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  • Title: Infant physiology, nutritional requirements, and lactational adequacy.
    Author: Whitehead RG.
    Journal: Am J Clin Nutr; 1985 Feb; 41(2 Suppl):447-58. PubMed ID: 3969951.
    Abstract:
    This article addresses the question of the length of time a given volume of breast milk can be expected to satisfy infant nutritional needs without the introduction of other foods. Breast milk requirements in infants are generally assessed either on the basis of recommended dietary allowances or the measured amounts of breast milk consumed. Recommended dietary allowances for infancy in terms of energy, vitamins, and minerals are highly speculative. The energy composition of milk is not a constant factor. Moreover, recommended dietary allowances do not take into account individual variability of energy needs. More research is needed on the extent to which metabolic adaptation or natural selection may have modified infant requirements in different areas. It is generally believed that the Food and Agriculture Organization/World Health Organization (FAO/WHO) allowances are inaccurate; if followed, almost all infants would require substantial supplementation before 3 months of age. The author approached the problem of estimating breast milk requirements by determining the levels of milk intake that were compatible with adequate rates of growth. This analysis indicated that from 2-8 months standard rates of growth were being achieved on energy intakes substantially lower than recommended values. The minimum energy intake at 6-8 months was about 90 kcal/kg. The data suggest that requirements may rise again in the 2nd half of infancy, reaching conventionally accepted levels by 1 year of age. The finding that breast milk yields of 1000 ml/day are sufficient for boy infants up to 12 weeks and for girl infants up to 24 weeks is compatible with the view that breastfeeding alone should satisfy the needs of most infants at least up to 3 months.
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