Infant brain development is the fastest in the early years of life compared to the rest of the body. The neonatal brain, which is one-third to one-fourth of the size of the adult brain at birth, grows rapidly to reach 72% of adult volume within the first year, suggesting that the majority of brain growth happens during the first year of life. 

The foetal period, early life, and childhood are critical periods for the development and programming of metabolic systems, including the skeleton. Peak bone mass attained during early life determines lifelong skeletal fragility.¹ Peak bone mass is the amount of bone acquired when accrual ceases or reaches a plateau at some point after the completion of growth and development. 

Infants and young children experiencing immune-mediated responses to cow’s milk (CM) face immediate and long-term health issues. CM Protein allergy (CMPA) is among the most common food allergies in early life and approximately 60% of patients present with IgE-mediated CM. Most children gradually outgrow their allergy and develop tolerance to milk proteins over time. Gut microbiota can influence the development of immune responses and food allergies during early infancy.¹

Cow’s milk allergy (CMA) and cow’s milk protein intolerance (CMPI) are primary diseases affecting infants.¹ CMA is one of the most common food allergies affecting children in the early years of life with a prevalence of 2–5%.^1,2 Children with persistent CMA exhibit IgE reactivity towards casein epitopes. Recent research shows that circulating casein-specific T cells are the most prevalent in children suffering from CMA.²

Lactose intolerance (LI) is a common gastrointestinal condition which is due to the inability to digest and absorb dietary lactose. About 70% of the world’s population suffer from LI due to a genetically programmed gradual decline in lactase expression after weaning, so-called lactase non-persistence.

Functional gastrointestinal disorders (FGIDs) in infants and toddlers are common worldwide and cover a variety of disorders associated with chronic, recurrent symptoms attributable to the gastrointestinal tract, but not explained by structural or biochemical abnormalities.

From early life to adulthood, the microbiota play a crucial role in the health of the infant. The microbiota in early life are not only a key regulator of infant health but also associated with long-term health.¹ The early life microflora is highly unstable and undergoes dynamic changes during the first few years. Various maternal factors along with the vertical microbial transfer from the mother, as well as the horizontal environmental transmission and internal factors relating to the infant, play a crucial role in modulating the gut microbiota

Soy-based enriched nutrition have been in use for more than 100 years and continue to be very popular as a nutritional supplement for growing infants.¹ Soy has been studied for over 40 years in children and provides high quality nutrition that results in positive growth patterns.² Moreover, the increase in cow's milk allergy and vegetarian dietary preferences are driving consumers toward cow's milk alternatives.³ 

Hypoallergenic enriched nutrition, including extensively hydrolyzed (EH) protein supplements or amino acid-based (AA) supplements, are recommended for the dietary management of infants with CMPA who cannot be breastfed. Typically, the majority of infants with CMPA are managed effectively on an EH enriched nutrition. Increasing evidence supports lowering total protein content in both hypoallergenic enriched nutrition supplements and routine enriched nutrition supplements to be more in line with the amount of protein found in human milk.³

Inborn Errors of Metabolism (IEM) are rare genetic (inherited or congenital) disorders, in which the body does not properly breakdown the nutrients and generate energy. Children affected by this are unable to survive beyond the age of 1 due to complications caused by protein build-up in the body.

Acute diarrheal illness is a major global public health concern, especially in developing countries. Diarrhea is the second cause of morbidity and mortality in children under 5 years of age and accounts for around 15% of all childhood death; it is responsible for more than 1 million deaths each year.¹

Gut microbes play important roles in mammalian homeostasis, including providing essential nutrients, metabolizing dietary fibre into short chain fatty acids, and ensuring proper development of the immune system. Therefore, the gut microbiota is considered a crucial factor for proper early life development and lifelong health.

Prematurity is the leading cause of neonatal morbidity and mortality . Globally 15% of the newborns are Low Birth Weight due to Preterm or Intra Uterine Growth Retardation (IUGR). In India the number is 28 %. ¹   Extremely preterm (<28 weeks’ gestational age) and Extremely Low Birth Weight (ELBW, birth <1000 g) babies are born during the late second and third trimesters of pregnancy. ²   

The use of human breast milk for enteral nutrition is preferred for preterm infants, as it provides adequate amounts of energy, proteins, lipids, carbohydrates, microelements, and water for growth and development. Furthermore, breast milk contains antimicrobial factors (e.g. immunoglobulin A, leucocytes, lactoferrin and lysozymes), and growth hormones and factors².

Growth failure in preterm infants remains extremely common despite advances in neonatal care.¹ These premies can grow at the fetal growth rate of at least 15 g kg−1day−1 in the newborn intensive care unit (NICU), which parallels fetal growth, but because adequate weight gain commences only after 1–2 weeks it does not result in catch-up growth during the hospital stay.²  These graduates of the NICU frequently enters into the home setting at a physical size and weights below the 10th centile for age¹

Preterm birth (before 37 gestational weeks) poses a risk of poorer neurocognitive functioning. This risk is highest for those born very preterm (<32 weeks) or at very low birth weight (VLBW; <1500g), and effects span beyond childhood. Explaining this vulnerability are factors that underlie and result from preterm birth, including pregnancy complications and immaturity-related health problems.