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ARS Home » Southeast Area » Little Rock, Arkansas » Arkansas Children's Nutrition Center » Research » Publications at this Location » Publication #195468
Title: ESTIMATING HUMAN BREAST MILK ENERGY INTAKE IN 3-MONTH OLD INFANTS

Author
item SMITH, STACEE - ACNC
item Gilchrist, Janet
item BADGER, THOMAS - ACNC/UAMS

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 3/17/2006
Publication Date: 4/6/2006
Citation: Smith, S., Gilchrist, J.M., Badger, T.M. 2006. Estimating human breast milk energy intake in 3-month old infants [abstract]. In: Proceedings of Arkansas Dietetic Association Annual Meeting, April 6-7, 2006, Little Rock, Arkansas.

Interpretive Summary: Some have proposed that breast-fed (BF) infants have a lower lifetime risk of obesity than infants who are formula fed (FF). In order to study this theory, we need to compare energy intake between BF and FF infants. Several equations to assess the energy intake of BF infants have been published. We used data from BF infants in the Beginnings study to compare three equations. We compared the results to the Dietary Reference Intakes (DRI). We also compared the results to intake of our FF infants. The equations gave very different results (468 vs. 500 vs. 543 calories/day). All of the results were at least 20% lower than the DRI (624 calories/day). All of the results were also much lower than intake of our FF infants (712 calories/day). Despite the difference in intake, our BF and FF infants gained weight at the same rate. More work is needed in this area to refine equations to assess BF intakes. This work is critical to study the early causes of childhood obesity and may also be helpful in the next revision of the DRI for infants.

Technical Abstract: Several researchers have published equations to estimate caloric intake in exclusively breastfed (BF) infants. Our Beginnings study offers an opportunity to compare these estimates in a well-defined sample of healthy, BF infants (n=79, 38F, 41M) and contrast them to the Daily Reference Intake (DRI) and to intakes from comparable milk-fed (MF) infants (n=81, 31F, 50M). Heinig et al. (DARLING study), Krebs et al., and Butte et al. reported a mean (+/- SD) calculated energy intake of 85.9 +/- 11.3, 79 +/- 11, 74 +/- 20 kcals/kg/day, respectively, to estimate BF intake in healthy 3-month-old infants. By inserting weights from our 3-month-old BF subjects into the varied calculations, the differences among all three of the equations are statistically significant (p=<0.001, Heining mean = 543.1 kcal/d, Krebs mean = 467.8 kcal/d, Butte mean = 499.5 kcal/d). A discrepancy also exists between the estimations of caloric intake of BF infants and the current DRI for energy (p=<0.001). Based on any of these equations, at 3 months of age, BF infants would have consumed ~20% fewer kcals than the DRI while their MF counterparts consumed ~14% more kcals than the DRI (p=<0.001). In our sample, BF and MF infants gained a similar amount of weight per day between birth and 3 months (29.43 g/day vs. 28.86 g/day, p=0.616). These values were also applicable when groups were separated by gender. Accordingly, caloric intake from any of these equations would suggest that BF infants consumed ~28% fewer calories per day than MF infants. Implying that MF and BF infants grow at similar rates, despite significant differences in daily caloric consumption and fewer calculated calories than the DRI recommends. As we continue to investigate the early origins of childhood obesity, the ability to accurately estimate breast milk intake and kcal consumption is critical. Perhaps, as it has been argued, there is also a need to reevaluate the DRI to more accurately define an infant's actual intake. Should there be a separate DRI for BF and MF infants? Does DRI overestimate an infant's energy requirements at 3 months of age? Do infants metabolize milk-based formula and breast milk differently? There are many questions yet to be answered. Further research into estimation of breast milk energy intake and composition, infant body composition differences and metabolism of breast milk is necessary.