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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements. Washington, DC: The National Academies Press. doi: 10.17226/25943.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements. Washington, DC: The National Academies Press. doi: 10.17226/25943.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements. Washington, DC: The National Academies Press. doi: 10.17226/25943.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements. Washington, DC: The National Academies Press. doi: 10.17226/25943.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements. Washington, DC: The National Academies Press. doi: 10.17226/25943.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements. Washington, DC: The National Academies Press. doi: 10.17226/25943.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements. Washington, DC: The National Academies Press. doi: 10.17226/25943.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements. Washington, DC: The National Academies Press. doi: 10.17226/25943.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements. Washington, DC: The National Academies Press. doi: 10.17226/25943.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements. Washington, DC: The National Academies Press. doi: 10.17226/25943.
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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model for Determining Age-Specific Nutrient Requirements Kathleen Rasmussen, Ann L. Yaktine, and Alice Vorosmarti, Editors Committee on Scanning for New Evidence on the Nutrient Content of Human Milk Food and Nutrition Board Health and Medicine Division A Consensus Study Report of

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by contracts between the National Academy of Sciences and the U.S. Department of Agriculture (Contract 59-0204-9-207) and the U.S. Department of Health and Human Services (Contract 75F40120P000019). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-68344-9 International Standard Book Number-10: 0-309-68344-0 Digital Object Identifier: https://doi.org/10.17226/25943 Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2020 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2020. Scanning for new evidence on the nutrient content of human milk: A process model for determining age- specific nutrient requirements. Washington, DC: The National Academies Press. https://doi.org/10.17226/25943.

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Each report has been subjected to a rigorous and independent peer-review process, and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

COMMITTEE ON SCANNING FOR NEW EVIDENCE ON THE NUTRIENT CONTENT OF HUMAN MILK KATHLEEN M. RASMUSSEN (Chair), Cornell University, Ithaca, New York MEGHAN AZAD, University of Manitoba, Canada LARS BODE, University of California, San Diego MICHELLE MCGUIRE, University of Idaho, Moscow LAURIE NOMMSEN-RIVERS, University of Cincinnati, Ohio IAN J. SALDANHA, Brown University School of Public Health, Rhode Island Health and Medicine Division Staff ANN L. YAKTINE, Director, Food and Nutrition Board ALICE VOROSMARTI, Associate Program Officer ZARIA FYFFE, Senior Program Assistant v

Reviewers This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following individuals for their review of this report: LINDSAY H. ALLEN, U.S. Department of Agriculture; University of California, Davis PATSY BRANNON, Cornell University SHARON M. DONOVAN, University of Illinois at Urbana-Champaign DONNA GEDDES, The University of Western Australia JOSEPH LAU, Brown University MARGARET NEVILLE, University of Colorado RACHEL NOVOTNY, University of Hawai‘i at Mānoa RAFAEL PÉREZ-ESCAMILLA, Yale University XIAOBIN WANG, Johns Hopkins University School of Medicine and Children’s Center Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by JOHN W. ERDMAN, University of Illinois at Urbana-Champaign, and SUZANNE P. MURPHY, University of Hawai‘i at Mānoa. They were responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies. vii

Contents SUMMARY 1 1 INTRODUCTION 5 Background for the Study, 5 Committee’s Task and Approach, 6 Organization of the Report, 8 References, 8 2 METHODOLOGICAL APPROACH TO EVIDENCE SCANNING 9 Justification, 9 Approach, 9 Screening and Data Abstraction, 15 References, 16 3 RESULTS 17 Literature Search Results, 17 References , 56 4 DISCUSSION AND FUTURE DIRECTIONS 63 Approach to the Evidence-Scanning Process, 63 Findings, 64 Future Directions, 66 APPENDIXES A ACRONYMS AND ABBREVIATIONS 67 B OPEN SESSION AGENDA 69 C LITERATURE SEARCH RESULTS 71 D REVISED SEARCH CRITERIA 85 E DATA ABSTRACTION SPREADSHEET 93 F COMMITTEE MEMBER BIOGRAPHIES 97 ix

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Human milk is considered the biologic norm for feeding the human infant during the first 6 months of life, and it is a preferred food from 6 to 12 months. It is a complex food and exerts its biologic effects well beyond its known nutritional value; however, human milk composition and the complexity of its composition is not wholly known or understood. Thus, defining the composition of milk, as well as both the individual and combined effects of milk components and the volume consumed on infant growth and development, is central to optimizing infant health. Furthermore, defining human milk composition, volume, and the myriad factors that influence milk components is needed for developing future Dietary Reference Intake (DRI) standards for nutrient intakes during the first 12 months of life.

Scanning for New Evidence on the Nutrient Content of Human Milk examines the new and emerging evidence describing the nutrient content of human milk as well as the volume of milk consumed, both of which are needed to understand nutrient consumption by healthy breastfed infants. An evidence scan approach was used to summarize the status of the published literature on the nutrient content of human milk and to identify new evidence on nutrients in human milk that could inform the need for a systematic review as a component of the DRI process.

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