Pediatric Growth and Nutrition Branch (PGNB)

Overview/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.

The branch supports research to understand the relevant biological systems and factors that influence 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. PGNB also encourages research to explore the external contextual (social, behavioral, and environmental) factors that influence these processes.

Furthermore, PGNB supports translational and systems-based research in the application of behavioral science, medical science, and nutrition science to develop interventions for 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.

Developmental Endocrinology: Studies the underlying molecular physiology of congenital and acquired pituitary, thyroid, adrenal, and gonadal disorders, as well as diabetes and metabolic syndrome in children, in addition to the development of therapies for these disorders
Bone Health in Childhood and Young Adulthood: Examines the regulation of bone accrual in adolescence, the interaction of muscle and bone, and the determinants of peak bone mass
Childhood Obesity: Focuses on identifying developmental origins and pathogenesis of childhood obesity, early risk factors and sensitive time periods of exposure to risks for childhood obesity, and the impact of macrosocial policies on the prevention and treatment of childhood obesity
Nutrition Science: Supports research leading to the development and implementation of dietary recommendations to promote health and prevent disease; includes studies of nutrient requirements of preterm and growth-restricted infants and the contributions of breastfeeding and human milk and its components to optimal infant nutrition
- Agriculture and Diet: Value Added for Nutrition, Translation, and Adaptation in a Global Ecology (ADVANTAGE) Project: Explores the intersections that comprise the global nutritional ecology and supports stakeholders as they address ecology-related knowledge and evidence gaps
- Biomarkers of Nutrition for Development–Knowledge Indicating Dietary Sufficiency (BOND-KIDS): Examines the nutritional needs and assessment issues for school-age children (5 through 19 years)
- Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN) Project: Examines the ecology of human milk and its functional implications for both the lactating parent and infant
- Human Milk Composition Initiative (HMCI): Supports development of human milk composition data in the United States and Canada for use by policymakers, researchers, and other stakeholders
Child Health Research Career Development Award (CHRCDA) Program: Supports pediatrician-scientists during their junior faculty years, with a focus on training clinicians in basic science to stimulate innovative research in pediatrics and provide a foundation for pursuit of an academic career (visit Institutional Training Grants [T32/K12] for more information)
Pediatric Scientist Development Program (PSDP): Supports pediatricians during their fellowship years, providing 2 or 3 years of 100%-protected laboratory time without clinical responsibilities for trainees to explore basic science (visit Institutional Training Grants [T32/K12] for more information)
Nutrition for Precision Health (NPH) Program: PGNB leads NICHD’s activities on this NIH-wide program, which is supported through the NIH Common Fund. The program seeks to develop algorithms that 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

Bone Mineral Density in Childhood Study (BMDCS) (Historical/For Reference Only): This multicenter study, supported by NICHD from 2001 to 2011, identified predictors of the timing and magnitude of peak bone mass, a major determinant of osteoporosis in later adulthood. Comparable to the Centers for Disease Control and Prevention growth curves for children and adolescents, the BMDCS developed reference curves for bone mineral density, bone accrual, and linear growth velocities to serve as a valuable tool for both clinicians and investigators worldwide. Data are available in NICHD’s Data and Specimen Hub (DASH).
Child Health and Development Study (CHDS): The CHDS began in 1959 as a companion to the Collaborative Perinatal Study and includes data on more than 20,000 pregnancies. CHDS data 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. Data are available in NICHD’s DASH.
Fels Longitudinal Study : This large study began in 1929 to evaluate human growth and body composition changes over the lifespan. NICHD funded data collection on more than 1,400 individuals enrolled at birth. The North American Standard Tables of Height and Weight and other standards of bone age and skeletal development used Fels data and are in widespread use in the United States and abroad.
Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) Study PubMed Articles: These scientific articles resulted from the HAPO study, partially funded by PGNB.
National Collaborative on Childhood Obesity Research (NCCOR) : This collaborative effort focuses on accelerating progress to reduce childhood obesity in America, especially among high-risk populations and communities. NCCOR provides a library of internal resources as well as online tools 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 contributed to the development of these materials.

Karen Winer, Acting Branch Chief
Main Research Areas: Pediatric endocrinology including disorders of linear growth, pubertal timing, and tempo; disorders of the gonads and adrenal, pituitary, and thyroid glands; bone health and osteoporosis prevention including determinants of peak bone mass, genetic disorders of skeletal growth, and bone accrual; metabolic programming and metabolic syndrome leading to type 2 diabetes in children
Heather Brockway, Program Official
Main Research Areas: Developmental origins of human disease, specifically metabolic disorders and obesity; impact of adverse perinatal events on long-term infant and maternal health; evolution of human disease; sex and population disparities in health outcomes
Layla Esposito, Program Official
Main Research Areas: Behavioral and environmental interventions for childhood obesity prevention and treatment; behavioral and psychosocial determinants of childhood obesity
Porschae Fon, Extramural Support Assistant
Dorothy Tucker, Staff Assistant
Jenny Wilson, Program Analyst

Highlights

ADVANTAGE (Agriculture and Diet: Value Added for Nutrition, Translation, and Adaptation in a Global Ecology) Project Virtual Meetings. In spring 2023, PGNB sponsored this series of working group meetings to better understand the intersection of food systems, diet, nutrition, and health.
Biomarkers of Nutrition for Development–Knowledge Indicating Dietary Sufficiency (BOND-KIDS) Working Group Meetings. In 2022, PGNB sponsored this series of working group meetings to examine the nutritional needs and assessment issues for school-age children (5 through 19 years). Visit the meeting page to access recordings of all four working group discussions.
BEGIN Project Webinar Series. In early 2021, PGNB sponsored a series of meetings to examine the ecology of human milk and its functional implications for both lactating parent and infant. Visit the meeting page to access recordings of all five working group discussions.
- The American Journal of Clinical Nutrition recently published a supplement about the BEGIN Project .
Exploring the Science Surrounding the Safe Use of Bioactive Ingredients in Infant Formula: Considerations for an Assessment Framework. In fall 2021, PGNB collaborated with the U.S. Food and Drug Administration (FDA) to sponsor a 2-day workshop focused on the functional state-of-the-science of biologically active human milk components and analogs and the implications for safety assessments when used in infant formula. Access the recordings from Day 1 and Day 2.
Bridging the Biological and Communication Sciences on Nutrients and Environmental Contaminants in Foods to Support Child Development. In early 2023, PGNB, in collaboration with the FDA, sponsored a 2-day workshop focusing on research in risk communication, environmental contaminants in food, and the role of nutrition as they relate to child development. Access the recordings from Day 1 and Day 2.

Pediatric Growth and Nutrition Branch (PGNB)

Overview/Mission

Branch Research Priorities

Human Milk Composition and Function

Nutrition for Preterm Infants

Childhood Growth

Childhood Obesity

Puberty

Branch Research Programs and Networks

Branch-Funded Projects

Researcher Tools and Resources

Program Scientists, Staff, and Research Areas

Highlights