title: Breast milk and complementary food intake in Brazilian infants according to socio-economic position.
abstract: OBJECTIVE
  (a) To compare breast milk and complementary food intake between breast-fed infants from high and low socio-economic status (SES) aged 8 months of age; (b) To compare these intakes with PAHO/WHO recommendations.
  
  
  METHODS
  Cross-sectional, community-based study in Pelotas, Brazil. Breast milk and complementary food intake were compared between 8-month-old infants from high (n=35) and low SES (n=30). Breast milk intake was measured using the 'dose-to-the mother' deuterium-oxide turnover method; complementary food intake was assessed using a questionnaire and by 24 hours food weighing.
  
  
  RESULTS
  Energy intake from breast milk (51.1 ± 26.4 kcal/kg/d) was not different between social groups, being in line with current recommendations. However, energy intake from complementary foods (34.5 ± 22.7 kcal/kg/d) and from milk, including breast milk, cow's milk and formula (60.1 ± 19.6 kcal/kg/d), were significantly higher than recommendations. Total energy intake was 20% higher than recommended (93.3 ± 24.4 versus 77.3 kcal/kg/day, p<0.001). This was mainly due to a high intake of complementary foods and addition of cow's milk to breast milk. Introduction of complementary foods before 6 months was common. In the high SES group, more infants consumed vegetables (p=0.005) and fruit (p=0.020), whereas fats and sugar tended to be consumed less frequently (p=0.05 and p=0.17, respectively).
  
  
  CONCLUSIONS
  Feeding habits deviate from PAHO/WHO recommendations, especially for infants of lower SES. Of main concern are the high-energy intake and early introduction of cow's milk and complementary foods. This may be important in view of metabolic programming and the development of obesity and associated diseases later in life.
authors.affiliation: VU University, Amsterdam, the Netherlands. joke_romulus@yahoo.com
authors.forename: Johanna J C
authors.initials: JJ
authors.lastname: Romulus-Nieuwelink
authors.forename: Colleen
authors.initials: C
authors.lastname: Doak
authors.forename: Elaine
authors.initials: E
authors.lastname: Albernaz
authors.forename: Cesar G
authors.initials: CG
authors.lastname: Victora
authors.forename: Hinke
authors.initials: H
authors.lastname: Haisma
mesh_terms: D001628:Beverages; D001938:Brazil; D001942:Breast Feeding; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects; D002149:Energy Intake; D005260:Female; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006293:Health Promotion; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D008895:Milk, Human; D018673:Nutrition Policy; D009749:Nutrition Surveys; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires