Submitted to: Journal of Nutrition
Publication Type: Peer reviewed journal
Publication Acceptance Date: 5/13/2007
Publication Date: 7/3/2007
Citation: Galpin, L., Thakwalakwa, C., Phuka, J., Ashorn, P., Maleta, K., Wong, W.W., Manary, M.J. 2007. Breast milk intake is not reduced more by the introduction of energy dense complementary food than by typical infant porridge. Journal of Nutrition. 137(7):1828-1833. Interpretive Summary: Infants in developing countries such as rural Malawi often slow their growth at 4 months of age because of insufficient energy intake from breast milk alone. These infants often are fed corn or soy porridge to prevent growth faltering. The study is designed to test if an energy-dense complementary food can prevent growth faltering without affecting breast milk intake more than the traditional corn/soy porridge. Forty-four healthy 6-month-old infant/mother pairs were studied for one month. Breast milk intake was measured using the dose-to-mother deuterium dilution method. The results showed that the energy-dense complementary food did not affect breast milk intake more than the traditional corn/soy porridge.
Technical Abstract: The effect of different energy densities of complementary foods on breast milk consumption is not well understood. In this study, we tested the hypothesis that provision of fortified spread (FS), a micronutrient fortified, energy-dense (22 kJ/g), ready-to-use food, to Malawian infants would not decrease their breast milk intake more than a traditional corn + soy blended flour (CSB). Forty-four healthy 6-mo-old infant and mother pairs were enrolled in a prospective, parallel group, investigator-blinded, randomized controlled complementary feeding trial. Infants were randomized to receive 25 g/d of FS, 50 g/d of FS, or 72 g/d of CSB. The primary outcome was the difference in breast milk intake after 1 mo of complementary feeding as measured by the dose-to-mother deuterium oxide dilution technique. Outcomes were compared using repeated measures ANOVA. A total of 41 mother-infant pairs completed the study. At enrollment, 88% of the infants had received corn porridge. At baseline, the infants consumed 129 +/- 18 g.kg body wt(-1).d(-1) (mean +/- SD) of breast milk. After 1 mo of complementary feeding with 25 g/d FS, 50 g/d FS, or 72 g/d CSB, their breast milk consumption was 115 +/- 18 g.kg body wt(-1).d(-1), a significant reduction; however, the effects of the complementary foods did not differ from one another (F-value model = 4.33, P = 0.0008 for effect of time and P = 0.69 for effect of type of food). The results suggest that complementary feeding of Malawian infants with FS has the same effect on their breast milk intake as complementary feeding with traditional CSB porridge.