NANCY F. BUTTE, PHD, MARDIA G. LOPEZ-ALARCON, MD, PHD, CUTBERTO GARZA, MD, PHD
World Health Organization, 2002
This review, which was prepared as part of the background documentation for a WHO expert consultation, evaluates the nutrient adequacy of exclusive breastfeeding for term infants during the first 6 months of life. Nutrient intakes provided by human milk are compared with infant nutrient requirements. To avoid circular arguments, biochemical and physiological methods, independent of human milk, are used to define these requirements.
In this review nutrient adequacy of exclusive breastfeeding is most commonly evaluated in terms of growth. Other functional outcomes, e.g. immune response and neurodevelopment, are considered when data are available. The dual dependency on exogenous dietary sources and endogenous stores for meeting requirements is also considered in evaluating human milk’s nutrient adequacy. When evaluating the nutrient adequacy of human milk, it is essential to recognize the incomplete knowledge of infant nutrient requirements in terms of relevant functional outcomes. Particularly evident is the inadequacy of crucial data for evaluating the nutrient adequacy of exclusive breastfeeding for the first 4 to 6 months.
Mean intakes of human milk provide sufficient energy and protein to meet mean requirements during the first 6 months of infancy. Since infant growth potential drives milk production, the distribution of intakes likely matches the distribution of energy and protein requirements.
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