Infant Health


Research Team

Professor Clare Wall

Professor Clare Wall heads the Nutrition Department at the Faculty of Medical and Health Sciences at the University of Auckland and is the Principal Investigator of the Infant Health priority research programme. Her research interest is in the inter-relationships between the determinants of nutritional status and health outcomes of the paediatric population.


Public Summary

Principal Investigator: Associate Professor Clare Wall, University of Auckland

Weaning is a period of marked physiological change. The introduction of solid foods and the changes in milk consumption are accompanied by significant gastrointestinal tract (GI), immune and developmental adaptations. It is especially in this period of weaning that there are opportunities for the development of complementary food products that aid and support the maintenance of optimal health. Recent discoveries have highlighted how the infant immune system co-evolves with GI microbiota (microbes including bacteria) in a mutualistic relationship, a crucial event that affects the host’s immune system throughout life. Research has also demonstrated that aberrant GI microbiota during infancy is associated with disease conditions later in life. Comparative studies of the genetic material in the GI tact have underscored the dominant role played by diet in shaping the composition and function of GI microbiota.

Tranche 1: 2014 – 2019

Collaborating Organisations: Malaghan Institute, AgResearch, Riddet Institute, Computational Systems Biology Institute (COSBI), University of Trento, Italy

To research the relationship between nutrition, microbiota and infant immune health a multidisciplinary team was established.  Professor Martin Kussmann was the principal investigator working with Dr Olivier Gasser (Malaghan), Professor Warren McNabb (Riddet), and Associate Professor Nicole Roy (AgResearch) and COSBI). Associate Professor Clare Wall from the University of Auckland undertook the clinical trial on behalf of the infant health team. The expertise of the team enabled a systems level approach to be applied to the research whereby an interrogative picture could be demonstrated of the effect of food on metabolism, immunity and function in the whole person, and their organs and tissues. The High-Value Nutrition Infant Health priority research programme investigated if it is possible to interrogate age appropriate New Zealand whole foods and food components to identify candidates, which feed beneficial GI bacteria.  The programme also investigated if it is possible to produce this candidate food into a commercial product which can be fed to infants.

Kūmara was identified as a candidate food, which could support the development of beneficial microbiota. A pilot study was conducted (Nourish to Flourish) which recruited 40 infants prior to the commencement of the introduction of solid foods. Thirty of these infants consumed the kūmara complementary feeding product over a 6-month period and 10 infants received a probiotic control.  Infant feeding behaviour, infant health status and biological samples were collected at three time points (baseline, then 3 months and 6 months after commencing solid food).  The biological samples included faecal, urine, saliva and blood samples. The samples were used to assess the extent to which the complementary feeding had modulated the infant GI microbiota. Retention of infants in the study was excellent with only five infants not completing the study. The kūmara was well tolerated and no adverse events relating to the intervention were reported.

The pilot study demonstrated that it is feasible to recruit infants, feed a known prebiotic food to infants over a 6-month period, and collect biological samples and health parameters, which allow the measurement of immune efficacy of the complementary food. The study has also demonstrated the importance of the collaboration of scientists with expertise in clinical research, immunology, metabolomics and microbiomics.  Outcomes from this pilot study will be available later in 2019.  The study presents opportunities for food and beverage companies to consider the development of other suitable complementary feeding products with known prebiotic properties.  These food products can be tested in the planned Randomised Controlled Clinical Trials in New Zealand and Asia in the next phase of the HVN programme through 2019-2024.

Tranche 2: 2019 – 2024

Collaborating Organisations: Malaghan Institute, AgResearch, Riddet Institute, Plant and Food Research

The aim of this programme is to prove the impact of complementary foods on infant health, focusing on immunity and a reduced number of infections in early life.  During infancy, the introduction of solid foods (weaning) and the changes in milk consumption are accompanied by significant gastrointestinal tract (GI), immune and developmental adaptations [Backhed 2015].  It is especially in this period of weaning that there are opportunities for the development of complementary F&B products that aid in the maintenance of optimal health.  Recent discoveries have highlighted how the infant immune system co-evolves with GI microbiota in a mutualistic relationship, a crucial event that impacts on the host’s immune system throughout life, and how aberrant GI microbiota during infancy is associated with disease conditions later in life [Sjogren 2009; Tamburini 2016].

High-Value Nutrition has identified “Weaning Foods for Health” as a global megatrend in consumer purchasing behaviours.  The present research programme will generate knowledge and methods to support future product development and validation by NZ companies, which will provide support for food-health claims on supporting infant immune development.  The first objective of our five-year plan is the design and conduct of a Randomised Controlled Trial (RCT) of identified complementary foods in Asian Infants living in NZ (2019-2022).  The RCT will be based on the results and outcomes of our pilot clinical trial (2018-2019). 

The RCT will incorporate learnings from the pilot study at the following levels: (i) design of experimental prebiotic weaning food prototypes; (ii) integration and interpretation of longitudinal, multidimensional clinical with molecular phenotyping data; and (iii) documenting associations and – if possible – causality between prebiotic feeding, growth of immune health-beneficial microbes in the infant gut and reduced number of infections and vaccine- specific antibody responses.  The findings from the RCT and in-vitro work will inform the development and delivery of a further trial to be conducted in NZ, which will recruit infants and involve their parents from a consumer perspective.

Infant Health highlights