie Hinde and Horseman, {Nelson D.} and Hovey, {Russell C.} and Edward Janoff and Krebs, {Nancy F.} and Lebrilla, {Carlito B.} and Lemay, {Danielle G.} and MacLean, {Paul S.} and Paula Meier and Morrow, {Ardythe L.} and Josef Neu and Nommsen-Rivers, {Laurie A.} and Raiten, {Daniel J.} and Monique Rijnkels and Victoria Seewaldt and Shur, {Barry D.} and {Van Houten}, Joshua and Peter Williamson",
note = "Funding Information: The pool of highly-trained investigators qualified to study problems in lactation biology has been diminished due to a variety of factors. Historically, many land grant colleges had formal departments and training programs in dairy and animal sciences, often funded by the USDA. Because milk production worldwide now exceeds demand and formula is widely available, revenue for studies of lactation biology has decreased dramatically. The result has been the reduction, if not closure, of some of these departments, and a concomitant disappearance of training programs in lactation biology. Further, support from federal funding agencies such as NIH is often targeted toward disease rather than studies of normal biology. In the field of mammary gland biology and lactation the majority of this support is directed toward breast cancer rather than lactation biology. In addition a lack of formal clinical training in lactation biology in medical school curricula coupled with the cancer orientation of conferences and other traditional venues means that there are few places where scientists in all disciplines that now require knowledge of lactation biology can exchange information and ideas. Therefore, we need to implement new programs and resources to repopulate the diminishing pool of lactation biologists. In particular, federal funding agencies must make a conscious commitment to set aside resources to rebuild this cadre of investigators through new training programs, workshops, conferences, travel grants, and similar initiatives as described below. Funding Information: Acknowledgments The authors and conference participants wish to thank NIH grant PO1-HD38129-08 (SMA, PI), Pfizer Nutrition, the Dairy Research Institute, the Children{\textquoteright}s Hospital Foundation, The Department of Obstetrics and Gynecology and the Health and Wellness Center of the University of Colorado Denver for their generous support of this conference. MCN, SMA, SMD, JLM, TMB, KH, RCH, PM, and DJR are thanked for multiple readings and editing of the entire manuscript. All other authors contributed both discussion and written materials to this work.",
year = "2012",
month = jun,
doi = "10.1007/s10911-012-9261-5",
language = "English (US)",
volume = "17",
pages = "167--188",
journal = "Journal of Mammary Gland Biology and Neoplasia",
issn = "1083-3021",
publisher = "Springer New York",
number = "2",
}