title: Growth and intakes of energy and zinc in infants fed human milk.
abstract: The objectives of this study were to examine the growth pattern of healthy infants who were fed human milk exclusively for > or = 5 months and its relationship to intakes of milk, energy, and zinc. Monthly anthropometric measurements were obtained on 71 infants through 7 months of age and on 43 through 9 months. Milk zinc concentrations were determined and milk intake was measured by 3-day test weighing. Mean (+/- SD) calculated energy intake from human milk was 106 +/- 20, 79 +/- 11, 70 +/- 10, and 57 +/- 12 kcal/kg per day at 2 weeks and 3, 5, and 7 months of age, respectively; intake from milk plus solids was 70 +/- 13 kcal/kg at 7 months. Zinc intakes from human milk were 2.3 +/- 0.68, 1.0 +/- 0.43, 0.81 +/- 0.42, and 0.52 +/- 0.31 mg/day at these points. The maximum mean weight-for-age percentile for both sexes was 62 at 2 months; the mean percentile declined to 33 by 7 months and to 25 by 9 months of age. Mean length-for-age percentile declined from 43 at 2 weeks of age to 28 and 26 by 7 and 9 months of age, respectively. Energy intake at 2 weeks of age was positively associated with the weight increment from 2 weeks to 7 months of age (p = 0.003) and with a change in weight-for-age z scores from 2 weeks to 3 months of age (p = 0.028). Mean energy intakes of healthy breast-fed infants are lower through the first 7 months of life than current recommendations. Zinc intakes of breast-fed infants are likely to be adequate, on average, through 5 months of breast-feeding but subsequently are marginal without the introduction of weaning foods. Revision of standards for growth based on observations in breast-fed infants may be appropriate, but the possibility of growth-limiting nutrient deficiencies should also be investigated.
authors.affiliation: Department of Pediatrics, University of Colorado Health Sciences Center, Denver 80262.
authors.forename: N F
authors.initials: NF
authors.lastname: Krebs
authors.forename: C J
authors.initials: CJ
authors.lastname: Reidinger
authors.forename: A D
authors.initials: AD
authors.lastname: Robertson
authors.forename: K M
authors.initials: KM
authors.lastname: Hambidge
mesh_terms: D001827:Body Height; D001835:Body Weight; D001942:Breast Feeding; D002149:Energy Intake; D005260:Female; D006801:Humans; D007225:Infant Food / Q000032:analysis; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology*; D007231:Infant, Newborn / Q000254:growth & development*; D008137:Longitudinal Studies; D008297:Male; D008895:Milk, Human / Q000737:chemistry / Q000378:metabolism; D012016:Reference Values; D012044:Regression Analysis; D015032:Zinc / Q000032:analysis* / Q000097:blood
chemical_list: D015032:Zinc