Expert Insights: In Conversation with Prof. Meghan Azad

At UNLOKall, we bring together leading voices shaping the future of early life nutrition and child health. Through our expert interviews, we explore real-world perspectives on emerging evidence, clinical practice, and prevention, helping healthcare professionals translate science into meaningful impact.

Meet the Expert

Prof. Meghan Azad

Professor Meghan Azad participated as a speaker in the UNLOKall session Preventing Food Allergy: Early-Life Nutrition & Emerging Evidence. Watch the recording here.

She is a professor of Pediatrics and Child Health at the University of Manitoba, and studies how infant nutrition and the microbiome influence child development and long-term health. She directs the Manitoba Interdisciplinary Lactation Centre (MILC), leads the International Milk Composition (IMiC) Consortium, and serves as Knowledge Mobilization Chair for the CHILD Cohort Study. She also directs the THRiVE Discovery Lab and holds leadership roles in national and international breastfeeding and human milk research networks.

You are internationally recognized for your work on early life experiences and their impact on long term health. What first drew you to studying this critical period?

To be honest, it was a bit of an accident. I was looking to move out of bench science into something more applied, and I came across an opportunity to work on the infant microbiome through the CHILD Cohort Study. But once I got started, I found it fascinating. Early life is such a powerful window – the exposures and experiences we have at the very beginning can shape development, health, and disease risk for years to come. That idea, central to the DOHaD framework, really drew me in.

What’s kept me in the field is seeing those long-term effects unfold. I’m still following many of those same infants, who are now teenagers. Over time, my focus has narrowed toward early life nutrition – especially human milk – because it sits at the intersection of biology, clinical care, and prevention in a way that is both complex and highly impactful.

Your recent work has focused strongly on human milk and breastfeeding. What do you see as the greatest value in advancing research and practice in this area?

Human milk is one of the most important and least understood aspects of early life nutrition. It’s not just food – it’s a dynamic biological system containing nutrients, immune factors, microbes, hormones, and many other bioactive components that shape infant development. We still have a lot to learn.

At the same time, from a practice perspective, the biggest opportunity is in better supporting breastfeeding. The evidence that breastfeeding matters is already quite strong, and most parents have received that message. The real challenge is helping families achieve their feeding goals. This comes down to education and support. Many healthcare providers have limited training in lactation, so advancing practice means equipping them with the knowledge and skills to support breastfeeding effectively in real-world settings.

Where do you see the biggest gaps between current clinical practice and the evidence on early life nutrition?

One of the biggest gaps is that the science is clear in many areas, but it’s not consistently reflected in practice. We know that mother’s own milk, direct breastfeeding, and early feeding practices are critically important – yet the systems to support them are often lacking. For example, lactation is still not fully integrated into medical and nursing education, and in many settings it’s not treated as a core part of care. That is starting to change, but not fast enough.

A concrete example is colostrum. We know how important it is, yet we don’t always ensure that every newborn receives colostrum from their own mother as a top priority. If we truly valued human milk for the biological resource it is, we would design our healthcare systems very differently around those first hours and days.

How do the courses you contributed to support clinicians, nurses, and allied health professionals in their day to day practice?

These courses are really designed to bridge that gap between evidence and practice. Many providers did not receive formal training in lactation, and even for those who did, the science has evolved quickly. The goal is to make the science accessible, while also keeping it clinically meaningful. That means helping providers understand not just what the evidence shows, but why it matters – so they can apply it in day-to-day care, whether they are supporting a new mother, troubleshooting feeding challenges, or making decisions in a clinical setting.

What developments in early life nutrition are you most excited about in the coming years?

Scientifically, I’m especially excited about the shift toward understanding human milk as a responsive biological system. For example, emerging work suggests that signals from the infant – potentially through saliva during breastfeeding – may influence milk composition. This kind of bidirectional communication could fundamentally reshape how we think about lactation. I’m also excited about expanding beyond the areas I’ve traditionally focused on, like nutrients and microbiome components, to study things like immune cells and extracellular vesicles. These are newer areas with a lot of potential.

At the same time, there are important developments in training and clinical care. We now have a board-certified specialty in breastfeeding and lactation medicine, and a new lactology program in development at UC San Diego. These signal a growing recognition of how important this field is.

Finally, I think there is important work ahead in areas like pumped milk and donor milk. While direct breastfeeding is ideal, it’s not always possible. So we need better evidence on how to store, handle, process, and even match milk in these contexts – research that can have very practical impact for many families.

Learn from Prof. Meghan Azad’s Expertise