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Breast milk and energy intake in exclusively, predominantly, and partially breast-fed infants

European Journal of Clinical Nutrition volume 57, pages 1633–1642 (2003)Cite this article

Abstract

Objective: To investigate the extent to which breast milk is replaced by intake of other liquids or foods, and to estimate energy intake of infants defined as exclusively (EBF), predominantly (PBF) and partially breast-fed (PartBF).

Design: Cross-sectional.

Setting: Community-based study in urban Pelotas, Southern Brazil.

Subjects: A total of 70 infants aged 4 months recruited at birth.

Main outcome measures: Breast milk intake measured using a ‘dose-to-the-mother’ deuterium-oxide turnover method; feeding pattern and macronutrient intake assessed using a frequency questionnaire.

Results: Adjusted mean breast milk intakes were not different between EBF and PBF (EBF, 806 g/day vs PBF, 778 g/day, P=0.59). The difference between EBF and PartBF was significant (PartBF, 603 g/day, P=0.004). Mean intakes of water from supplements were 10 g/day (EBF), 134 g/day (PBF) and 395 g/day (PartBF). Compared to EBF these differences were significant (EBF vs PBF, P=0.005; EBF vs PartBF, P<0.001).

The energy intake of infants receiving cow or formula milk (BF+CM/FM) in addition to breast milk tended to be 20% higher than the energy intake of EBF infants (EBF, 347 kJ/kg/day vs BF+CM/FM, 418 kJ/kg/day, P=0.11).

Conclusions: There was no evidence that breast milk was replaced by water, tea or juice in PBF compared to EBF infants. The energy intake in BF+CM/FM infants tended to be 20% above the latest recommendations (1996) for breast-fed and 9% above those for formula-fed infants. If high intakes are maintained, this may result in obesity later in life.

Sponsorship: International Atomic Energy Agency through RC 10981/R1.

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Acknowledgements

We thank the women who participated in the study, and acknowledge contributions of Mara Santos, Verina Silva, Mirian Franz for sample collection; Ana Beatriz Palmeira and Ana Lucia Isquierdo for anthropometric measurements; Rita Silveira for quality control; Wilian Trinidade for data management, and Angélica Rodrigues for secretarial help. We thank Professor Roel Vonk (Groningen University) for stimulating discussions during the process of revision.

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  1. W A Coward: Guarantor: A Coward.

Authors and Affiliations

  1. Departamento de Medicina Social, Universidade Federal de Pelotas, Pelotas, RS, Brazil

    H Haisma, E Albernaz & C G Victora

  2. Elsie Widdowson Laboratory, MRC Human Nutrition Research, Cambridge, UK

    W A Coward & A Wright

  3. Zoological Laboratory, Groningen University, Haren, The Netherlands

    H Haisma & G H Visser

  4. Institute of Child Health, MRC Childhood Nutrition Research Group, London, UK

    J C K Wells

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  1. H Haisma
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Correspondence to H Haisma.

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Haisma, H., Coward, W., Albernaz, E. et al. Breast milk and energy intake in exclusively, predominantly, and partially breast-fed infants. Eur J Clin Nutr 57, 1633–1642 (2003). https://doi.org/10.1038/sj.ejcn.1601735

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