Randomized controlled trial of 4 compared with 6 mo of exclusive breastfeeding in Iceland: differences in breast-milk intake by stable-isotope probe

Wells, Jonathan C. K.; Jonsdottir, Olof H; Hibberd, Patricia L.; Fewtrell, Mary; Þórsdóttir, Inga; Eaton, Simon; Lucas, Alan; Gunnlaugsson, Geir; Kleinman, Ronald E.

doi:10.3945/ajcn.111.030403

Cited by 48 publications

(60 citation statements)

References 30 publications

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“…A small underestimation of the intake of breastmilk may have occurred; the overall daily intake of milk, however, does not show significant differences when comparing NBF (formula or formula + cow milk) with ABF (estimated breastmilk only or estimated breastmilk + formula) infants. The mean energy intake of ABF infants was 547 kcal/d, a value lower than the one estimated by WHO [7], but comparable to the one from a recent study [47]. Finally, the assessment of the intake of some micronutrients was incomplete due to the lack of information on these elements in the labels of commercial baby food which prevented a complete nutritional analysis for infants consuming these products.…”

Section: Discussionmentioning

confidence: 76%

Patterns of nutrients’ intake at six months in the northeast of Italy: a cohort study

et al. 2014

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BackgroundAdequate complementary feeding is recognized as an important predictor of health later in life. The objective of this study was to describe the feeding practices and nutrients’ intake, and their association with breastfeeding at six months of age, in a cohort of infants enrolled at birth in the maternity hospital of Trieste, Italy.MethodsOut of 400 infants enrolled at birth, 268 (67%) had complete data gathered through a 24-hour feeding diary on three separate days at six months, and two questionnaires administered at birth and at six months. Data from feeding diaries were used to estimate nutrients’ intakes using the Italian food composition database included in the software. To estimate the quantity of breastmilk, information was gathered on the frequency and length of breastfeeds.ResultsAt six months, 70% of infants were breastfed and 94% were given complementary foods. The average daily caloric intake was higher in non-breastfed (723 Kcal) than in breastfed infants (547 Kcal, p < 0.001) due to energy provided by complementary foods (321 vs. 190 Kcal, p < 0.001) and milk (363 vs. 301 Kcal, p = 0.007). Non-breastfed infants had also higher intakes of carbohydrates, proteins, and fats. The mean intake of macronutrients was within recommended ranges in both groups, except for the higher protein intake in non-breastfed infants. These consumed significantly higher quantities of commercial baby foods than breastfed infants.ConclusionsContrary to what is recommended, 94% of infants were not exclusively breastfed and were given complementary foods at six months. The proportion of daily energy intake from complementary foods was around 50% higher than recommended and with significant differences between breastfed and non-breastfed infants, with possible consequences for future nutrition and health.

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Section: Discussionmentioning

confidence: 76%

Patterns of nutrients’ intake at six months in the northeast of Italy: a cohort study

et al. 2014

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“…The first results from a RCT-study situated in a developed country (Iceland) have recently been published (85). Infants taking part in the study were exclusively breastfed and randomized to introduce complementary foods at 4 or 6 months while continuing to breastfeed.…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations

Hörnell¹,

Lagström²,

Lande³

et al. 2013

Food & Nutrition Research

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132

138

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The present systematic literature review is part of the 5th revision of the Nordic Nutrition Recommendations. The overall aim was to review recent scientific data valid in a Nordic setting on the short- and long-term health effects of breastfeeding (duration of both any and exclusive breastfeeding) and introduction of foods other than breast milk. The initial literature search resulted in 2,011 abstracts; 416 identified as potentially relevant. Full paper review resulted in 60 quality assessed papers (6A, 48B, and 6C). A complementary search found some additional papers. The grade of evidence was classified as convincing, probable, limited-suggestive, and limited-no conclusion. The evidence was convincing of a protective dose/duration effect of breastfeeding against overweight and obesity in childhood and adolescence, overall infections, acute otitis media, and gastrointestinal and respiratory tract infections. The evidence was probable that exclusive breastfeeding for longer than 4 months is associated with slower weight gain during the second half of the first year which could be part of the reason behind the reduced risk of later overweight or obesity. There was also probable evidence that breastfeeding is a protective factor against inflammatory bowel disease, celiac disease, and diabetes (type 1 and 2), provides beneficial effects on IQ and developmental scores of children as well as a small reductive effect on blood pressure and blood cholesterol levels in adulthood. Other associations explored were limited-suggestive or inconclusive. In conclusion, convincing and probable evidence was found for benefits of breastfeeding on several outcomes. The recommendation in NNR2004 about exclusive breastfeeding for 6 months and continued partial breastfeeding thereafter can stand unchanged. The relatively low proportion of infants in the Nordic countries following this recommendation indicates that strategies that protect, support and promote breastfeeding should be enhanced, and should also recognize the benefits for long-term health.

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“…The breastfed infant exhibits fairly tight self-regulation of energy intake, with decreasing consumption of HM in response to caloric intake from CF [16], even when breastfeeding frequency is maintained [3, 5]. A reduction in infant demand for HM will impact maternal milk supply so that caloric contribution from HM will tend to decrease as intake of solids increases.…”

Section: Introductionmentioning

confidence: 99%

Complementary Feeding: Critical Considerations to Optimize Growth, Nutrition, and Feeding Behavior

Young

Krebs

2013

Curr Pediatr Rep

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This review focuses on complementary feeding (CF) in westernized settings where primary health concerns are risk of obesity and micronutrient inadequacy. The current evidence is reviewed for: (1) when CF should be introduced, (2) what foods (nutrients and food types) should be prioritized and avoided, and (3) how the infant should be fed. Special attention is paid to the underlying physiological differences between breast- and formula-fed infants that often result in distinctly different nutritional and health risks. This difference is particularly acute in the case of micronutrient inadequacy, specifically iron and zinc, but is also relevant to optimal energy and macronutrient intakes. Emphasis is placed on the complex interplay among infants’ early dietary exposures; relatively high energy and nutrient requirements; rapid physical, social and emotional development; and the feeding environment—all of which interact to impact health outcomes. This complexity needs to be considered at both individual and population levels and in both clinical and research settings.

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Randomized controlled trial of 4 compared with 6 mo of exclusive breastfeeding in Iceland: differences in breast-milk intake by stable-isotope probe

Abstract: On a group basis, EBF to age 6 mo did not compromise infant growth or body composition, and energy intake at age 6 mo was comparable to that in CF infants whose energy intake was not constrained by maternal breast-milk output.

Cited by 48 publications

References 30 publications

Patterns of nutrients’ intake at six months in the northeast of Italy: a cohort study

Patterns of nutrients’ intake at six months in the northeast of Italy: a cohort study

Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations

Complementary Feeding: Critical Considerations to Optimize Growth, Nutrition, and Feeding Behavior

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