The literature on the relationship between early infant feeding and growth shows that after the first 3 or 4 months, breast-fed infants in the developed world are lighter than formula-fed infants with markedly lower adiposity. There is some evidence of a slightly lower rate of linear growth over the first year or so. These differences in weight and length do not apparently persist beyond the first few years of life. In the developing world the situation is very different. The growth curves of breast-fed infants of malnourished mothers may falter between the third and sixth month of life. However, the generally poor quality of the supplementary foods offered in the developing world and the increased risk of diarrhoeal infections mean that supplementary feeding before the age of 6 months is unlikely to lead to a growth advantage and may well lead to growth faltering.
PIP: A review of the research literature on the relationship between early infant feeding and growth indicates that, after the first 3 or 4 months, breast-fed infants in developed countries are lighter than formula-fed infants and have markedly lower adiposity. There is some evidence of a slightly lower rate of linear growth over the first year of life, but any differences in weight and height do not persist beyond this point. Very different trends are found in developing countries. The growth curves of breast-fed infants of malnourished mothers may falter between the third and sixth months of life. However, given the generally poor quality of the supplementary food offered in developing countries and the increased risk of diarrheal infections, supplementary feeding before 6 months of age is unlikely to produce a growth advantage and may well lead to growth faltering. After 6 months, the growth advantage of supplementary feeding will be dependent on the nutritional quality of the weaning food, the effect on the child's breast milk intake, and the risk of infection. It is probable that the observed association between prolonged breast feeding and malnutrition arises from confounding factors such as poverty and the delayed weaning of sickly children. Other issues addressed in this review include the energy requirements of breast-fed infants, colostrum feeding, and nutritional status in relation to vitamin and mineral intake.