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Metabolisable energy consumption in the exclusively breast-fed infant aged 3–6 months from the developed world: a systematic review

Published online by Cambridge University Press:  08 March 2007

John J. Reilly ,
Susan Ashworth  and
Jonathan C. K. Wells
John J. Reilly*
Affiliation:
University of Glasgow Division of Developmental Medicine, Yorkhill Hospitals, Glasgow G3 8SJ, UK
Susan Ashworth
Affiliation:
University of Glasgow Library, Hillhead Street, Glasgow G12 8QQ, UK
Jonathan C. K. Wells
Affiliation:
MRC Childhood Nutrition Research Centre, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
*
*Corresponding author: Dr John J. Reilly, fax +44 (0) 141 201 9275, email jjr2y@clinmed.gla.ac.uk
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Abstract

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The present study aimed to evaluate evidence on metabolisable energy consumption and pattern of consumption with age in infants in the developed world who were exclusively breast-fed, at around the time of introducing complementary feeding. We carried out a systematic review aimed at answering three questions: how much milk is transferred from mother to infant?; does transfer increase with the age of the infant?; and what is the metabolisable energy content of breast milk? Thirty-three eligible studies of 1041 mother–infant pairs reported transfer at 3–4 months of age, the weighted mean transfer being 779 (SD 40) g/d. Six studies (99 pairs) measured transfer at 5 months, with a weighted mean transfer of 827 (SD 39) g/d. Five studies (72 pairs) measured milk transfer at 6 months, reporting a weighted mean transfer of 894 (SD 87) g/d. Nine longitudinal studies reported no significant increases in milk transfer after 2–4 months. Twenty-five studies on breast-milk energy content were based on 777 mother–infant pairs. The weighted mean metabolisable energy content was 2·6 (SD 0·2) kJ/g. Breast-milk metabolisable energy content is probably lower, and breast-milk transfer slightly higher, than is usually assumed. Longitudinal studies do not support the hypothesis that breast-milk transfer increases markedly with age. More research on energy intake in 5–6-month-old exclusively breast-fed infants is necessary, and information on the metabolisability of breast milk in mid-infancy is desirable. This evidence should inform future recommendations on infant feeding and help to identify research needs in infant energy balance.

Keywords

Infant nutritionBreast feedingComplementary feedingEnergy metabolism
Type
Research Article
Information
British Journal of Nutrition , Volume 94 , Issue 1 , July 2005 , pp. 56 - 63
Copyright
Copyright © The Nutrition Society 2005

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