Nourishing Growing Brains: Maternal Micronutrient Supplementation during Lactation, Human Milk B-Complex Vitamins, and Infant Neurodevelopment - Abstract Micronutrients are critical for healthy brain development and growth, but deficiencies are common in countries with high rates of undernutrition. Early infancy, a particularly sensitive period for brain development, is a time when many infants fully depend on the micronutrient content of mother’s milk to meet their ongoing dietary requirements. Inadequate micronutrient status in a mother may lead to deficiencies of certain micronutrients in breast milk, such as vitamin B6 or B12, and may jeopardize an infant’s neurodevelopment. It is possible this problem may be prevented by providing lactating mothers with daily micronutrient supplementation. The central hypothesis of the proposed research is that maternal MMS during lactation will improve infant neurodevelopment, partly due to higher levels of B-complex vitamin in maternal milk. I propose the following specific aims: 1) to determine if maternal multiple micronutrient supplementation during lactation improves infant neurodevelopment, 2) to quantify the effect of maternal multiple micronutrient supplementation during lactation on B-complex vitamin content in milk, and 3) to measure the association between B-complex vitamin content in milk and neurodevelopment. I will accomplish this through two parent studies, a clinical trial of multiple micronutrient supplementation among lactating mothers in Ethiopia (R01HD107475) and an established observational lactation cohort in Bangladesh. Knowledge gained from this study will address a critical global gap related to maternal micronutrient supplementation during lactation and provide data needed to inform global guidelines. This K23 Career Development Award is being proposed by Dr. Krysten North, a neonatologist and physician- scientist studying nutrition interventions to optimize neurodevelopment among infants in resource-limited settings. Dr. North’s training aims are to develop expertise related to 1) global clinical trials, 2) human milk composition, 3) advanced statistical analysis of correlated data, and 4) infant neurodevelopmental assessment. Her mentorship team includes Dr. Anne CC Lee (primary mentor; global maternal-newborn clinical trials), Dr. Christopher Duggan (co-secondary mentor; micronutrients among children in low-resource settings), and Dr. Mandy Belfort (co-secondary mentor; effects of infant nutrition on neurodevelopment). The candidate is positioned in an ideal environment at Brigham and Women’s Hospital and Harvard Medical School, with rich resources for training and collaboration. She has crafted a detailed career development and training plan that includes an expert scientific advisory committee, mentored research, didactic coursework, and a timeline for manuscript and R01 development. After this K23 period, Dr. North will transition to independence as a researcher and leader in the field of nutrition interventions to improve neurodevelopment for vulnerable infants in resource- limited settings.
