TEP Hall of Fame_Awardees

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HALL OF FAME Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 1

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Trainee Expansion Program OVERVIEW OF AWARDEES We are pleased to present the TEP Bridge Fund and TEP Travel Fund awardees. Each talented individual received a scholarship of up to USD 100,000 or up to USD 10,000 to help advance their career. Table of Contents AWARDEES 2024 .................................................................................................................................................. 5 RACHEL WALKER ........................................................................................................................................................... 6 RUTHFIRST AYANDE ....................................................................................................................................................... 7 DOROTHY BUNDI ........................................................................................................................................................... 8 HATICE ÇETINKAYA ........................................................................................................................................................ 9 HASLINA ABDUL HAMID .............................................................................................................................................. 10 XUEHUA JIN ................................................................................................................................................................. 11 AWARDEES 2023 ................................................................................................................................................ 12 BROCK WILLIAMS ........................................................................................................................................................ 13 LAASYA DEVI ANNEPUREDDY ...................................................................................................................................... 14 MAHESHWAR BHASIN ................................................................................................................................................. 15 MICHAEL PITINO ......................................................................................................................................................... 16 MICHELLE ASBURY ...................................................................................................................................................... 17 AWARDEES 2022 ................................................................................................................................................ 18 ADWOA GYAMFI .......................................................................................................................................................... 19 MICHAEL PITINO ......................................................................................................................................................... 20 OMOBOLAJI ADEWUYI ................................................................................................................................................ 21 MARION BENDIXEN ..................................................................................................................................................... 22 SARA SHAMA ............................................................................................................................................................... 23 AWARDEES 2021 ................................................................................................................................................ 24 JORDYN TINKA WALLENBORN ..................................................................................................................................... 25 KELSEY COCHRANE ...................................................................................................................................................... 26 ALEXANDRA GOGEL .................................................................................................................................................... 27 NINA JUNTEREAL ......................................................................................................................................................... 28 NATALIE SCIME ............................................................................................................................................................ 29 JOHANNE SPECKLES .................................................................................................................................................... 30 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 2

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AWARDEES 2020 ................................................................................................................................................ 31 ALEXANDRA GEORGE .................................................................................................................................................. 32 YANG LU ...................................................................................................................................................................... 33 SARAH TURNER ........................................................................................................................................................... 34 AWARDEES SUMMER 2019 ................................................................................................................................. 35 YARDEN GOLAN MAOR ............................................................................................................................................... 36 KOZETA MILIKU ............................................................................................................................................................ 37 ASHLEY NELSON .......................................................................................................................................................... 38 TONNY JIMMY OWALLA .............................................................................................................................................. 39 AWARDEES SPRING 2019 .................................................................................................................................... 40 ALEXANDRA GEORGE .................................................................................................................................................. 41 ANURADHA RAVI ......................................................................................................................................................... 42 AWARDEES SUMMER 2018 ................................................................................................................................. 43 EVA NANICK ................................................................................................................................................................. 44 STEPHANIE L. MARTIN ................................................................................................................................................. 45 GRACE CAROLL ............................................................................................................................................................ 46 YIMIN CHEN................................................................................................................................................................. 47 AWARDEES SPRING 2018 .................................................................................................................................... 48 ALBA BOIX AMARÓS .................................................................................................................................................... 49 ANITA ESQUERRA-ZWIERS ........................................................................................................................................... 50 CAMILLE DUGAS .......................................................................................................................................................... 51 KIRSTEN MEYER ........................................................................................................................................................... 52 RUKSHAN MEHTA ........................................................................................................................................................ 53 AWARDEES SUMMER 2017 ................................................................................................................................. 54 JAMES BUTCHER .......................................................................................................................................................... 55 KASSANDRA HARDING ................................................................................................................................................ 56 KYLY WHITFIELD .......................................................................................................................................................... 57 AWARDEES 2017 ................................................................................................................................................ 58 ADRIANA GAITÁN ........................................................................................................................................................ 59 CLARISA MEDINA POELINIZ ......................................................................................................................................... 60 KOZETA MILIKU ............................................................................................................................................................ 61 LARISSE MELO ............................................................................................................................................................. 62 SARAH BOOTHMAN .................................................................................................................................................... 63 SARAH REYES ............................................................................................................................................................... 64 AWARDEES 2016 ................................................................................................................................................ 65 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 3

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ALECIA-JANE TWIGGER ............................................................................................................................................... 66 KIMBERLY LACKEY ....................................................................................................................................................... 67 KLARA STRYDOM ......................................................................................................................................................... 68 MELANIE WANGE LARSSON ........................................................................................................................................ 69 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 4

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Trainee Expansion Program AWARDEES 2024 We are pleased to present the awardees of the TEP Bridge Funds and the TEP Travel Funds, who each received up to USD 100,000 or up to USD 10,000 respectively to advance in their academic ca- reer. TEP Trainee Bridge Fund Awardee Rachel Walker TEP Trainee Travel Fund Awardees Hatice Çetinkaya 5 Ruthfirst Ayande Dorothy Bundi Linking the Placenta to Secre- tory Activation and Milk Vol- ume in Mothers of Preterm In- fants TBF Awardee 2024 Neonatal Feeding Practices, Lactation Support, and Infant Outcomes: A Needs Assessment to Elucidate Facilitators of, Gaps in, and Opportunities for Improv- ing, Neonatal Lactation Outcomes for Vulnerable Infants in Ghana TBF Awardee 2024 Exploring community-based ap- proaches for improving lactation and optimizing the nutritional status of lactating women and their infants in informal settlements in Kenya. TTF Awardee 2024 Elucidating biological under- pinnings of impaired lactation with transcriptome analysis of human milk fat layers TTF Awardee 2024 Haslina Abdul Hamid Xuehua Jin Hormonal Concentrations of Preterm Breast Milk and Its Association with Infant Growth Outcomes TTF Awardee 2024 Human Milk Xenobiotics in Women with Low and Normal Milk Supplies: Implications for Infant Exposure TTF Awardee 2024 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program

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TBF Awardee 2024 RACHEL WALKER Rachel’s work is focused on investigating the bio- logical mechanisms behind low milk volume and developing practical solutions to improve milk pro- duction in vulnerable populations. In this project, Rachel will investigate the biological and clinical aspects of lactation in a global context. She will travel to Uganda to complete this project under the mentorship of both Dr. Elias Kumbakumba at Mba- rara University of Science and Technology in Uganda and Dr. Paula Meier at Rush University in the United States. This project will investigate the potential use of the placenta to predict delayed secretory activation, milk fatty acids, and milk volume during the first postpartum weeks in mothers giving birth to pre- term infants. The study cohort will be recruited at the Mbarara Regional Referral Hospital in Mba- rara, Uganda and use field friendly methods to connect placental features to early lactation. The PlacentaVision algorithm will calculate placental dimensions and features at birth with digital photo- graphs, and we will measure daily milk sodium concentrations, dried milk spot fatty acid composi- tion, and daily pumped milk volume during hospi- talization. Dr. Rachel Walker has a PhD in nutritional sci- ences from Penn State, where she studied the role of fatty acid metabolism in inflammatory signaling and resolution. She spent a year in a dairy re- search lab with Kevin Harvatine, PhD, conducting animal studies on nutrition and milk fat synthesis, after which she did her postdoctoral fellowship training with Alison Gernand, PhD, MPH, an expert in global health, micronutrients, pregnancy, and the placenta. She is also trained as a Certified Lac- tation Counselor, with expertise in breastfeeding education and support. Dr. Walker's two main sci- entific interests are lipids and milk, and she strives to use her work to make life better for families, mothers, and infants. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 6

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TBF Awardee 2024 RUTHFIRST AYANDE Infants born preterm (<37 weeks gestational age) miss in-utero nutrition, including nutrients essential to growth and neurodevelopment. Yet, there is a wide gap in the literature about preterm infant feed- ing in low-middle-income countries (LMICs), even though they account for more than 60% of preterm births globally and a higher proportion of global preterm infant deaths. Preliminary informal conver- sations with the leadership of a hospital in Northern Ghana also reveal that one of the areas requiring immediate attention is the nutrition support of pre- term and low-birth-weight infants admitted to their neonatal intensive care unit (NICU) and Special Care Baby Unit (SCBU). Interventions to optimize maternal milk delivery to improve neonatal feeding in this population would be beneficial. However, there is a need for data on the adequacy of current NICU/SCBU feeding practices and their relation- ship to infant outcomes before nutritional improve- ments can be investigated. Ruthfirst’s TEP Trainee Bridge Fund project aims to generate preliminary data on neonates' lactation and feeding practices at the Tamale Teaching Hos- pital in Ghana and assess maternal milk nutrient composition as an initial step to conducting more extensive lactation interventions in Ghanaian NI- CUs/SCBUs in the future. Ruthfirst Ayande, PhD MSc RD, plans her expan- sion program to be co-hosted by two institutions: the Yale School of Medicine, her current institution, and the Tamale Teaching Hospital in Ghana, her home country. She will travel to Ghana for data col- lection and participant interviews for the first half of the grant year, then return to Yale to complete hu- man milk nutrient analysis for the second half of the grant year. Her co-mentors, Dr. Alhassan Ab- dul-Mumin and Dr. Sarah N. Taylor will collaborate throughout the grant period to support her work. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 7

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TTF Awardee 2024 DOROTHY BUNDI The first 1000 days of life is a critical window of opportunity to enhance the nutritional and health outcomes of mothers and their infants. For the in- fant, it is a period of rapid growth and development and therefore, adequate nutrition is key to the op- timal programming of life course health outcomes. Breast milk is the gold standard for infant feeding under 6 months. However, in Kenya, optimal breastfeeding practices in the first 6 months post- partum and complementary feeding thereafter are largely inadequate, particularly among the most impoverished families living in the growing number of informal urban settlements. In addition, despite increasing evidence of the importance of maternal nutrition and health, the limited evidence shows that women’s nutrition and health indicators in the pre- and postnatal periods are rarely assessed and/or addressed, as the focus is often on the in- fant. Through the joint Aga-Khan University and Oxford University Women in Science Research Fellow- ship, Dorothy is currently conducting a study on evaluating the baseline nutrition and growth status of lactating mothers and their infants which will be followed by co-design & piloting the interventions in an informal settlement in Nyeri, Central Kenya. This will inform her PhD project that seeks to rigorously evaluate a community-based interven- tion to optimize the nutritional status of lactating women and their infants in informal settlements in Kenya. Dorothy Bundi, MSc. student, will travel to Jimma University, Ethiopia under the mentorship of Dr. Mubarek Abera, who is known for his expertise in maternal and child nutrition and his thoughtful ap- proach to research collaborations and mentorship. This TEP will provide Dorothy with an opportunity to gain experience in designing and implementing interdisciplinary community-based scalable re- search on behavioral aspects of human lactation. In addition, she will acquire skills on assessment and interpretation of body composition measures (PeaPod, BodPod with Air Displacement Plethys- mography method) for the mother-child pairs in their first 1000 days of life. These skills will be use- ful in advancing the Nutrition assessment of the mother-child pairs beyond the weight, height and MUAC and in understanding the quantitative deter- minants of breastfeeding practices. The end goal of this program is to establish a Human Milk and Lactation Research Institute in Kenya, which will contribute to generating policy-relevant evidence to enhance the attainment of Sustainable Develop- ment Goal 3 targets 3.1 and 3.2. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 8

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TTF Awardee 2024 HATICE ÇETINKAYA Objectively measured milk production is rarely un- dertaken in human populations and there is a par- ticular lack of investigation into molecular mecha- nisms that might influence variation in human milk production. Using the NICHD-funded MOM2Child study, the proposed project aims to identify biolog- ical underpinnings of dysfunctional lactation by comparing milk fat layer transcriptomes of the bot- tom versus the top milk producers at 2 weeks post- partum. To objectively assess milk production, we will use a previously validated maternal milk pro- duction rate (MPR) measure. Given that low milk supply is one of the most im- portant reasons for early breastfeeding termina- tion, this research will contribute to our knowledge on the molecular mechanisms of the lactational dysfunction to develop effective interventions to support lactation success. Hatice Çetinkaya, is a PhD student in Epidemiol- ogy in the Department of Environmental & Public Health Sciences in the College of Medicine, Uni- versity of Cincinnati. She is also a Presidential Fel- low at the University of Cincinnati Graduate Col- lege. Hatice holds a Bachelor of Science degree in nutrition and dietetics from Izmir Katip Celebi Uni- versity, Izmir, Türkiye and a Master of Science in nutrition from the University of Cincinnati. Hatice’s research focuses on studying the effects of mater- nal and environmental factors on milk composition, breastfeeding experience, and maternal and child health. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 9

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TTF Awardee 2024 HASLINA ABDUL HAMID Breast milk is an essential source of nutrition for preterm infants, providing critical bioactive compo- nents that support their growth and development. Among these components, hormones such as pro- lactin and insulin play a significant role in metabolic regulation and growth outcomes. Prolactin contrib- utes to lactation and immune modulation, while in- sulin influences glucose metabolism and energy utilization. However, the precise relationship be- tween these hormones in preterm breast milk and infant growth parameters remains insufficiently ex- plored. This project aims to investigate the concentrations of prolactin and insulin in preterm breast milk and their association with infant growth parameters such as weight, length, and head circumference. Understanding how these hormones influence in- fant growth is key to optimizing nutritional strate- gies to prevent postnatal growth failure, a common challenge in preterm infants. Specifically, the study will also explore the influence of other infant and maternal factors, including gestational age and birth weight, on breast milk hormone concentration and its subsequent impact on growth outcomes. A longitudinal follow-up of infant growth at 1, 3, and 6 months corrected age will be conducted to estab- lish potential correlations between hormone levels and growth trajectories. Findings from this re- search will provide valuable insights into the role of breast milk hormones in neonatal nutrition and contribute to evidence-based clinical practices aimed at improving preterm infant health out- comes. Haslina Abdul Hamid is a senior lecturer and re- searcher at the National University of Malaysia. She holds a Ph.D. in Child Health (Neonatal Nutri- tion) from the University of Nottingham. Her re- search focuses on neonatal nutrition and postnatal growth, with a particular interest in breast milk composition and preterm infant growth. Haslina will travel to and conduct her research at the Larsson- Rosenquist Foundation Oxford Centre for the En- docrinology of Human Lactation (LRF OCEHL), University of Oxford, under the mentorship of Pro- fessor Fadil Hannan. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 10

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TTF Awardee 2024 XUEHUA JIN Xuehua will travel to and conduct her TTF project at the Department of Food Chemistry and Toxicol- ogy, The University of Vienna, under the mentor- ship of Prof. Benedikt Warth, PhD. Hundreds of xenobiotics with diverse origins have been detected in human milk, including contami- nants of emerging concern, personal care products and other current-use substances reflecting life- style. During this project, Xuehua aims to develop laboratory and statistical expertise in analysing hu- man milk xenobiotics using advanced liquid chro- matography-mass spectrometry (LC-MS) tech- niques. This work involves quantifying more than 80 compounds, including exogenous hormones and environmental toxicants. This study repre- sents the first comprehensive quantification of such a wide array of xenobiotics in human milk samples from Australian women, and it is the first to explore these xenobiotics in the context of low and normal milk supplies. Additionally, the inclu- sion of infant milk intake data provides a unique opportunity to estimate infant exposure more accu- rately and the potential to explore co-exposures to multiple xenobiotics and their additive or synergis- tic effects. Xuehua Jin is a Ph.D. candidate at the School of Molecular Sciences, The University of Western Australia, under the supervision of Prof. Donna Geddes. She holds a B.Sc. and M.Sc. in Food Sci- ence and Engineering from China Agricultural Uni- versity. Her current research focuses on the inves- tigations of human milk composition and maternal factors between women with low milk supply and those with normal milk supply. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 11

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Trainee Expansion Program AWARDEES 2023 We are pleased to present the awardees of the TEP Bridge Funds and the TEP Travel Funds, who each received up to USD 100,000 or up to USD 10,000 respectively to advance in their academic ca- reer. TEP Trainee Bridge Fund Awardee Miranda Loutet TEP Trainee Travel Fund Awardees Maheshwar Bhasin Brock Williams In-facility lactation and feeding support in low-resource settings to increase sur- vival among small vulnerable newborns: evaluation of a pilot study to implement a feeding support package in NICUs in Tanzania, Malawi and India-Uttar Pra- desh TBF Awardee 2023 Determining the Presence and Functional Capacity of Dietary Food Allergens in Human Milk TTF Awardee 2023 Laasya Devi Annepureddy Understanding the impact of Human Milk Oligosaccharides (HMOs) on adipocyte function TTF Awardee 2023 Michael Pitino Neurodevelopmental impact of Non-exclusive colostrum feed- ing in infants within first year of life. TTF Awardee 2023 Characterizing the cellular response of neonatal enteroids to simulated infant digesta from donor human milk treated by high-pressure pro- cessing versus Holder pasteuriza- tion TTF Awardee 2023 Michelle Asbury Systems-level repertoire of hu- man milk components as driv- ers of microbial and immune development in preterm infants TTF Awardee 2023 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation 12 Trainee Expansion Program

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TTF Awardee 2023 BROCK WILLIAMS Brock will travel to and conduct his Trainee Travel Fund (TTF) project at the University of Rochester School of Medicine, under the mentorship of Pro- fessor Kirsi Järvinen-Seppo, PhD MD. His project has the title: Determining the Presence and Func- tional Capacity of Dietary Food Allergens in Human milk. Brock aims to perform and develop assays for the detection of common dietary food allergens in hu- man milk, as well as determining their functional capacity. These skills will allow Brock to assess the associations between maternal diet and lifestyle, and the transfer of dietary food allergens into hu- man milk in two distinct cohorts. It is his future goal to design and conduct research which is aimed at expanding our understanding of the mechanisms of food allergy development and prevention through lactation. Brock Williams, PhD MSc RD CNSC, Registered Dietitian and Postdoctoral Research Fellow, Divi- sion of Allergy, Department of Pediatrics, Univer- sity of British Columbia (Vancouver, Canada). Brock’s postdoctoral research, under the supervi- sion of Dr. Edmond Chan, is focused on furthering nutritional approaches for the primary prevention and treatment of food allergies in children. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 13

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TTF Awardee 2023 LAASYA DEVI ANNEPUREDDY Human milk oligosaccharides (HMOs) are crucial for infant nutrition, providing essential prebiotics that support the development of a healthy gut mi- crobiota and immune system. They play a signifi- cant role in promoting optimal growth and meta- bolic health in infancy. However, their potential benefits extend beyond early life, particularly re- garding metabolic outcomes. However, the under- lying mechanisms of how HMOs regulate metabo- lism remain poorly understood. This project aimed to investigate the impact of HMOs on adipose tissue development, and insulin signaling. Understanding how HMOs influence these processes is key to uncovering their roles in weight regulation and long-term metabolic health. Specifically, this research explored how secretory factors, in obesity, can disrupt insulin signaling, contributing to dysregulation. The findings suggest that HMOs could potentially have a role in modulating insulin sensitivity. Future investigations will focus on the interactions be- tween these oligosaccharides and key regulatory components of the insulin signaling pathway. Laasya Devi Annepureddy, is a Ph.D. candidate at the Thayer School of Engineering, Dartmouth College, NH. She holds a B.Sc. in Biomedical En- gineering from the Illinois Institute of Technology, Chicago. Her research focuses on maternal-infant health outcomes and lactation. Laasya is actively investigating the roles of functional differences in lactocytes in milk secretion and developing an in vitro model to validate these findings. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 14

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TTF Awardee 2023 MAHESHWAR BHASIN Colostrum, the bioactive-rich milk for the first three days of newborn life postpartum, contains numer- ous beneficial compounds crucial for infant health. However, globally, one in three infants receives for- mula supplementation, potentially missing out on these critical benefits. Maheshwar’s doctoral re- search focuses on investigating the impact of non- exclusive colostrum feeding (NECF) on various as- pects of childhood health, including allergies, growth, infections, and neurodevelopment. During his research exchange at the Larsson- Rosenquist Foundation Centre for Neurodevelop- ment, Growth and Nutrition of the Newborn (LRF NGN) at University Hospital Zurich, Maheshwar analysed Ages and Stages Questionnaire (ASQ) data from the ORIGINS cohort from Western Aus- tralia to explore how NECF might affect neurode- velopmental outcomes in infants. This analysis aims to provide evidence supporting exclusive co- lostrum feeding in the early days of life, contrib- uting to long-term health outcomes for infants. Maheshwar Bhasin’s project was conducted un- der the mentorship of Prof. Dr. med. Giancarlo Na- talucci, aiming to enhance our understanding of the critical role of colostrum in early neurodevelop- ment and promote informed infant feeding prac- tices worldwide. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 15

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TTF Awardee 2023 MICHAEL PITINO Michael will travel to and conduct his TTF project at Oregon Health and Science University, under the mentorship of Dr. Sarah Andres, PhD, Assis- tant Professor of Pediatrics. Using cutting-edge methods to produce human in- fant-derived enteroids (intestinal cells cultured 3- dimensionally to mimic physiology), Michael will in- vestigate how processing and simulated digestion impact overall intestinal health (e.g., cellular mor- phology, inflammatory markers, barrier function). Furthermore, the project will support the skill de- velopment during Michael’s postdoctoral training as well as further expand the reach of his research program in human milk science. Michael Pitino, PhD, MSc, Postdoctoral Scholar, Oregon State University. Michael’s research interests are broadly focused on optimizing the nutritional quality and functional- ity of bioactive proteins in donor human milk and delineating the downstream impact of processing on infant nutrient digestion, and gut physiology. He is currently examining how high-pressure pro- cessing, a novel milk processing technique, im- pacts intact protein digestion and the release of bi- oactive peptides using highly sensitive mass spec- trometry-based proteomic tools. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 16

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TTF Awardee 2023 MICHELLE ASBURY Michelle will conduct her TEP Trainee Travel Fund project at the University of Minnesota (USA), under the mentorship of Dr. Abigail Johnson, RD PhD. Using a longitudinal preterm cohort (BLOOM study) of ~400 mother-infant dyads, Michelle will integrate multi-omic (proteomic, lipidomic, metab- olomic, and glycomic) human milk data and con- struct a novel computational tool, called “nutrient trees”, to apply systems biology methods to human milk. She hopes this computational tool will enable researchers in the field to deeply characterize the complexity and inter-relatedness of human milk components and their role in shaping infant devel- opment. Michelle Asbury, MSc PhD, is a Postdoctoral As- sociate in the Departments of Physiology & Phar- macology and Pediatrics at the University of Cal- gary (Canada), as part of Dr. Marie-Claire Arrieta’s lab. She holds MSc and PhD degrees in Nutritional Sciences from the University of Toronto (Dr. Debo- rah O’Connor’s lab) where she studied the role of early-life nutrition for growth and microbiome de- velopment of very-low-birth-weight infants. Build- ing upon her prior research, Michelle is now fo- cused on characterizing the complex nutritional and immunological “system” of human milk and its importance for orchestrating microbiome assembly and immune system development in preterm in- fants. In addition to the TEP, Michelle’s research is generously supported by postdoctoral fellowships from the Killam Laureates, Molly Towell Perinatal Research Foundation, and L’Oreal Canada- UNESCO. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 17

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Trainee Expansion Program AWARDEES 2022 We are pleased to present the awardees of the TEP Bridge Funds and the TEP Travel Funds, who each received up to USD 100,000 or up to USD 10,000 respectively to advance in their academic ca- reer. TEP Trainee Bridge Fund Awardees Adwoa Gyamfi TEP Trainee Travel Fund Awardees Omobolaji Adewuyi Designing and testing a community- based lactation counseling model in Ghana: a Trial of Improved Practices TBF Awardee 2022 Michael A. Pitino Proteomic and peptidomic profiling of donor human milk after high-pres- sure processing and dynamic in vitro digestion simulating the preterm in- fant TBF Awardee 2022 Multiple micronutrient supplementa- tion and its effect on human milk selenium and zinc levels in the highlands of Nigeria TTF Awardee 2022 Marion M. Bendixen Sara Shama Influence of maternal health on hu- man milk biomarkers of secretory activation in pump-dependent moth- ers of critically ill infants TTF Awardee 2022 Understanding the impact of human milk oligosaccharides on the micro- bial colonization of very low birth weight infants TTF Awardee 2022 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 18

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TBF Awardee 2022 ADWOA GYAMFI Adwoa will conduct her TEP Trainee Bridge Fund project at the School of Public Health, University of Ghana, under primary mentorship from Professor Richmond Aryeetey, PhD, MPH, and secondary mentorship from Dr. Amber J. Hromi-Fiedler, PhD, MPH (Research Scientist, Yale University). She aims to design and test the feasibility of inte- grating evidence-informed community-based lac- tation counseling into Ghana’s primary healthcare system. Adwoa’s primary objectives are to: identify unmet needs in community-level breastfeeding counseling and support in rural Ghana; train lay volunteers as community-based lactation counse- lors and public health nurses as lactation counsel- ing supervisors; and test feasibility and the acceptability of a community-based lactation coun- seling model. Adwoa Gyamfi, PhD, MPH, BSc., RN (with Post Graduate Certificates in Education, Clinical Genet- ics and Genomics), University of Ghana. Adwoa is a Ghanaian with several years of clinical experience and health education in Ghana and the United States. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 19

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TBF Awardee 2022 MICHAEL PITINO Michael will conduct his TEP Trainee Bridge Fund project at the College of Public Health and Human Sciences, Oregon State University, under the men- torship of Dr. Dave Dallas, PhD. Using highly sensitive mass spectrometry-based techniques, Michael plans to further investigate the impact of a novel milk processing technique on subsequent protein digestion and bioactive peptide generation using proteomic and peptidomic tools. Dr. Michael A. Pitino, PhD, MSc., hons. BSc., De- partment of Nutritional Sciences, University of To- ronto / Hospital for Sick Children. His research has been focused on maximizing the nutritional quality and bioactivity of donor human milk, towards optimizing acute and long-term health outcomes of vulnerable preterm infants. Mi- chael has been investigating alternative pro- cessing methods for donor human milk pasteuriza- tion to improve both milk quality and milk banking policies, while examining the complex interplay be- tween processing and outcomes during and follow- ing digestion. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 20

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TTF Awardee 2022 OMOBOLAJI ADEWUYI Omobolaji will travel to and conduct his TEP Trainee Travel Fund project at the School of Mo- lecular Sciences, The University of Western Aus- tralia, under the mentorship of Professor Donna Geddes, PhD. Omobolaji plans to gain further exposure and build his capacity on laboratory analysis, statistical anal- ysis and modeling, and publication in microbi- omics, lipidomic and proteomics. Ultimately, he plans to run larger multicenter RCTs on micronutri- ent supplementation and effects of micronutrients in human milk in Sub Sahara Africa. Omobolaji Adewuyi, PhD Candidate, Department of Human Nutrition & Dietetics, Faculty of Public Health, College of Medicine, University of Ibadan. Omobolaji’s PhD research is focused at investigat- ing the effect multiple micronutrient supplementa- tion has on selenium and zinc of human milk and serum of lactating mothers. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 21

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TTF Awardee 2022 MARION BENDIXEN With this TEP Trainee Travel Fund project, and in collaboration with Professor Donna Geddes, PhD, and the research team at the University of Western Australia, Marion will gain laboratory and statistical skills analyzing previously collected milk samples for protein, citrate, lactose, macro- and trace ele- ments (markers of SA) to evaluate variations of hu- man milk composition, which is essential for opti- mization of nutrition and growth of infants. Marion aims to determine whether maternal health conditions (diabetes, hypertension, obesity) are associated with differences in mother’s milk bi- omarkers of secretory activation (SA) and milk vol- ume in pump dependent mothers of critically ill in- fants. Marion M. Bendixen, PhD, MSN, RN, IBCLC, As- sistant Professor, College of Nursing, University of Florida. Marion is a nurse researcher at University of Flor- ida and a clinical nurse/lactation consultant at Win- nie Palmer Hospital for Women and Babies. She completed a two-year postdoctoral training under the mentorship of Leslie Parker, PhD, Professor in the Colleges of Nursing and Medicine at University of Florida. Trainee Expansion Program Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation 22

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TTF Awardee 2022 SARA SHAMA Sara will travel to and conduct her TEP Trainee Travel Fund (TTF) project at the University of Cali- fornia San Diego, under the mentorship of Profes- sor Lars Bode, PhD. This will provide her with the opportunity to learn human milk oligosaccharide (HMO) analyses and gain insights into novel bioinformatic approaches. The skills acquired through this program will allow her to explore the impact of HMO intake on the mi- crobial colonization of preterm infants. In doing so, Sara hopes to provide foundational knowledge that can be used towards rehabilitating perturbed gut microbiomes and improving the clinical outcomes of preterm infants. Sara Shama, MSc, RD, registered dietitian and PhD candidate, University of Toronto / Hospital for Sick Children. She holds a Bachelor of Applied Sci- ence from the University of Guelph and a Master of Science from the University of Toronto. Under the supervision of Dr. Deborah O'Connor, Sara’s research work focuses on understanding the impact of the mother's milk microbiota and oli- gosaccharides on the preterm infant gut microbi- ota. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 23

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Trainee Expansion Program AWARDEES 2021 We are pleased to present the awardees of the TEP Bridge Funds and the TEP Travel Funds, who each received up to USD 100,000 or up to USD 10,000 respectively to advance in their academic ca- reer. TEP Trainee Bridge Fund Awardee Jordyn Tinka Wallenborn TEP Trainee Travel Fund Awardees Kelsey Cochrane Human milk impact on child gut microbiota and growth TBF Awardee 2021 Alexandra Gogel Natalie Scime Proteomic analysis and varia- tions in the milk proteome over time TTF Awardee 2021 Human milk composition and mothers’ health TTF Awardee 2021 Nina Juntereal Developmental origins of dis- ease and maternal/infant diet optimization TTF Awardee 2021 Lactation-related outcomes among critically ill infants TTF Awardee 2021 Johanne Spreckels Function of breastmilk com- ponents in infant gut organ- oid models TTF Awardee 2021 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation 24 Trainee Expansion Program

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TBF Awardee 2021 JORDYN TINKA WALLENBORN Jordyn’s TEP Trainee Bridge Fund project will draw from a community-centered pilot randomized con- trol trial she is currently conducting in Lao People’s Democratic Republic (Lao PDR) — that aims to in- crease exclusive breastfeeding rates. Partnering with internationally recognized researchers — Drs. Christopher Stewart, Watcharin Loilome, and Gün- ther Fink — Jordyn’s TEP project will assess the impact of human milk on child gut microbiota and growth through an integrative analysis of bioactive micro- and macro-nutrient factors. In a statement of thanks, Jordyn said, “I am excited to start working with and learning from Drs. Chris- topher Stewart, Watcharin Loilome, and Günther Fink; and am thankful for their invaluable support on this application. I would also like to personally thank the ISRHML committee and the Family Lars- son-Rosenquist Foundation for selecting my appli- cation and supporting my research career in hu- man milk and lactation. I am honored to be se- lected and look forward to providing critical and novel data on the relationship between the infant gut microbiome and child growth, and human milk composition.” Dr. Jordyn Tinka Wallenborn, PhD, MPH, is a postdoctoral researcher at the Swiss Tropical and Public Health Institute (Swiss TPH). She holds a Bachelor of Science in Community Health from Minnesota State University Moorhead, a master’s in public health (MPH) with a concentration in in- fectious disease management from North Dakota State University, and a PhD in epidemiology from Virginia Commonwealth University. Jordyn’s re- search focuses on the mother, infant, and human milk triad with a global perspective. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 25

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TTF Awardee 2021 KELSEY COCHRANE With her TEP Trainee Travel Fund grant, Kelsey will work with Dr. Lars Bode, a renowned global ex- pert and influential leader in human milk research, to obtain specialized training at the University of California San Diego, USA. In a statement of thanks, Kelsey said, “With the Trainee Travel Fund, I will take my first steps in be- coming an academic scholar in the field of breast- milk research. Thank you, selection committee, for honoring me with this award, and helping me set the stage for my future career as a Clinician Scien- tist in public health nutrition research.” Kelsey Cochrane, RD, BSc, is a registered dieti- tian currently working toward a PhD in Human Nu- trition at the University of British Columbia. She holds a Bachelor of Science degree in Nutrition from the University of Saskatchewan. Her research interests include developmental origins of disease, establishment of epigenetic marks, and optimiza- tion of maternal and infant diet, specifically in sup- plementation of folic acid vs folate in low-risk preg- nant women. Trainee Expansion Program Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation 26

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TTF Awardee 2021 ALEXANDRA GOGEL Alexandra’s TEP Trainee Travel Fund grant will en- able her to learn the methods required for proteo- mic analysis and explore variations in the milk pro- teome both within a feed and over time by studying with Dr. David Dallas at Oregon State University, USA. In a statement of thanks, Alexandra extended a heartfelt thank you to the ISRHML and Family Larsson-Rosenquist Foundation Trainee Expan- sion Program for this opportunity to expand her re- search experience in the field of human milk and lactation. Alexandra Gogel is a PhD candidate in the De- partment of Animal, Veterinary, and Food Sciences at the University of Idaho. She holds a Bachelor of Science in Zoology from Washington State Univer- sity. Her research is focused on exploring human milk collection methods and the associated varia- tion on components including the milk microbiome and lipids. She also researches the association of the human milk microbiome to infant and maternal health. Trainee Expansion Program Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation 27

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TTF Awardee 2021 NINA JUNTEREAL The TEP Trainee Travel Fund grant will give Nina the opportunity to analyze collected samples and generate effect sizes to inform the feasibility of an experimental study. She will work alongside Dr. Donna Geddes and her team at the University of Western Australia. Nina Juntereal, BSN, RN, is a PhD candidate in Nursing and Hillman Scholar in Nursing Innovation at the University of Pennsylvania. She obtained her Bachelor of Science in Nursing with a minor in Nutrition from the University of Pennsylvania. Her research focuses on lactation related outcomes among diverse childbearing families and critically ill infants. Her dissertation research explores the role of antenatal milk expression, the expression of colostrum during the late third trimester of preg- nancy and its relationship to the development of milk supply and secretory activation. She collabo- rates with the Children’s Hospital of Philadelphia to advance the science of lactation for mothers of in- fants prenatally diagnosed with congenital anoma- lies. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 28

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TTF Awardee 2021 NATALIE SCIME With support from her TEP Trainee Travel Fund grant, Natalie will lead a project investigating whether human milk composition is associated with mother’s long-term cardiometabolic health, under the mentorship of Dr. Meghan Azad at the University of Manitoba, Canada. In a statement of thanks, Natalie said this experi- ence will enable her to develop expertise in the bi- ology of lactation, management of human milk samples, and analysis of complex biological da- tasets as a complement to her existing training in population health and life course epidemiology. Natalie Scime is a PhD candidate in Epidemiology and Canadian Institutes of Health Research (CIHR) Canada Graduate Scholar at the University of Calgary, Alberta, Canada. She holds a Bachelor of Health Sciences degree and a master’s in health Promotion from Western University. In her re- search, she uses diverse datasets to study the in- terrelationships between reproductive factors and women’s health across their lifespan. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 29

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TTF Awardee 2021 JOHANNE SPECKLES Breast milk is important for the developing infant gut microbiota and immune system. However, large studies investigating factors shaping the breast milk composition are scarce and the mech- anisms underlying beneficial effects of breast milk on infant health are incompletely understood. As part of her PhD project, Johanne uses the Dutch birth cohort Lifelines NEXT to identify factors affecting the breast milk microbiota and human milk oligosaccharide profile and to investigate how different breast milk components affect the early in- fant gut microbiota development and infant health. The TEP Trainee Travel Fund grant enables her to visit Christopher Stewart’s lab at Newcastle Uni- versity in England. During her stay, she will learn how to work with infant gut organoid models to characterize the function of breast milk compo- nents, selected based on her first findings in the Lifelines NEXT cohort. Johanne Spreckels is a PhD candidate at the group of Alexandra Zhernakova at the University Medical Center Groningen, the Netherlands. She holds bachelor’s and master’s degrees in biomed- ical sciences from the Philipps University of Mar- burg, Germany, and from Linköping University, Sweden, respectively. In her Master thesis, she studied how the maternal immune system changes during pregnancy. Afterwards, she continued with studying the effect of probiotics on the gut microbi- ota of preterm infants. In 2018, she started her PhD research exploring how maternal and environmen- tal factors shape the breast milk microbiota and hu- man milk oligosaccharide composition, and how breast milk components affect infant gut microbiota development and health. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 30

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Trainee Expansion Program AWARDEES 2020 We are pleased to present the awardees of the TEP Bridge Funds and the TEP Travel Funds, who each received up to USD 100,000 or up to USD 10,000 respectively to advance in their academic career. TEP Trainee Bridge Fund Awardee Alexandra George TEP Trainee Travel Fund Awardees Yang Lyu Reducing the risk of obesity and diabetes through human milk TBF Awardee 2020 Sarah Turner Identifying the effect of di- gested human milk on human enteroid model TTF Awardee 2020 Breastfeeding Experiences During the COVID-19 Pan- demic: A comparative quali- tative study of UK and Cana- dian mothers TTF Awardee 2020 Trainee Expansion Program Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation 31

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TBF Awardee 2019 ALEXANDRA GEORGE Despite the knowledge that breastfeeding reduces the risk of obesity, the mechanisms through which this occurs are unknown. Human milk plays an es- sential role in infant metabolic programming, prim- ing the infant for the optimal start at life. In addition to high BMI and rapid weight gain, plasma lipid dysregulation is a predictor of diabetes develop- ment in adults; healthy and obese adults have dif- ferent plasma lipid profiles. The plasma lipidome of breastfed and formula fed infants also appears to be different. There are a number of lipid species, from both human and animal studies, with potential bioactive roles, therefore this project aims to iden- tify and investigate these in human milk, and inter- rogate them in relation to infant growth and obesity and diabetes risk. Alexandra George has recently completed her PhD in human milk biochemistry at The University of Western Australia. Prior to this, Alexandra com- pleted a Bachelor of Science with Honours (Uni- versity of Western Australia) and a Bachelor of Medical Laboratory Science (University of Otago), always with a focus on human health and improve- ment of technology for understanding, diagnostics and treatment. Human milk and lactation science has quickly become Alexandra’s key research in- terest, an area where there is extraordinary poten- tial to improve human short- and long-term health outcomes. The Trainee Bridge Fund is allowing Al- exandra to conduct research at the Baker Heart and Diabetes Institute alongside metabolomics, obesity and diabetes experts. There she is explor- ing potential bioactive lipids of human milk and fur- ther integrating human milk and lactation science into diabetes and obesity research. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 32

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TTF Awardee 2020 YANG LU Little is known about how human milk derived pep- tides play their roles in infant health. While some of these peptides are originally from mother’s milk, the process of digestion in the infant gastrointesti- nal tract also releases a number of unknown po- tentially bioactive peptides. Our group previously found that digested colostrum/ transitional human milk (tHM) originating from different mothers exhib- its anti-inflammatory effects to varying degrees. This inspires our hypothesis that variability may re- side in peptide differences. To further identify the effects of digested colostrum/tHM harboring bioac- tive peptides, we want to incorporate the human enteroids model, a physiologically relevant model closer to translation, into our study. By tracking a variety of cell markers via immunohistochemistry and qRT-PCR, we will determine how digested co- lostrum/tHM impacts the proliferation and differen- tiation, epithelial barrier integrity and pro-inflamma- tory response in human enteroids under inflamma- tion. Yang Lyu, PhD, is a Postdoctoral Fellow of Dr. Yi- min Chen’s research group at the University of Idaho. She earned her bachelor's in biology and master's in food science from China Agricultural University, after which she completed her PhD in food science at UMass Amherst under the guid- ance of Dr. David A. Sela. Her doctoral work fo- cused on how bifidobacteria, an infant gut benefi- cial microbe, utilizes the human milk urea. She is currently investigating the bioactivities of peptides released from digested colostrum/ transitional hu- man milk, including anti-inflammatory effects on in- testinal epithelial cells and antimicrobial activities against intestinal pathogens. With the support of the Trainee Travel Fund, she was mentored by Dr. Misty Good at Washington University in St. Louis and developed skills in utilizing enteroids as a re- search model. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 33

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TTF Awardee 2020 SARAH TURNER The COVID-19 pandemic has changed the way health care practitioners provide breastfeeding support. The aim of this project is to understand how these changes have impacted women’s expe- riences with infant feeding. This project involves conducting semi-structured interviews with women living in Canada or the United Kingdom who began breastfeeding during the COVID-19 lockdown. Data will be analyzed using comparative thematic analysis, and results will be translated into various formats including a scientific publication, a public commentary and virtual presentations to general population, health care professional and govern- ment audiences in Canada and the UK. Sarah Turner is a PhD Candidate in the Azad Lab at the University of Manitoba, in Winnipeg, Mani- toba, Canada. Her research focuses on how breastmilk and breastfeeding contribute to child cognitive development and behaviour. She is inter- ested in how both the nutritional qualities of breast- milk and the social-emotional benefits of breast- feeding, such as the mother-child relationship, contribute to infant cognitive and behavioural out- comes. Sarah is passionate about knowledge translation, teaching, and effective science com- munication. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 34

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Trainee Expansion Program AWARDEES SUMMER 2019 We are pleased to present the awardees of the TEP Bridge Funds and the TEP Travel Funds, who each received up to USD 100,000 or up to USD 10,000 respectively to advance in their academic career. TEP Trainee Bridge Fund Awardee Yarden Golan Maor Ashley Nelson Genomic characterization of regulatory elements that ef- fect human breastmilk pro- duction TBF Awardee 2019 Effect of human milk on the intestinal epithelium and its associated immune compart- ment TTF Awardee 2019 TEP Trainee Travel Fund Awardees Kozeta Miliku Genome-wide association studies (GWAS) of human milk fatty acids TTF Awardee 2019 Tonny Jimmy Owalla Secretion of malaria vaccine antigens in breastmilk during asymptomatic/active malaria infection TTF Awardee 2019 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 35

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TBF Awardee 2019 YARDEN GOLAN MAOR Breastmilk is the optimal dietary source for infants, as it supplies all the nutritional requirements for the first six months of life. It contains macro- and mi- cronutrients as well as numerous bioactive com- pounds and several different cell types, including epithelial, myoepithelial, stem cells and leuko- cytes. Genetic variation in the mom may have var- ious effects on breastmilk components and supply and subsequently affect child health and even lead to disease. However, not much is known about the genetic factors affecting breastmilk composition and production. This study will characterize the breastmilk cell transcriptome (single-cell RNA- seq), regulome (ATAC-seq and Cut&Tag), and var- iome (genotyping arrays) and link them to create a novel and important genomic lactation dataset. Samples will be collected under both physiological (e.g., colostrum, mature milk and involution) and pathological (e.g., low milk production) conditions, to study the mechanisms underlying different lac- tation pathologies and to characterize how genetic variation influences lactation outcomes and infant growth. Collectively, the results of this study will significantly impact mother and infant health worldwide and expand our toolbox to improve breastfeeding and help mothers dealing with breastfeeding issues and related diseases. Yarden Golan Maor, PhD, is a molecular nutrition scientist. After completing her Bachelor of Nutrition Science with Honour she started to study for a PhD degree under the supervision of Prof. Assaraf at the Technion (Israel Institute of Technology, Haifa, Israel). Her PhD research focused on studying the transport mechanism of zinc into human breastmilk and how mutations in the Zinc transporter 2 (ZnT2) may lead to Transient neonatal zinc deficiency (TNZD) in exclusively breastfed infants. During her PhD Yarden also developed a genomic test for early diagnosis of TNZD using cells that are pre- sent in the mother’s breastmilk. Yarden recently started her post-doc research under the mentor- ship of Prof. Nadav Ahituv from the University of California San Francisco where she will continue to discover the effect of genetic variations on hu- man breastmilk production and components. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 36

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TTF Awardee 2019 KOZETA MILIKU Fatty acids are a vital component of human milk. They influence infant growth, neurodevelopment and immune function, and they provide ∼50% of milk’s energy content. In the CHILD Cohort Study Kozeta and authors have recently shown that mothers’ diets (fish oil supplements and dietary fish intake) are associated with omega-3 milk fatty ac- ids levels and FADS gene variants determine the concentrations of milk omega-6 fatty acids. Yet, not much in known on other genetic determinants of human milk fatty acids levels, and the combined interactions of gene and diet in human milk fatty acids are not widely explored. Kozeta Miliku, MD, PhD, is a post-doctoral fellow at Children’s Hospital Research Institute of Mani- toba, University of Manitoba in Winnipeg, Canada. Her research interests are the fields of human milk and lactation and the developmental origins of health and disease. Kozeta’s current work in the Azad lab is focused in determining the role of hu- man milk composition on infant health outcomes and identifying the mechanisms. She will visit Dr. Duan’s lab at Queen’s University to advance her genetic/genomic research skills and study the ge- netic determinants of human milk fatty acids. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 37

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TTF Awardee 2019 ASHLEY NELSON Human milk (HM) is known to promote infant health and many of its effects occur in the gastrointestinal tract. However, our current understanding of the specific effects of HM on the gut epithelium and its associated immune compartment is limited. This project aims to expand our knowledge of the ef- fects of HM on different cell subsets of the intesti- nal epithelium through use of human intestinal en- teroids. Enteroids, aka “mini-guts”, are generated from primary biopsies of the human intestinal epi- thelium and form structures in vitro that maintain their cellularity and closely resemble the intact gut epithelium. Thus, enteroids are an optimal tool to elucidate the specific effects of HM on the human intestinal epithelium. Under the mentorship of Dr. Sasirekha Ramani at Baylor College of Medicine, Ashley will learn the nuances of enteroid culture, enabling her to establish this cutting edge model in her research on the mechanisms whereby HM pro- motes health. Ashley Nelson is a second year PhD candidate in the Immunology program at the University of Roch- ester School of Medicine and Dentistry in New York. She received her BSc with high honors in Bi- otechnology and Molecular Bioscience at the Rochester Institute of Technology. Ashley is inter- ested in studying the effects of human milk on gut epithelial function, with a focus on epithelial cell subsets as well as immune cell populations. She is also the president of a graduate student organiza- tion at the University of Rochester called Graduate Students Raising Families which helps support and advocate for student parents. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 38

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TTF Awardee 2019 TONNY JIMMY OWALLA 88 breastmilk samples of asymptomatic Plasmodium falciparum- infected breastfeeding mothers in Uganda High sensitivity ELISA for detection of Plasmodium falciparum antigen pLDH and pHRP2 in breastmilk Plasmodium falciparum HRP2 & pLDH antigens are shed in 15% of breastmilk samples of Plasmodium falciparum infected mothers (Van den Elsen, Verhasselt and Egwang, in press) Is Circumsporozoite protein (CSP) antigen, an immune component of the leading malaria vaccine (RTS,S), present in breastmilk ? ➝ Develop highly sensitive and specific techniques for detection of P. falciparum CSP vaccine antigen in breastmilk ➝ Determine if CSP is found free or bound to Antibody ➝ Analyse levels of CSP in 88 breastmilk samples ELISA Western Blot Mass Spectometry Public health significance of malaria CSP antigen shedding in breastmilk in Ugandan infants ➝ Influence on immune reactivity and susceptibility to Plasmodium falciparum infection? ➝ Influence on malaria vaccine efficacy? According to the World Health Organization, more than 200 million cases of malaria occur yearly worldwide with the majority in infants aged under 5 years. This highlights the need for a successful strategy of prevention of malaria infection espe- cially in early life. Breastfeeding is the most effi- cient way to prevent child morbidity and mortality related to respiratory and gastro-intestinal infec- tious disease. In contrast, there is conflicting evi- dence on malaria prevention by breastfeeding. We propose the original hypothesis that the presence of malaria antigen in breastmilk may stimulate an- timalarial immune defenses and reduce malaria risk in breastfed infants. Our preliminary data con- firms the shedding of Plasmodium falciparum histi- dine-rich protein 2 (pHRP-2) and lactate dehydro- genase (pLDH) in breastmilk of 15% of breastfeed- ing mothers with asymptomatic-malaria in Uganda. The goal of this project is to investigate whether (i) the malaria vaccine antigen CSP is secreted in breastmilk since this may influence specific anti- malarial immune responses and malaria risk in vaccinated infants; (ii) CSP is free or complexed with maternal antibodies in breastmilk. These questions are significant because CSP is the major component of the new leading RTS,S vaccine. Therefore, we expect that shedding of CSP anti- gens in breastmilk may be particularly efficient for infant immunization and prevention of malaria in breastfed infants. To address these questions, I will set up ELISA, Western blotting and Mass Spec- trometry analysis, for detection of CSP in breast- milk samples from Ugandan mothers under the su- pervision of Professor Valerie Verhasselt during my visit to the University of Western Australia. Tonny Jimmy Owalla is a Research Associate at Med Biotech Laboratories, Kampala-Uganda with a strong background in malaria. He holds a BSc in Biomedical Laboratory Technology from Makerere University, Kampala-Uganda and expects to attain the MSc in Molecular Biology and Biotechnology from the same university in January 2020. During his undergraduate research, Tonny studied natural immune responses to blood stage malaria vaccine candidates in pregnant women and children in Uganda under Professor Thomas Egwang. This cultivated in him a special interest in maternal and infant immunology. He is currently interested in un- derstanding if malaria vaccine antigens are se- creted in breastmilk during asymptomatic/active malaria infection. He anticipates that this Trainee Travel Fund will enable him to acquire important skills relevant to his future research on the role of breastfeeding in antimalarial immunity. Tonny will be jointly mentored by Professors Verhasselt and Egwang. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 39

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Trainee Expansion Program AWARDEES SPRING 2019 We are pleased to present the awardees of the TEP Travel Funds, who each received up to USD 10,000 to advance their academic career. TEP Trainee Travel Fund Awardees Alexandra George Anuradha Ravi Human Milk Lipidomics and Infant Outcomes TTF Awardee 2019 Impact of HMOs and milk mi- crobiota on the infant gut mi- crobiome TTF Awardee 2019 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 40

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TTF Awardee 2019 ALEXANDRA GEORGE anti-inflammatory and anti-infection processes. The methodologies will be used to investigate the influence these lipids have on infant growth, health and development. Alexandra George is a third year PhD candidate in the School of Molecular Sciences, at The Uni- versity of Western Australia. Alexandra has a strong interest in metabolomics and what ‘omics technologies such as mass spectrometry can tell us. This interest led Alexandra to her PhD research that she is carrying out in Australia, under the su- pervision of Dr. Donna Geddes. Alexandra’s PhD research focuses on the complex human milk lip- idome: developing and optimising lipidomics meth- odology and identifying and characterising the li- pids of human milk. With the advancement of mass spectrometry and chromatographic techniques, the potential to fully characterise human milk is im- proving exponentially, and, excitingly, comprehen- sive human milk lipidomics is becoming more prac- tical and possible. Human milk lipids comprise approximately 5% of all human milk macronutrients and deliver over 50% of the infant’s daily energy intake. It is under- stood that approximately 98% of these lipids are triacyl glycerides and that fatty acids are involved in infant neural development. Despite this, we know surprisingly little about the complex human milk lipidome and the specific influence lipids have on infant outcomes. The majority of human milk li- pid research focuses on fatty acids, which contrib- ute to structures such as triglycerides, sphingomy- elins, gangliosides and phospholipids; yet the var- iation of all lipids, both inter- and intra-individual, is not fully understood – likely from a lack in compre- hensive methodology. In her PhD research, Alex- andra has recruited a longitudinal cohort of moth- ers and infants, collecting hundreds of milk sam- ples and substantial complementary data, to inter- rogate the human milk lipid profile. With support from the ISRHML FLRF TTF, she will work to de- velop and optimise lipidomics methodologies to analyse the milk lipids which have been least char- acterised, such as gangliosides, which are pro- posed to be involved in infant brain development, Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 41

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TTF Awardee 2019 ANURADHA RAVI Breastfeeding profoundly influences the develop- ing microbiota and has subsequent benefits to in- fant health. Human milk oligosaccharides (HMO) and microbiota are two major milk components that influence the infant microbiota. With pre- and pro- biotic properties, they can modulate the environ- ment of the infant gut by creating a permissive en- vironment for sustainable colonization and trans- mitting new bacterial species. Currently, there is lack of knowledge in understanding the effect of HMOs on the microbes in the milk and their com- bined modulation of the infant gut. Working with in- vestigators from the CHILD Study at the University of Manitoba and the University of Calgary Interna- tional Microbiome Centre, Anu will analyze shot- gun metagenome data to study the impact of HMOs and milk microbiota on the structure and function of the infant gut microbiome. Dr. Anuradha (Anu) Ravi is a postdoctoral re- search scientist at Quadram Institute Biosciences in Norwich, United Kingdom. She completed her PhD in 2017 from Norwegian University of Life Sci- ences, Norway. Her dissertation research was on using 16S rRNA and shotgun metagenome se- quencing to study the prevalence and persistence of antibiotic resistance genes in mother and child cohorts from Norway and Spain. Anu’s research in- terests improving our current knowledge on the effects of breastmilk microbiome in the development of infant microbiota and pre- venting allergies. She is interested in using high throughput sequencing technologies and cutting- edge bioinformatics tools for achieving this. Anu believes that the TEP award will be an important step towards this goal and a great opportunity to widen her skillset. She will be mentored by Dr. Me- ghan Azad who is a distinguished mentor and co- leads the Manitoba site of the CHILD study. is focused on Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 42

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Trainee Expansion Program AWARDEES SUMMER 2018 We are pleased to present the awardees of the TEP Bridge Funds and the TEP Travel Funds, who each received up to USD 100,000 or up to USD 10,000 respectively to advance in their academic career. TEP Trainee Bridge Fund Awardees Eva Naninck Mum don’t stop bugging me – does stress affect breast- milk composition and the ne- onatal gut microbiome? TBF Awardee 2018 Stephanie L. Martin Acceptability and feasibility of interventions to improve ex- clusive breastfeeding among informal working mothers in urban Tanzania. TBF Awardee 2018 TEP Trainee Travel Fund Awardees Grace Carroll Costing a maternity leave cash-transfer to support breastfeeding among women employed in the informal economy. TTF Awardee 2018 Yimin Chen Bioactive peptides in di- gested human milk TTF Awardee 2018 Trainee Expansion Program Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation 43

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TBF Awardee 2018 EVA NANICK Stress is a very common, unavoidable factor in the lives of many mothers and their infants, known to have a lasting impact on infant development and later health. Human milk conveys biological mes- sages from mother to infant via numerous bioac- tive compounds, including microbiota, an important emerging factor in neonatal health and program- ming. However, currently we know remarkably little about how stress affects human milk composition. This project aims to fill this gap. Specifically, the goal of this project is to investigate the microbial content of breastmilk from stressed and control mothers and study how this relates to gut microbi- ome establishment and emotional development of their infants. For this, the Amsterdam-Mother’s- Milk-Study cohort will be used, a collaborative initi- ative of stress researchers (Dr. Korosi) and experts in neonatal care (Prof. van Goudoever) and nutri- tional scientists in the Netherlands. The use of this cohort will allow for the integration of microbial analyses of breastmilk and infant fecal samples with ancillary information on maternal stress levels, nutritional and hormonal human milk composition and measures of child development. The findings of this project hopefully lead to recommendations for nursing mothers in inevitably stressful situa- tions. Eva Naninck, PhD, is a postdoctoral researcher at the University of Amsterdam (the Netherlands) where she manages the Amsterdam Mother’s Milk Study. Eva received her B.Sc. in psychobiology and her M.Sc. in Neuroscience (with honors) from the University of Amsterdam. During her PhD at the SILS center for Neuroscience under the super- vision of Dr. Korosi and Prof. Lucassen, she stud- ied how stress impacts brain development, with a focus on the role of early nutrition. Her preclinical research showed that nutritional supplementation of the lactating dam can protect her offspring from the negative effects of stress exposure in early life. After obtaining her PhD, Eva started translating her findings ‘from bench to bedside’. She set up the Amsterdam Mother’s Milk Study to investigate how stress modulates human milk composition. Her re- search is aimed to provide a new, integrated un- derstanding on how various key components of hu- man milk essentially contribute to infant health and development and how this is affected by stress. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 44

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TBF Awardee 2018 STEPHANIE L. MARTIN Tanzania, like many countries in Sub-Saharan Af- rica, is experiencing rapid urban growth. While ur- banization can contribute to health improvements and economic advances, current infant feeding practices and child health outcomes in urban areas of Tanzania fall below those of their rural counter- parts. Maternal employment is a barrier to optimal breastfeeding practices worldwide, and for women in urban areas working informally (without legal or social protection) exclusive breastfeeding for 6 months is particularly challenging. As the urban population grows, context-specific interventions to support optimal feeding practices are needed. This project will use qualitative methods to examine barriers and facilitators to exclusive breastfeeding and assess the acceptability and feasibility of potential interventions to support ex- clusive breastfeeding among women working infor- mally in Moshi Urban District, Tanzania. infant Stephanie Martin, PhD, is an assistant professor in the Department of Nutrition at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. She is also a fellow of the University’s Carolina Population Center and a Certified Lactation Counselor. Stephanie’s re- search focuses on the design and evaluation of be- havioral interventions to improve infant feeding practices and maternal and child nutrition in re- source limited settings. She is currently examining family members’ experiences supporting infant feeding practices in East Africa. Stephanie com- pleted her PhD in nutrition at Cornell University in 2016. Prior to pursuing her PhD, she worked as a global health practitioner, and implemented policy- , health facility-, and community-level programs to promote exclusive breastfeeding and maternal and child nutrition. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 45

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TTF Awardee 2018 GRACE CAROLL in maternity protection Many women live in low- and middle-income coun- tries lack maternity leave benefits as they are more likely to be engaged in unprotected jobs in the in- formal economy. This absence of social protection is one of the structural and societal barriers that in- terfere with women’s ability to breastfeed optimally. Investing for working women in the informal economy is an important so- cial equity mechanism that can also improve breastfeeding outcomes. Currently, there is a lack of country-level guidance for estimating costs to support governments assess the financial feasibil- ity for scaling up breastfeeding programs, such as maternity leave benefits. With mentorship from Dr. Mireya Vilar-Compte, Grace will standardize a costing framework and estimate the costs for a ma- ternity cash-transfer informally employed women in three low- and middle-income countries. for Grace Carroll is a Research Associate at the Yale School of Public Health and a member of the Be- coming Breastfeeding Friendly research team. Grace’s research interests are focused on improv- ing breastfeeding outcomes and preventing chronic diseases among vulnerable populations by effectively translating research into policy. Grace holds a Bachelor of Science in Biology from Union College, a Master of Arts in Education from Oak- land University, and a Master of Public Health in Social and Behavioral Sciences from the Yale School of Public Health. Grace anticipates this pro- ject funded by the TEP Travel Fund will help pre- pare her for a doctoral program and career in the field of maternal and child nutrition and health. Grace will be mentored by Dr. Mireya Vilar- Compte, a distinguished mentor and professor in health economics at the Universidad Iberoameri- cana in Mexico City. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 46

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TTF Awardee 2018 YIMIN CHEN Human milk (HM) is the single intervention that has consistently been shown to protect premature in- fants from developing necrotizing enterocolitis, which is characterized by severe inflammation and tissue necrosis. The most common location of dis- ease occurs at the ileocecal region – the most dis- tal portion of the small intestine and most proximal portion of the large intestine. HM consumed by the infant is fully digested when it reaches this region of the gastrointestinal tract, thus it is most clinically relevant to ascertain bioactive peptides released from digestion and determine the peptides most re- sponsible for suppressing inflammation and cyto- toxicity. Once these bioactive peptides are identi- fied, it is Yimin’s long-term goal to determine spe- cific maternal characteristics that influence the presence and quantity of these bioactive peptides, and subsequently translating this information to maternal interventions that will positively modify the peptide profile in the HM produced. Dr. Yimin Chen is a postdoctoral research associ- ate at the University of Illinois in Chicago. She completed her PhD with a 15-year background as a nutrition support dietitian with specialization in gastroenterology, critical care, and neonatology. Yimin’s dissertation research showed that in vitro digested colostrum/transitional human milk (tHM) from different mothers suppressed inflammation and cytotoxicity in varying degrees. She will extend this research by profiling the bioactive peptides re- leased in digested colostrum/tHM to determine the peptides responsible for inflammation and cytotox- icity suppression with the support of the Trainee Travel Fund. She will be mentored by Dr. Dallas at Oregon State University, and gain mass spectrom- etry-based peptidomics expertise. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 47

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Trainee Expansion Program AWARDEES SPRING 2018 We are pleased to present the awardees of the TEP Travel Funds, who each received up to USD 10,000 to advance their academic career. TEP Trainee Travel Fund Awardees Alba Boix Amorós Anita Esquerra-Zwiers Breastmilk biomarkers for mastitis TTF Awardee 2018 Camille Dugas GDM, breastfeeding and the risk for obesity and T2DM in children TTF Awardee 2018 Rukshan Mehta Mycotoxin contamination of human breastmilk TTF Awardee 2018 Human milk biomarkers for perceived insufficient milk supply TTF Awardee 2018 Maternal IgA and the infant microbiome Kristen Meyer TTF Awardee 2018 Shirin Moossavi Breastmilk bacteria strain di- versity TTF Awardee 2018 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 48

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TTF Awardee 2018 ALBA BOIX AMARÓS Breastmilk (BM) hosts commensal bacteria under normal conditions. However, an imbalance in the bacterial ecosystem can lead to an overgrowth of opportunistic pathogens that may lead to mam- mary infections, such as mastitis, which is one of the main causes of early weaning. Staphylococcus aureus infections are responsible for acute masti- tis, causing inflammation and systemic flu-like symptoms. Other commensal bacteria normally present in BM can overgrowth and lead to sub- acute mastitis, which is a less acute state of the disease, but fastidious and with difficult diagnosis. Little is known about changes in milk components, such as proteins and antibodies, associated to lac- tational mastitis. In addition, hormonal content dur- ing the disease has not been assessed before. Po- tential differences in BM composition between the healthy status and mastitis could be used as bi- omarkers of the disease, and novel bacterial next- generation sequencing approaches could help to better understand its etiology. Alba Boix Amorós graduated from the Polytech- nic University of Valencia (Valencia, Spain) with a BSc degree in biotechnology, after which she com- pleted a MSc in biomedical research. During her master thesis, she developed a flow cytometry pro- tocol to accurately quantify bacterial loads in differ- ent human samples, including breast-milk. Alba is currently finishing her PhD, under the direction of Dr. Maria Collado and Dr. Alex Mira, in Valencia (Spain). Her work focuses on studying the human breastmilk microbiota in healthy conditions and during lactational mastitis. She is excited to work at Dr. Donna Geddes’s lab, where they will com- pare several breastmilk components in samples from healthy and mastitis-suffering women, to ex- amine potential biomarkers of the disease. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 49

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TTF Awardee 2018 ANITA ESQUERRA-ZWIERS Maternal perceived milk insufficiency is one of the main reasons cited for discontinuation of lactation. This barrier prevents infants from receiving optimal nutrition in their first year of life. Much research has been done on social, attitudinal, and behavioral de- terminants of breastfeeding but research is limited on the role of biological determinants. A better un- derstanding of the biological determinants may of- fer practitioners a means of targeting early breast- feeding interventions to mitigate complications as- sociated with a mother's perceived insufficient milk supply. This study will provide Anita with the tools to identify human milk biomarkers and evaluate any associations with perceived insufficient milk supply in term mothers controlling for attitudinal, social, and behavioral factors. Anita will obtain 100 term milk samples and measure perceived insuffi- cient milk supply. These samples will then be sent to the School of Molecular Sciences at the Univer- sity of Western Australia, Perth Australia where Anita will travel and collaborate with their research team to learn how to conduct human milk analysis, discuss, and disseminate these results. Dr. Anita Esquerra-Zwiers, RN is an Assistant Professor in Nursing at Hope College, Holland, MI. Anita’s dissertation research focused on mothers of preterm infants and the impact of donor human milk on mother’s own milk feedings. During her time working with mothers of preterm infants she learned that some mothers were unable to provide exclusive human milk feedings regardless of their behavioral and motivational factors to provide for their infants. Since the completion of her disserta- tion, she has been establishing her research group focusing on social, attitudinal, behavioral, physio- logical, and biological determinants of breastfeed- ing with term mothers. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 50

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TTF Awardee 2018 CAMILLE DUGAS Previous works showed that breastfeeding is asso- ciated with a reduced risk of obesity among chil- dren exposed to gestational diabetes mellitus (GDM) in utero, but a longer breastfeeding dura- tion seems necessary to achieve this protective ef- fect when compared to children unexposed to GDM. This may be due to the breastmilk composi- tion of women with prior GDM that would be al- tered. However, no study compared microRNAs content of breastmilk of women with and without a history of GDM. MicroRNAs are small RNAs parti- cles involved in biological phenomena. They are present in human milk and are transferred to the breastfed infant. As they may be involved in health programing by epigenetic mechanisms, the study of microRNAs content in breastmilk of women with prior GDM could allow us to better understand the association between breastfeeding and chil- dren’s later health among a population at high-risk of developing obesity and type 2 diabetes. Camille Dugas received both her B.Sc. and M.Sc. in nutrition from Laval University (Quebec City, Canada). During her master’s degree, she studied the impact of infant feeding practices on glycemic and anthropometric profiles of children exposed to gestational diabetes mellitus (GDM) in utero. To further investigate the association between breast- feeding and subsequent health of children ex- posed to GDM, an objective of her current Ph.D. thesis is to compare breastmilk composition of women with and without a recent history of GDM. Camille will use funds of the Trainee Travel Fund to do a two months internship in Dr Bertrand Kaeffer’s laboratory, at Nantes University, in France, to learn a technic developed by Dr Kaeffer’s team to evaluate microRNAs content of breastmilk. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 51

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TTF Awardee 2018 KIRSTEN MEYER Breastfeeding significantly impacts the develop- ment of the infant gut microbiome as breastmilk contains many bioactive components that serve to interact with and influence the microbiota in the in- fant gut. We aim to evaluate the impact of IgA, a highly abundant immunoglobulin in human milk that provides passive immunity to the infant in early life. Using maternal stool, breast milk, and infant stool samples collected from mother-infant pairs coupled with metagenomics sequencing of bacte- rial DNA, we aim to 1. identify which bacteria are targeted by maternal IgA in each body site, 2. de- termine if IgA targets exclusively pathogens, or if beneficial microbes are targeted as well, and 3. de- termine if identical bacterial strains are targeted in both breastmilk and the infant gut, suggesting ver- tical transmission of IgA-coated bacteria. This will inform our understanding of how maternal IgA in- fluences the infant microbiome and will help us un- derstand if the role of IgA in breastmilk may extend beyond providing passive immunity to the infant. Kristen Meyer received her BSc in Chemistry from Washington State University and is now in the Medical Scientist Training (MD/PhD) Program at Baylor College of Medicine in Houston, Texas. Training in the lab of Dr. Kjersti Aagaard, Kristen’s thesis research focuses on bioactive components of breastmilk and understanding how the milk mi- crobiome, human milk oligosaccharides, and ma- ternal immunoglobulins interact to influence the trajectory of infant microbial development. Kristen will use the funds from the Trainee Travel Fund to study in the lab of Dr. Nicola Segata in Trento, Italy to learn computational tools for metagenomic anal- ysis, which she will use to perform strain-level mapping of IgA-coated bacteria in breastmilk and stool samples from mother-infant pairs. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 52

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TTF Awardee 2018 RUKSHAN MEHTA Food safety concerns and environmental expo- sures are gaining increasing visibility as issues of importance in global health. Mycotoxins are fungal agents found in 25% of the world’s food supply chains. We are interested in characterizing con- tamination of human breastmilk with mycotoxins in Haryana, India among breastfeeding mothers with children 2-4 months of age. To date, there is no data looking at breastmilk mycotoxins among women in Haryana, the last mile link in the bio am- plification pathways for these contaminants along the food chain. As part of a larger NIH funded study aimed at understanding the role of maternal mal- nutrition on lactation performance, this add-on will help us examine the levels of exposures in breast- milk of mothers using high-throughput liquid chro- matography/mass spectrometry (LC/MS). We fur- ther hope to understand the role of the contami- nants on human health, including inflammatory markers in the mother and subsequent impacts on gut integrity in the breastfeeding infant. Mehta in collaboration with Drs. Young and Kannan will work with CFTRI in India to learn extraction and quantification protocols for breastmilk mycotoxins, as part of this TEP. Rukshan Mehta is a PhD student in the Doctoral program in Nutrition and Health Sciences at Emory University. Rukshan’s dissertation will focus on the role of environmental exposures including myco- toxins and pesticides in breastmilk and their impact on child health. Rukshan is particularly interested in the intersecting roles of environmental health and nutrition with a focus on mothers and children in low and middle-income countries. She has worked on several international development pro- jects employing implementation science modalities and is very interested in sustainable global health interventions such as breastfeeding. Rukshan completed her undergraduate degree at the Uni- versity of Toronto and has a master’s degree in so- cial work from the same. She began her PhD after spending 5 years working in international develop- ment both in Canada and overseas, last on a ran- domized control trial evaluating the effectiveness of multiple micronutrient powders to reduce ane- mia in children. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 53

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Trainee Expansion Program AWARDEES SUMMER 2017 We are pleased to present the awardees of the TEP Bridge Funds and the TEP Travel Funds, who each received up to USD 100,000 or up to USD 10,000 respectively to advance their academic career. TEP Trainee Bridge Fund Awardees James Butcher TEP Trainee Travel Fund Awardee Kyly Whitfield Characterizing the breastmilk microbiome with culture-en- riched molecular profiling TBF Awardee 2017 Kassandra Harding Evaluation of the first breast- feeding social media market- ing campaign in Ghana TBF Awardee 2017 Responsive feeding TTF Awardee 2017 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 54

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TBF Awardee 2017 JAMES BUTCHER Once thought to be sterile, breastmilk is now ac- cepted to contain complex microbial communities and must supply all of the nutrients required by these commensal microbes. Microorganisms in the mother’s milk are important to colonize the gut of a new-born infant to help establish a healthy gut flora - all bacteria present in the gut and essential for human digestion and uptake of nutrients. How the breastmilk microbiota adapts, responds and thrives under various conditions is currently un- known and merits investigation. Unfortunately, rou- tine microbiota profiling techniques are ill suited to this task, as they are confounded by breastmilk’s inherently low microbial biomass. This project will develop protocols for overcoming these limitations and allow researchers to assess how alterations in the environment and ultimately in breastmilk com- position impact microbiota composition and micro- bial functions. Dr. James Butcher received both his BSc and PhD in Biochemistry from the University of Ottawa, Canada, where he studied iron regulation in the pathogen Campylobacter jejuni. James subse- quently completed a Canadian Institutes for Health Research/Canadian Association for Gastroenterol- ogy postdoctoral fellowship in Inflammatory Bowel Disease at the Children’s Hospital of Eastern On- tario and studied the role of the microbiota in this increasingly prevalent disease. He is currently characterizing gut microbiota development in very low birth weight infants and studying how different feeding regimes influence gut microbiota composi- tion in this vulnerable population. James will use the funds from the Trainee Bridge Fund to develop protocols for phenotypically characterizing breast- milk microbiotas and study how breastmilk micro- biotas respond to alterations in iron bioavailability. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 55

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TBF Awardee 2017 KASSANDRA HARDING There is a gap in published research regarding dis- semination of breastfeeding related information approaches through social media platforms. This approach has the potential to be more cost-effec- tive than traditional campaigns, especially when combined with strategies to acquire high exposure and engagement. The utilization of social network analysis could be one approach to optimizing the dissemination of such campaigns given the inter- relation between mass media campaigns, social support and breastfeeding practices. This study will implement, monitor and evaluate a breastfeed- ing social media marketing campaign through Fa- cebook and Twitter and test different paths to dis- seminate campaign messages incorporating social network targeting methods. Dr. Kassandra Harding is a Postdoctoral Associ- ate at the Yale School of Public Health and a mem- ber of the Becoming Breastfeeding Friendly re- search team. Her research focuses on maternal and child nutrition and health in low-resource set- tings. Specifically, her interests include: 1) har- nessing an understanding of health behavior and beliefs and employing innovative social media marketing methods to develop and improve breast- feeding interventions and promotion of local ca- pacity building; 2) supporting breastfeeding through a focus on women’s social networks, em- powerment, and mental health in low-income set- tings. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 56

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TTF Awardee 2017 KYLY WHITFIELD Health outcomes are influenced not only by what, but how infants are fed; feeding modality may play a key role in shaping children’s eating behaviors and caregivers’ feeding practices as children de- velop. Responsive feeding allows infants to initiate and terminate feedings without caregiver interfer- ence, encouraging appropriate energy consump- tion and development of effective abilities to self- regulate intake in response to hunger and satiation cues. Alternatively, non-responsive feeding pat- terns, such as encouraging an infant to finish a bot- tle or feeding while distracted by technology, may lead to overfeeding and decrease the quality of the feeding interaction. To date, there has been no ex- ploration of responsive infant feeding in Nova Sco- tia, the province with among the lowest breastfeed- ing rates in Canada. Kyly and Alison will videore- cord feeding sessions with 20 mother-infant dyads in Halifax, Canada (10 breast-feeding and 10 feed- ing human milk from a bottle), for objective respon- sive feeding analysis in Alison’s lab. Kyly hopes that this highly specific training in assessment of responsive feeding and feeding interactions can help to inform the development of infant feeding guidelines for Nova Scotia. Dr. Kyly Whitfield is an Assistant Professor in the Department of Applied Human Nutrition at Mount Saint Vincent University in Halifax, Canada. Kyly is passionate about breastfeeding and global nutri- tion: most of her research aims to identify and com- bat micronutrient deficiencies during ‘the first thou- sand days’ window, from conception through 2 years. Kyly completed her PhD in Human Nutrition at the University of British Columbia under the su- pervision of Dr. Tim Green, where she studied the efficacy of thiamine-fortified fish sauce to address maternal thiamine deficiency and infantile beriberi in rural Cambodia. Kyly is keen to continue explor- ing public health-relevant breastfeeding research, this time ‘at home’ in Canada, focusing on respon- sive feeding among human milk-fed infants in Hal- ifax. Kyly will be mentored by Dr. Alison Ventura (California Polytechnic State University), a leading expert in the study of mother-infant interactions during feeding and responsive feeding. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 57

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Trainee Expansion Program AWARDEES 2017 We are pleased to present the awardees of the TEP Travel Funds, who each received up to USD 10,000 to advance their academic career. TEP Trainee Travel Fund Awardees Adriana Gaitán Clarisa Medina Poeliniz Endocannabinoid metabo- lome of breastmilk Tight junction closure in over- weight and obese women TFF Awardee 2017 Kozeta Miliku HMO analysis in the CHILD cohort TTF Awardee 2017 Sarah Boothman Global breastfeeding promo- tion and protection policy TTF Awardee 2017 Larisse Melo Sarah Reyes TTF Awardee 2017 B-vitamins in human milk TTF Awardee 2017 Bacterial communities of hu- man milk pumped and stored at home TTF Awardee 2017 Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 58

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TTF Awardee 2017 ADRIANA GAITÁN Endocannabinoids, endogenous lipid mediators, play a role in establishing the suckling response of the newborn by activating the cannabinoid recep- tor type 1 in the infant’s brain, in turn activating the oral-motor musculature needed for milk suckling. The established suckling response in turn supports maternal-infant bonding and maintains infant feed- ing behavior. The mechanism of actions and the role of the endocannabinoid metabolome in breast- milk (BM) are not fully understood. Pregnancy complications such as gestational diabetes melli- tus can modify the endocannabinoid metabolome of BM; however, the resulting effect on infants’ de- velopment remains to be defined. BM samples were collected from an underserved population in the highlands of Guatemala and will be analyzed for fatty acids, their derived endocannabinoids, and related signaling lipids using state of the art methodology, liquid chromatography-mass spec- trometry. This analysis will set the stage for devel- oping hypotheses for future studies that will help to elucidate how this biological system modulates in- fant health and development. Moving forward, I plan to collect BM samples in Baton Rouge, Loui- siana, USA to evaluate the fatty acids and endocannabinoid metabolome in a population that has one of the highest rates of over nutrition among pregnant and breastfeeding women in the United States. In this regard, we will be able to evaluate how maternal nutritional status can affect the fatty acids and endocannabinoid metabolome of BM. Adriana Gaitán is originally from Guatemala in Central America. She has a bachelor’s degree in food science from the Zamorano Pan-American Agricultural School, a master’s in human nutrition, and is working on her PhD in human nutrition at Louisiana State University, USA under the direc- tion of Dr. Carol Lammi-Keefe. Her research has been focused on maternal and infant health, spe- cifically evaluating the benefits of omega-3 fatty acids during pregnancy and infant outcomes. Adri- ana will study the endocannabinoid metabolome in different populations to gain a better understanding of its role in the quality of breast milk for the devel- oping infant. After completing her PhD, she plans to work in a research group (industry or academic) as part of a multidisciplinary group of scientists that generate research in this field. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 59

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TTF Awardee 2017 CLARISA MEDINA POELINIZ Overweight (BMI≥25) and obese (BMI≥30) moth- ers are more likely to experience delayed onset of lactation and suboptimal breastfeeding rates than are non-overweight and obese mothers. These clinical findings suggest that the normal process of tight junction (TJ) closure in the mammary gland is impaired. Although patterns of TJ closure have been described for healthy populations, no previ- ous research has examined this patterning for overweight and obese mothers. This research will enroll 20 overweight and obese breast pump de- pendent mothers of infants hospitalized in the ne- onatal intensive care unit (NICU), and collect serial 12-hourly human milk (HM) specimens from these women during the first 14 days post-birth. All pumped HM volume will be weighed (nearest 0.1 gram) and mothers will record the timing of their “milk coming in”. HM specimens will be analyzed by Clarisa under the supervision of basic science colleagues at the University of Western Australia. Statistical analyses will focus on patterning of 5 HM biological markers (lactose, protein, sodium, po- tassium, citrate) and determining their relationship to standard clinical measures of secretory activa- tion and coming to volume that occur in the early postpartum period. Clarisa Medina Poeliniz is a pediatric nurse prac- titioner who has been working in maternal-child health for the past 17 years. The overall goal of her research is to understand the biologic mechanisms of maternal overweight and obesity on lactation outcomes and to design diagnostics and/or inter- ventions for this population. She is currently pursu- ing her PhD in nursing science at Rush University under the direction of Drs. Paula Meier and Aloka Patel. Her research focus is patterning of TJ clo- sure using HM biologic markers for breast-pump dependent mothers of NICU infants with a pre- pregnancy BMI≥25. She will examine the relation- ship between these patterns and measure HM vol- ume and sensations of “milk coming in”. Clarisa is excited to travel to the University of Western Aus- tralia and work alongside Dr. Donna Geddes and her team. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 60

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TTF Awardee 2017 KOZETA MILIKU Overweight, obesity and cardiovascular disease are major public health problems in both Western and non-Western countries. Breastfeeding can re- duce the risk of childhood obesity and high blood pressure, although the evidence is not consistent. A key bioactive component of human milk are hu- man milk oligosaccharides (HMO), however their role in the development of childhood obesity and cardiovascular health is still unexplored. It is sug- gested that certain HMO are associated with infant body composition, but their effect on childhood obesity and blood pressure has not been studied and the maternal factors that influence HMO pro- duction are mostly unknown. The objective of this study is to characterize the integrated roles of ma- ternal factors and HMO in the developmental ori- gins of childhood obesity and cardiovascular health, uniting the unique Canadian Healthy Infant Longitudinal Development (CHILD) cohort with new high-throughput methods for HMO analysis. Kozeta Miliku is a medical doctor from Albania, currently finishing her PhD at the Generation R Study in the Netherlands. Her doctoral research is focused on identifying early life determinants that affect growth and development in children, mainly kidney development. Her interest is exploring hu- man milk components, specifically human milk oli- gosaccharide’s role on obesity and high blood pressure in children. Kozeta, is defending her doc- torate thesis later this spring and plans on moving abroad to enrich her experience in the field of hu- man milk and lactation and developmental origins of health and disease. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 61

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TTF Awardee 2017 LARISSE MELO There are several information gaps regarding the nutrient content in human milk, especially concern- ing vitamins. It should be treated as a research pri- ority since human milk represents the main con- nection between the mother and child nutritional status. Little is known about the acceptable con- centrations of vitamins in breast milk, and much less is known about how to improve it. The USDA Western Human Nutrition Research Center (WHNRC) has worked towards developing and ap- plying methods for the efficient and accurate anal- ysis of nutrients in human milk, aiming to establish global reference values for human milk composi- tion. My background experience is in analyzing fat- soluble vitamins in breastmilk, and with this project I aim to expand my knowledge on the methodolog- ical approaches involved in the analysis of B-vita- mins in human milk. Larisse Melo graduated from the Federal Univer- sity of Rio Grande do Norte (Natal, Brazil) with a BSc degree in Human Nutrition. Still in her first un- dergraduate year, Larisse joined a research group as an Undergraduate Research Assistant, wherein she worked for four years with projects assessing vitamins A and E in breastmilk of low-income moth- ers in Brazil, as well as their dietary intake and the effect of supplementation on milk vitamin concen- trations. Larisse has recently started her MSc in Nutrition at the University of British Columbia (Van- couver, Canada), and her main goal is building a career in academic research for contributing to the development of public policies and recommenda- tions associated with the health of pregnant and lactating women. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 62

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TTF Awardee 2017 SARAH BOOTHMAN Navigating the interface between laboratory sci- ence and public policy provides a bridge in making changes that will truly benefit maternal, child and infant health. Using scientific results and translat- ing them to inform development of public policy is one thing in which I hope to gain experience during an internship at the World Health Organization. To advance understanding of how our ever-evolving, evidence-based knowledge related to human milk composition and lactation are applied to breast- feeding on a global scale, this project is designed to develop a more thorough understanding of the legal and policy aspects involved in world-wide promotion of breastfeeding and application of re- search in human milk and lactation. This internship will help equip me to more seamlessly cross disci- plinary boundaries. I hope to gain hands-on expe- rience working with programs relating to interna- tional breastfeeding promotion and protection, with a focus on national and international policy. Sarah Boothman is a PhD graduate student in the School of Biological Sciences at Washington State University. Sarah is looking forward to participating in a project that will allow her to combine her inter- ests in human nutrition, law and public health within the context of her current studies in biology, focusing on human milk. Sarah completed her undergraduate degree in hu- man nutrition at Washington State University and received her Juris Doctor from the University of Idaho College of Law. Prior to her graduate stud- ies, Sarah spent several years as a health educa- tor at a community hospital in a rural, underserved region, where she had the opportunity to get to know many wonderful people and was motivated to continue on to law school and later graduate school to be better equipped with skills and expe- rience to advocate for whatever community she finds herself in. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 63

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TTF Awardee 2017 SARAH REYES Many women rely on pumping and feeding their milk from a bottle to meet their breastfeeding goals. How storage and handling of human milk (HM) in at-home conditions influence its microbial ecology, which is likely important for colonization of the infant’s gastrointestinal tract and risk of infant illness, is poorly studied. Given that the American Academy of Pediatrics recommends HM-feeding without the distinction of how HM is fed (breast or bottle), it is important to fill these gaps in knowledge. We will characterize the bacterial com- munity of HM pumped and stored at home. To do this, we will conduct a randomized trial in Ithaca, NY in which women will pump their HM on two con- secutive pumping sessions using either their own pump or a hospital-grade pump. Randomization will be used to determine which pump each woman uses first. HM from both pumps will be stored at home and sampled on days 0, 2, and 30 after ex- pression. Samples will be shipped to the University of Idaho where next-generation sequencing of the 16S rRNA gene will be conducted. The results of this research will provide information about the ef- fect of pump type and storage under “real-life” conditions on the bacterial communities of HM, which can be used to inform evidence-based rec- ommendations for handling and storing HM. Sarah Reyes, MS is a doctoral candidate in the Division of Nutritional Sciences at Cornell Univer- sity. Ms. Reyes’s dissertation, guided by Kathleen Rasmussen, ScD, focuses on the microbial expo- sures’ infants receive when they are fed their moth- ers’ milk from a bottle instead of being fed at the breast as well as the relevance of this exposure to the bacterial communities in the infant gastrointes- tinal tract and infant health outcomes. Sarah’s doc- toral research combines training in biological sci- ence, epidemiology, and public health nutrition. Sarah’s work is supported by an NIH-sponsored training grant in nutrition, which focuses on training in translational research. Sarah’s long-term career goal is to gain an academic/research position in which she can use her training to advance the sci- ence and public health goals of maternal and child nutrition, particularly in the field of human milk and lactation. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 64

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Trainee Expansion Program AWARDEES 2016 We are pleased to present the awardees of the TEP Bridge Funds and the TEP Travel Funds, who each received up to USD 100,000 or up to USD 10,000 respectively TEP Trainee Bridge Fund Awardee Alecia-Jane Twigger to advance in their academic career. Mini mammary gland culture TBF Awardee 2016 HMO in human milk of HIV+ mothers TTF Awardee 2016 TEP Trainee Travel Fund Awardees Kimberly Lackey M. leprae in human milk TTF Awardee 2016 Melanie Wange Larsson Appetite hormones in human milk TTF Awardee 2016 Klara Strydom Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 65

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TBF Awardee 2016 ALECIA-JANE TWIGGER Extracting cells from milk provides direct access to live viable cells from the lactating mammary gland that can be compared to established characteris- tics and regenerative capabilities of mammary cells of non-pregnant, non-lactating women. Sort- ing and comparing gene expression and protein signatures of mammary cells obtained from breast mammoplasties and milk cells will elucidate differ- ences in mammary cell function during the resting and highly plastic periods of normal development. This project brings together expertise in human milk cells and state-of the art organoid culturing techniques to develop an in vitro model of human lactation that will revolutionize our understanding of the molecular characteristics of mammary cell development and function. Alecia-Jane Twigger is a biomedical scientist working in the field of human lactation for the past four and a half years as a part of the Human Lac- tation Research Group at the University of Western Australia. After completing her Bachelor of Sci- ence with Honors, she pursued a PhD examining the characteristics of the lactating mammary gland using cells isolated from human milk. Recently, Al- ecia-Jane has submitted her PhD thesis and plans on moving abroad to enrich her experience in mammary gland biology and develop new tech- niques to examine the lactating breast. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 66

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TTF Awardee 2016 KIMBERLY LACKEY In 2014, 80’544 women were newly diagnosed with leprosy, a bacterial infection caused by Mycobac- terium leprae. To date, the mechanism(s) of trans- mission for leprosy is (are) still not understood, but we hypothesize that one potential mechanism could be during infancy via breastmilk. To test this hypothesis, I will travel to Nepal, a leprosy-en- demic country, to collect milk samples (n = 5) from lactating women with leprosy as well as healthy controls. In Nepal, I will also analyze these sam- ples using an rtPCR assay that I developed for M. leprae in breastmilk. This project will serve as proof-of-concept that the leprosy bacterium is or is not present in human milk. We will then use this information as a starting point for more targeted in- vestigations into breastfeeding’s potential role in leprosy transmission or will provide concrete evi- dence that breastmilk is safe and still best for ba- bies born to leprosy-affected mothers. Kimberly Lackey is a PhD candidate in Biology at Washington State University under Dr. Shelley McGuire. Originally from Portland, OR, she also completed her BA and BS at Washington State. Her doctoral research focuses on methods to col- lect and preserve human milk samples collected in rural field conditions, as well as the subsequent analysis of these samples for both the overall mi- crobial community structure and for Mycobacte- rium leprae, the causative agent of leprosy. Her work and PhD will culminate in a proof-of-concept project to determine if M. leprae is present in the milk of women with leprosy. Kimberly is especially interested in women’s health and infectious dis- ease and would like to pursue a career in public health after completion of her PhD. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 67

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TTF Awardee 2016 KLARA STRYDOM Klara Strydom is a dynamic dietitian with a high standing academic record. Klara obtained her BSc Dietetics Degree in 2014 whereafter she was in- volved as a research assistant in a large cohort study. She is currently studying towards a master’s degree in nutrition at the University of Stellen- bosch, South Africa. The title of her thesis is "Body composition, Growth and nutritional intake of HIV exposed preterm, very- and extremely low birth weight infants in Tygerberg hospital, Western Cape." Her research assesses the effect of HIV- exposure on human milk oligosaccharides in moth- ers as well as body composition and gut microbi- ome in preterm infants living in a resource poor set- ting. Klara is looking forward to working alongside experts in her field of study at the Bode Laboratory during November 2016. Klara enjoys yoga, hiking and traveling and currently resides in the beautiful city of Cape Town, South Africa. HIV-exposed uninfected infants seem to have poorer growth and greater early mortality and mor- bidity rates than their HIV-unexposed counterparts. Human breastmilk composition is very diverse and distinct and there is an array of factors that can have an effect on the concentration of human milk oligosaccharides (HMOs). Once ingested HMOs prevent infections, stimulate beneficial bacterial growth promoting the gut microbiome and they have an anti-inflammatory effect. It has been hy- pothesized that the differences in breastmilk HMO composition are related to the infant’s growth and body composition. HMOs can regulate the gut flora, improve gastrointestinal activities and influ- ence the inflammatory processes, thus being di- rectly proportional to the growth and body compo- sition of the infant. However, there is a distinctive gap in literature whether HMO variety and uni- formity are associated with the infant gut microbi- ome variety and uniformity and whether they are directly proportional to early infant growth and body composition, especially in the context of HIV. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 68

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TTF Awardee 2016 MELANIE WANGE LARSSON Early high weight gain is a risk factor for later obe- sity. For the SKOT III study factors such as milk volume, appetite hormones and growth factors in milk and plasma, feeding pattern, eating behavior, and body composition are measured. The Travel Trainee Award allows Melanie to visit the Hartmann Human Lactation Research Group (HHLRG) at University of Western Australia and gives her a unique opportunity to gain more expe- rience in the field of research in human milk and lactation. Several of HHLRG´s research areas are very relevant for the PhD project of Melanie. A key area of her PhD study is appetite hormones in hu- man milk, a research area which HHLRG have great experience and expert knowledge in. During the stay at the HHLRG Melanie analyze human milk from her study in Denmark. In addition, Mela- nie will have the opportunity to observe the ongo- ing research at the HHLRG and learn about 24- hour milk profiles. Melanie Wange Larsson holds a master’s degree in human nutrition from Copenhagen University and is an associate professor at the Institute of Nu- trition and Midwifery, Metropolitan University Col- lege, Copenhagen, teaching nutrition and physiol- ogy including infant and child nutrition, growth and physiology of breastfeeding. Since 2014 Melanie has also been working on her Ph.D. at Copenha- gen University. The overall objective of Melanie’s PhD study is to examine exclusively breastfed infants with very high weight gain in the first months of life to have a better understanding of causes for the weight gain and consequences for these infants. The team has established a cohort (SKOT III) of exclusive breast- fed infants with excessive weight gain (weight-for- age z-score ≥2.00 SD) during the first months of life. Factors as appetite hormones in milk and in- fant blood, milk volume, feeding pattern, baby eat- ing behavior and body composition will be investi- gated. Founded by ISRHML and the Family Larsson-Rosenquist Foundation. Sponsored by the Family Larsson-Rosenquist Foundation Trainee Expansion Program 69