title: Breast milk and energy intake in exclusively, predominantly, and partially breast-fed infants.
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).
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Community-based study in urban Pelotas, Southern Brazil.
  
  
  METHODS
  A total of 70 infants aged 4 months recruited at birth.
  
  
  METHODS
  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.
  
  
  BACKGROUND
  International Atomic Energy Agency through RC 10981/R1.
authors.affiliation: Departamento de Medicina Social, Universidade Federal de Pelotas, Pelotas, RS, Brazil. h.haisma@biol.rug.nl
authors.forename: H
authors.initials: H
authors.lastname: Haisma
authors.forename: W A
authors.initials: WA
authors.lastname: Coward
authors.forename: E
authors.initials: E
authors.lastname: Albernaz
authors.forename: G H
authors.initials: GH
authors.lastname: Visser
authors.forename: J C K
authors.initials: JC
authors.lastname: Wells
authors.forename: A
authors.initials: A
authors.lastname: Wright
authors.forename: C G
authors.initials: CG
authors.lastname: Victora
mesh_terms: D001903:Bottle Feeding / Q000009:adverse effects / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D017666:Deuterium Oxide; D002149:Energy Intake / Q000502:physiology; D005260:Female; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D008895:Milk, Human; D009765:Obesity / Q000453:epidemiology / Q000209:etiology; D015430:Weight Gain
chemical_list: D017666:Deuterium Oxide