Review articleThe first model of keeping energy balance and optimal psycho affective development: Breastfed infants

- Breastfeeding is today believed to represent the element optimally connecting the requirements for growth and development.
- It is generally accepted that total energy expenditure is higher in formula-fed than breast-fed infants.
- Mothers who breastfeed promote in their children the development of self-regulatory mechanisms of energy intake.
- Breastfeeding has been associated with a greater cognitive development in childhood and lower risk of behavioral problems.
- The intestinal microbiome plays a central role in determinating the normal functioning of the brain through the so named “gut-brain axis”.

BackgroundBreastfed infants follow a peculiar growth fashion characterized by a rapid weight gain in the first weeks of life, then followed by a fast decrease in growth rates, a capacity to self-regulate the sense of hungry and satiety, and a minor propensity towards overweight and obesity later on, in parallel with a better neurodevelopmental performance.MethodsWe searched studies investigating the relationship between the feeding mode in infancy and the energy balance, so the possible associations with total energy expenditure and intake regulation. We focused the research on the interaction with the neuropsychological development and the possible role of microbiome in determinating the normal generation and regular functioning of the brain through the so named “gut-brain axis”.ResultsTotal energy expenditure (TEE) is different for breast-fed and formula-fed infants, in particular the feeding mode seems to affect the sleep organisation. Long-term breastfeeding, is one of the most studied factors of neurodevelopment, several studies reporting beneficial effects on child neuropsychological development. Probably this effect is modulated by genetic variations in fatty acid metabolism. Increasing data also showed that the intestinal microbiome exerts several functions which are able to influence neurodevelopment.LimitationsThere is considerable controversy over whether nutrition in early life has a long-term influence on neurodevelopment. Other studies are needed to confirm the association between breastfeeding and brain development.ConclusionsThe key points of energy disposal, the role and effects of the instestinal flora represent promising fields of investigation possibly leading to indications for the wide area of preventive medicine.