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For Healthcare Professionals Only Nestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Professor Mark Manary from Washington University and Adeline Lescanne, CEO of Nutriset, about ready-to-use therapeutic foods (RUTF) for severe acute malnutrition (SAM). Professor Manary describes how hospital-based treatment historically achieved only 45% recovery rates, prompting exploration of home-based alternatives. The RUTF concept, inspired by low-moisture foods like chocolate spread and halva, emerged through collaboration between André Briend and Michel Lescanne. Initial clinical trials in 2001 demonstrated dramatic improvements, achieving 90% recovery rates compared to 45% with traditional hospital care. The low water content prevents bacterial growth, enabling safe community-based treatment. Nutriset developed the Plumpy Field network, establishing local manufacturing facilities across 12-13 countries including Haiti, Nigeria, Ethiopia, and India, maintaining rigorous quality control from raw material sourcing through finished product testing. The company has treated over 65 million malnourished children. The episode highlights how RUTF has become a standard of care for community-based SAM management and underscores the importance of sustained partnerships and investment to ensure continued access for children who need treatment. For Healthcare Professionals Only Nestlé Nutrition Institute

For Healthcare Professionals Only Nestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Professor Hania Szajewska from the Medical University of Warsaw about probiotics and prebiotics in pediatric nutrition. Professor Szajewska emphasizes the importance of evidence-based definitions from the International Scientific Association for Probiotics and Prebiotics (ISAPP), requiring documented health benefits in randomized controlled trials before products can be classified as probiotics or prebiotics. The discussion highlights critical factors influencing infant gut microbiota development, including mode of delivery, feeding method, and antibiotic exposure, with breastfeeding providing human milk oligosaccharides (HMOs) that selectively promote bifidobacteria. Professor Szajewska reviews current evidence from ESPGHAN guidelines, noting that while biotic-supplemented formulas demonstrate safety and adequate growth support, clinical benefit evidence remains limited and strain-specific. She discusses targeted probiotic applications, including necrotizing enterocolitis prevention and acute gastroenteritis management, while acknowledging the need for identifying populations most likely to benefit from these interventions. For Healthcare Professionals Only Nestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Professor Chittaranjan Yajnik about the Developmental Origins of Health and Disease (DOHaD) theory. Professor Yajnik traces its origins to David Barker's "Fetal Origins of Adult Disease" hypothesis, which demonstrated geographic correlations between early-life deprivation and adult cardiovascular disease mortality across English counties. The theory has evolved beyond hypothesis status, supported by cohort studies, animal models, and research demonstrating how intrauterine and early-life conditions influence later risk of non-communicable diseases. Professor Yajnik discusses his collaboration with Barker beginning in 1991 and explains why India provided an ideal research setting given its high prevalence of low birth weight and rapidly increasing diabetes rates. He highlights the "Yajnik-Yudkin (YY) paradox," demonstrating that Indians develop diabetes at younger ages with lower BMI but higher body fat percentages compared to Europeans. The "thin-fat Indian baby syndrome" further showed that Indian newborns, despite being 800 grams lighter, exhibit proportionally higher adiposity and metabolic risk markers at birth, establishing critical evidence for DOHaD's relevance in South Asian populations and informing early-life intervention strategies. For Healthcare Professionals Only Nestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice speaks with Professor Josef Neu from the University of Florida about advances in preterm infant nutrition. Professor Neu traces the field's evolution from the late 1800s, when incubators adapted from poultry technology reduced mortality by half, through critical developments including infection control, mechanical ventilation, and surfactant therapy. The discussion highlights the unique nutritional demands of premature infants, requiring approximately 120 calories per kilogram daily and 3-4 grams of protein per kilogram to support rapid growth and neurodevelopment. Professor Neu addresses historical controversies, including delayed enteral feeding practices, and emphasizes the importance of early gastrointestinal tract stimulation for mucosal immunity and barrier function. Current best practices favor mother's own milk with fortification when necessary, supported by evidence-based guidelines from pediatric societies. Professor Neu also discusses precision nutrition approaches utilizing artificial intelligence, machine learning clustering, and digital twin technologies to tailor strategies by gestational age, sex, and early-life exposures. For Healthcare Professionals Only Nestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Dr. Howarth Bouis, 2016 World Food Prize laureate and founding director of HarvestPlus, about the development and impact of biofortification of staple crops. Dr. Bouis describes how his work began in the early 1990s, driven by the high recurrent costs of supplementation and the potential for crops themselves to deliver essential micronutrients. He outlines key challenges, such as combining nutrient density with high yields, ensuring bioavailability, achieving consumer acceptance, and sustaining long-term investment in crop development. Since its launch in 2003, HarvestPlus has developed biofortified varieties of 13 staple crops targeting iron, zinc, and vitamin A deficiencies. Evidence demonstrating higher-than-expected provitamin A bioavailability and meaningful iron absorption supported large-scale adoption. Today, biofortified crops are grown in more than 40 countries, reaching an estimated 400 million people. The discussion also explores future opportunities, including genetic modification technologies to further enhance micronutrient content in staple foods. For Healthcare Professionals Only Nestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice speaks with Professor Stanley Zlotkin from the University of Toronto about the development and global impact of sprinkles and multiple micronutrient powders (MNPs). Professor Zlotkin describes how his formative experience in Nigeria inspired his commitment to addressing childhood malnutrition. Recognizing poor compliance with traditional iron drops, Professor Zlotkin developed microencapsulated ferrous fumarate that could be sprinkled onto home-prepared complementary foods without affecting taste, color, or texture. The first efficacy trial in Ghana demonstrated effectiveness comparable to iron drops, supporting subsequent expansion to a formulation containing 17 essential vitamins and minerals. The intervention’s low cost, strong cost-effectiveness, and ease of use enabled large-scale implementation, with UNICEF now procuring millions of doses annually for use across low- and middle-income countries. Endorsed by WHO and included in the WHO Model List of Essential Medicines for Children, MNPs are now recognized as a key intervention for the prevention of childhood micronutrient deficiencies. For Healthcare Professionals Only Nestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Professor Keith West from Johns Hopkins University about the development and impact of universal vitamin A supplementation programs. Professor West traces the evolution from early clinical observations linking vitamin A deficiency to ocular manifestations and childhood blindness, to the pivotal studies in the 1980s by Alfred Sommer's team demonstrating its association with child mortality. He highlights the landmark Aceh trial (1983–1984), which showed a 34% reduction in preschool child mortality, followed by replication trials and meta-analyses across multiple countries demonstrating 23–30% mortality reduction. These findings supported large-scale implementation of twice-yearly supplementation programs in approximately 85 countries. The discussion also addresses ongoing questions around neonatal supplementation, noting regional differences in observed benefits. The episode underscores vitamin A supplementation as one of the most impactful global nutrition interventions, contributing to substantial reductions in child mortality worldwide. For Healthcare Professionals Only Nestlé Nutrition Institute

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Dr. Mercedes de Onis, the principal architect of the WHO Child Growth Standards now used in over 150 countries worldwide. Dr. de Onis discusses the limitations of earlier growth references, particularly the NCHS curves, which were based primarily on U.S. populations and often suggested growth faltering in breastfed infants. She describes the landmark WHO Multicentre Growth Study, conducted between 1997 and 2003 across six countries, which established prescriptive standards based on optimal growth conditions, including exclusive breastfeeding and supportive environments. Launched in 2006, the WHO Child Growth Standards introduced key metrics including BMI-for-age and velocity standards, supporting both population-level surveillance and individual clinical monitoring. This conversation highlights the significant scientific effort and international collaboration behind tools that healthcare professionals utilize daily, to guide nutritional care and promote healthy growth in children worldwide. For Healthcare Professionals Only Nestlé Nutrition Institute

Professor Kate Ward shares how calcium and iron are vital nutrients throughout the reproductive life course, with heightened importance during adolescence, pregnancy, and lactation. Adequate intake through balanced diets, and targeted supplementation where needed, supports bone health, fetal development, and anemia-prevention. Population-specific guidance and further research are key to addressing deficiencies and optimizing health outcomes for women and their offspring.  For Healthcare Professionals Only Nestlé Nutrition Institute

Dr. Otilia Perichart-Perera discusses how optimal maternal nutrition during lactation supports the mother’s health, as well as the infant’s growth and development. Breastfeeding increases energy and nutrient demands, making adequate intake of omega-3 fatty acids, iron, and vitamin D essential. Balanced diets, appropriate supplementation, and strong breastfeeding support can help sustain milk quality, prevent deficiencies, and promote continued breastfeeding success. For Healthcare Professionals Only Nestlé Nutrition Institute

Dr. Nandita Perumal highlights how balanced, diverse, and nutrient-rich diets are essential for healthy pregnancy outcomes. Increased energy and nutrient needs during pregnancy support maternal health, placental function, and fetal growth. Meeting, but not exceeding, these nutritional requirements helps ensure appropriate gestational weight gain and reduces the risk of adverse outcomes, supporting both maternal well-being and the child’s lifelong health trajectory. For Healthcare Professionals Only Nestlé Nutrition Institute

Dr. Linden Stocker and Professor Alexandra Kermack discuss how preconception nutrition and lifestyle choices made by both parents have a lasting impact on fertility, pregnancy outcomes, and the long-term health of their children. Balanced dietary patterns rich in essential macro and micronutrients, fiber, and antioxidants, support reproductive health, while excess alcohol, caffeine, and ultra-processed foods can pose risks. Early education, public health strategies, and tailored guidance can help integrate preconception nutrition into broader reproductive health practices. For Healthcare Professionals Only Nestlé Nutrition Institute

Professor Elvira Verduci talks about complementary feeding as a critical window for shaping future health, emphasizing its role in bridging nutrient gaps beyond six months. She explains the importance of introducing solids between 17 and 26 weeks, noting that earlier introduction may have health risks, while delays may cause deficiencies. She further explains how responsive feeding and parenting styles help build healthy eating habits, while starting before four months may raise obesity risk. Approaches should be tailored to each child’s needs, culture, and family practices to encourage lifelong healthy eating.​ For Healthcare Professionals Only Nestlé Nutrition Institute