Pediatric Growth and Nutrition Branch (PGNB)

Hand under X-RayOverview/Mission

PGNB serves as the focal point for NICHD extramural research in pediatric endocrinology and nutrition and their impact on health promotion and disease prevention throughout the life course. PGNB also serves as the focal point for NICHD training in child health research.

Specifically, PGNB supports research to understand the relevant biological systems and factors that influence the mechanisms of physical and neurological development beginning in utero and extending through the lifespan, as well as the role and impact of nutritional status in these systems; the branch also encourages research to explore the external contextual (social, behavioral, and environmental) factors that influence these processes.

PGNB further supports translational and systems-based research in the application of behavioral, medical, and nutritional science to develop interventions aimed at promoting health and mitigating disease during critical periods in human development.

We are interested in applications that align with the following research priorities. For more information about NICHD’s research themes, cross-cutting topics, and aspirational goals, visit the plan’s Scientific Research Themes and Objectives.

Human Milk Composition and Function

Strategic Plan Cross-Cutting Topic: Nutrition
Strategic Plan Aspirational Goal: Optimize infant survival by synthesizing human milk and individualizing it to the characteristics of the infant’s lactating parent

Gap: There is limited information regarding the composition of the bioactive components (nutritive and non-nutritive) of human milk and the functional mechanisms by which human milk components—acting both individually and together—affect the health of the infant and lactating parent.

Priority: Research aimed at (1) elucidating the factors affecting the ontogeny of human lactation (including mammary gland biology/function, maternal neuroendocrinology, nutrition, and the impact of these factors over the course of gestation, a feeding, a day, and the duration of lactation); (2) characterizing the systems biology of human milk including its composition and function according to stage of lactation, circadian biology, and infant gestational age; (3) applying this knowledge to understand the effects of (and differences among) directly breastfed, expressed/stored and bottle-fed, and banked/donor bottle-fed human milk on infant health and development; (4) improving our understanding of how human milk composition over time affects decisions regarding the timing and composition of complementary feeding practices; and (5) understanding the factors (social, cultural, behavioral, and environmental) that affect infant feeding choice.

Nutrition for Preterm Infants

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Cross-Cutting Topic: Nutrition
Strategic Plan Aspirational Goal: Enhance the survival and healthy development of preterm infants by exploring the role of environmental factors

Gap: Even though preterm birth accounts for more than 10% of live births in the United States and is a strong predictor of infant morbidity and mortality, there are no accepted standards for the nutritional care of preterm infants that cover their full developmental range—from infants born at the limits of viability to those born “near term.”

Priority: Research aimed at (1) ascertaining the macro- and micronutrient requirements to optimize survival, growth, and development for preterm infants; (2) discerning the impact of both total parenteral nutrition and enteral nutrition in the feeding of preterm infants; (3) understanding the factors that influence the ontogeny of the infant microbiomes (oral and gut) and whether or how those factors influence infant health and development; and (4) understanding the role of bioactive components of human milk (e.g., human milk oligosaccharides, peptides) in feeding preterm infants.

Childhood Growth

Strategic Plan Theme 1: Understanding the Molecular, Cellular, and Structural Basis of Development
Strategic Plan Aspirational Goal: Facilitate application of precision medicine approaches in children

Gap: Translational studies have shown that hormones and cytokines secreted from bone and muscle may be essential for normal linear growth and skeletal development. Furthermore, translational studies suggest that bone cells secrete hormones that may regulate metabolism and fertility. However, many gaps remain in our understanding of normal growth and development, and there is little research characterizing the endocrine functions of bone and describing its effects on the multitude of temporal changes that occur during growth and development over the various stages of childhood.

Priority: Research aimed at (1) identifying the genetic factors involved in bone acquisition and linear growth; (2) characterizing the molecular and cellular mechanisms responsible for the control of linear growth and the acquisition of bone and muscle mass; (3) elucidating the autocrine, paracrine, and endocrine effects of bone-derived hormones and how they evolve over time during childhood and into young adulthood; and (4) identifying approaches to prevent, treat, and reverse abnormal linear growth and bone loss resulting from chronic illness. 

Childhood Obesity

Strategic Plan Theme 4: Improving Child and Adolescent Health and the Transition to Adulthood

Gap: Childhood obesity is a serious problem in the United States with a prevalence approaching 20% in children and adolescents 2 to 19 years old, putting affected youth at risk for poor short- and long-term health. However, the pathophysiology of obesity in youth differs from that in adults, and there is a dearth of knowledge about how to effectively prevent and treat childhood obesity, especially in high-risk populations.

Priority: Research aimed at (1) identifying early risk factors and sensitive time periods for exposure to risks for childhood obesity; (2) elucidating the biological processes involved in the development of childhood obesity; and (3) using information on early risk factors and sensitive time periods to develop and test novel interventions for the prevention and treatment of childhood obesity, particularly in high-risk and underserved populations.

Puberty

Strategic Plan Theme 2: Promoting Gynecologic, Andrologic, and Reproductive Health
Strategic Plan Theme 4: Improving Child and Adolescent Health and the Transition to Adulthood

Gap: We have a limited understanding of the developmental processes and factors that contribute to the initiation of puberty and the determination of the tempo of developmental changes that occur during adolescence.

Opportunities: Research aimed at (1) understanding the mechanisms responsible for the onset of puberty and the genetic and epigenetic alterations that lead to disorders of pubertal timing and tempo; (2) elucidating the factors affecting the timing and duration of the pubertal growth spurt and their relevance on achieving optimal skeletal maturation and bone density; and (3) understanding the impact of pubertal timing and tempo on reproductive health. 

  • Human Milk: Focuses on understanding the complex biology of human milk and using a systems biology approach to uncover the myriad factors that influence the composition and function of human milk
  • Nutrition Science: Supports research on the intersection of nutrition, within the global health context, and the development and implementation of dietary recommendations to promote health and prevent disease; also investigates the complex nutritional relationships between the lactating parent and their fetus, the placental transfer of nutrients, and the role of nutrition in infant development
  • Growth and Development: Includes research on growth-promoting polypeptides, hypothalamic releasing factors, basic and clinical studies of the etiology and therapy of growth retardation, and studies of trans-membrane signaling in effector cells
  • Pediatric Endocrinology: Supports studies on the underlying molecular physiology of congenital and acquired pituitary, thyroid, adrenal, and gonadal disorders, as well as diabetes, obesity, and metabolic syndrome in children, in addition to the development of new therapies for these disorders
  • Childhood Obesity: Supports studies on identifying early risk factors and sensitive time periods for exposure to risks for childhood obesity, the pathogenesis of childhood obesity, and novel interventions for the prevention and treatment of childhood obesity
  • Developmental Origins of Health and Disease: Studies conditions that result from gene-environmental interactions from the pre-pregnancy period throughout pregnancy and into early childhood
  • Prevention of Chronic Disease: Focuses on understanding and preventing obesity, osteoporosis, cardiovascular disease, and diabetes
  • Nutrition for Precision Health Program: Trans-NIH program supported through the NIH Common Fund that aims to develop algorithms to predict individual responses to food and dietary patterns by applying artificial intelligence, microbiome research, and other advances to the large, diverse participant group of the All of Us research program
  • Child Health Research Career Development Award Program: Supports pediatrician-scientists during their fellowship training years; funding predominantly supports training clinicians in basic science to stimulate innovative research in pediatrics and to provide junior investigators with a foundation to pursue academic career goals (Visit https://www.nichd.nih.gov/grants-contracts/training-careers/extramural/institutional for more information)
  • Pediatric Scientist Development Program: Provides 2 or 3 years of 100%-protected laboratory time without clinical responsibilities for trainees to explore basic science. (Visit https://www.nichd.nih.gov/grants-contracts/training-careers/extramural/institutional for more information)

  • Bone Mineral Density in Childhood Study (BMDCS) (Historical/For Reference Only): The BMDCS (2001-2011) offered an unprecedented opportunity to identify predictors of the timing and magnitude of peak bone mass, a major determinant of osteoporosis in later adulthood. BMDCS investigators provided reference curves for bone accrual and linear growth velocity that are comparable to the Centers for Disease Control and Prevention linear growth and weight gain curves for children and adolescents. The reference curves generated by this carefully executed study provided the gold standard for normal bone accrual for generations to come. The study’s results enable practitioners to identify the adverse effects that chronic illness has on bone. Additionally, the results have clarified the effects that the timing of pubertal onset have on bone density and linear growth, as well as the need for height adjustment for dual-energy X-ray absorptiometry results in children. Data are available in NICHD’s Data and Specimen Hub (DASH).
  • Child Health and Development Study (CHDS): The CHDS includes 20,000 pregnancies and began in 1959 as a companion to the Collaborative Perinatal Study; its database and biosamples are available in NICHD's Data and Specimen Hub (DASH). Data from CHDS are particularly relevant for investigators studying maternal and placental origins of disease, especially the long-term effects of in utero exposure to organochlorines, such as DDT.
  • Fels Longitudinal Study external link: This is a large, long-running study evaluating human growth and body composition changes over the lifespan. NICHD-supported investigators followed more than 1,400 individuals enrolled at birth, beginning in 1930. The Fels Study provided growth data for the North American Standard Tables of Height and Weight, as well as for a comprehensive atlas of bone age and skeletal development. These standards are in widespread use in the United States and abroad.
  • Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) Study PubMed Articles: Lists scientific articles that resulted from the HAPO study, which was funded in part through PGNB.
  • National Collaborative on Childhood Obesity Research (NCCOR) external link: This collaborative focuses on accelerating progress to reduce childhood obesity in America, especially among high-risk populations and communities. NCCOR provides a library of internal resources external link as well as online tools external link such as the Measures Registry, the Catalogue of Surveillance Systems, and the Youth Compendium of Physical Activities, which may be useful for investigators studying childhood obesity. NICHD is an NCCOR member and has supported the development of these materials.

  • Andrew Bremer, M.D., Ph.D., M.A.S., Branch Chief
    Main Research Areas: Diabetes (type 1, type 2, and gestational); developmental origins of health and disease; metabolic programming; metabolic syndrome in children; the causes of obesity in childhood and the sequelae of childhood obesity in adulthood; maternal obesity and the effect of maternal nutrition on fetal programming; human milk; the role of nutrition in health and disease across the lifespan
  • Layla Esposito, Program Official
    Main Research Areas: Behavioral and environmental interventions for childhood obesity prevention and treatment; behavioral and psychosocial determinants of childhood obesity
  • Kimberlea Gibbs, Nutrition Specialist
    Main Research Areas: Infant and childhood nutrition; impact of food systems on sustainability, food security, and consumption patterns; food pathways and value chain effects on nutrition status across the lifespan; school and neighborhood food environments; international nutrition
  • Daniel Raiten, Program Official
    Main Research Areas: Infant feeding (maternal/fetal aspects of infant feeding); mammary gland biology and lactation (act of breastfeeding, biology of milk production, milk as a nutrient, etc.); nutrition (childhood, adolescent, HIV-related, and micronutrients)
  • Dorothy Tucker, Staff Assistant
  • Ashley Vargas, Program Official
    Main Research Areas: Infant, child, and maternal nutrition and dietetics including obesity; precision nutrition including microbiome, genomics, and biomarker development; human milk
  • Jenny Wilson, Program Analyst
  • Karen Winer, Medical Officer
    Main Research Areas: Bone health and osteoporosis prevention; muscle-bone-fat interactions related to growth during infancy and childhood; determinants of peak bone mass; genetic disorders leading to congenital skeletal disease or disorders of growth or maturation; pediatric endocrinology including disorders of pubertal tempo and timing or linear growth; childhood disorders of the thyroid, gonads, adrenal, and pituitary glands

Highlights

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