Duration of exclusive breast-feeding: introduction of complementary feeding may be necessary before 6 months of age

Br J Nutr. 2005 Dec;94(6):869-72. doi: 10.1079/bjn20051601.

Abstract

The WHO recommends exclusive breast-feeding for the first 6 months of life. At present, <2 % of mothers who breast-feed in the UK do so exclusively for 6 months. We propose the testable hypothesis that this is because many mothers do not provide sufficient breast milk to feed a 6-month-old baby adequately. We review recent evidence on energy requirements during infancy, and energy transfer from mother to baby, and consider the adequacy of exclusive breast-feeding to age 6 months for mothers and babies in the developed world. Evidence from our recent systematic review suggests that mean metabolisable energy intake in exclusively breast-fed infants at 6 months is 2.2-2.4 MJ/d (525-574 kcal/d), and mean energy requirement approximately 2.6-2.7 MJ/d (632-649 kcal/d), leading to a gap between the energy provided by milk and energy needs by 6 months for many babies. Our hypothesis is consistent with other evidence, and with evolutionary considerations, and we briefly review this other evidence. The hypothesis would be testable in a longitudinal study of infant energy balance using stable-isotope techniques, which are both practical and valid.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Age Factors
  • Bottle Feeding
  • Breast Feeding*
  • Energy Intake*
  • Energy Metabolism / physiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lactation / physiology
  • Male
  • Nutritional Requirements
  • Public Health
  • Time Factors