title: The first model of keeping energy balance and optimal psycho affective development: Breastfed infants.
abstract: Breastfed infants follow a peculiar growth fashion characterized by a rapid weight gain in the first weeks of life, then followed by a fast decrease in growth rates, a capacity to self-regulate the sense of hungry and satiety, and a minor propensity towards overweight and obesity later on, in parallel with a better neurodevelopmental performance.
  
  
  
  We searched studies investigating the relationship between the feeding mode in infancy and the energy balance, so the possible associations with total energy expenditure and intake regulation. We focused the research on the interaction with the neuropsychological development and the possible role of microbiome in determinating the normal generation and regular functioning of the brain through the so named "gut-brain axis".
  
  
  
  Total energy expenditure (TEE) is different for breast-fed and formula-fed infants, in particular the feeding mode seems to affect the sleep organisation. Long-term breastfeeding, is one of the most studied factors of neurodevelopment, several studies reporting beneficial effects on child neuropsychological development. Probably this effect is modulated by genetic variations in fatty acid metabolism. Increasing data also showed that the intestinal microbiome exerts several functions which are able to influence neurodevelopment.
  
  
  
  There is considerable controversy over whether nutrition in early life has a long-term influence on neurodevelopment. Other studies are needed to confirm the association between breastfeeding and brain development.
  
  
  
  The key points of energy disposal, the role and effects of the instestinal flora represent promising fields of investigation possibly leading to indications for the wide area of preventive medicine.
authors.affiliation: Pediatric Intermediate Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ospedale Cà Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. Electronic address: carlo.agostoni@unimi.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Agostoni
authors.affiliation: Pediatric Intermediate Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ospedale Cà Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mazzocchi
authors.affiliation: Pediatric Intermediate Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ospedale Cà Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy.
authors.forename: Ludovica
authors.initials: L
authors.lastname: Leone
authors.affiliation: Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Ciappolino
authors.affiliation: IRCCS "E. Medea" Scientific Institute, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Delvecchio
authors.affiliation: Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Altamura
authors.affiliation: Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, TX, USA.
authors.forename: Paolo
authors.initials: P
authors.lastname: Brambilla
mesh_terms: D001069:Appetite Regulation; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002648:Child; D002657:Child Development; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D063766:Pediatric Obesity / Q000517:prevention & control; D015430:Weight Gain
keywords: Breastfeeding; Energy balance; Microbiome; Neuropsychological development