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Human milk intake and growth faltering of rural Mesoamerindian infants
N F Butte1, S Villalpando, W W Wong
1USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030.
Insights
Growth faltering in Otomi infants was not linked to low human milk intake. Despite adequate energy intake, low fat and energy concentrations in breast milk may contribute to poor infant growth.
Area of Science:
- Human nutrition
- Pediatric growth and development
- Infant health
Background:
- Growth faltering in infancy is a significant concern, particularly in vulnerable populations.
- Understanding the role of human milk intake and nutrient composition is crucial for addressing infant malnutrition.
Purpose of the Study:
- To investigate the relationship between human milk intake, nutrient composition, and growth faltering in Otomi infants.
- To determine if inadequate human milk consumption or low nutrient density contributes to poor growth in this population.
Main Methods:
- Studied 30 Otomi infants from Capulhuac, Mexico, from 1 to 6 months of age.
- Measured human milk intake using the 2H dose-to-the-mother method.
- Analyzed milk for energy, protein, lactose, and fat concentrations; monitored infant growth and nutrient intake.
Main Results:
- Infants consumed adequate volumes of human milk (885-869 g/d).
- Human milk had abnormally low fat and energy concentrations, despite normal protein and lactose levels.
- Infants exhibited growth faltering, with declining growth velocities and Z scores by 6 months.
Conclusions:
- Growth faltering in Otomi infants was not attributable to insufficient human milk intake.
- Low energy and fat content in breast milk, rather than volume, may be a key factor limiting growth.
- Further research is needed to identify other potential growth-limiting nutrients or increased nutrient needs in this population.
Abstract:
To determine whether growth faltering during early infancy was attributable to inadequate intake of human milk, the nutrient intakes and growth of 30 Otomi infants from Capulhuac, Mexico, were studied at 4 or 6 mo of age. Growth was monitored monthly from 1 through 6 mo of age. The 2H dose-to-the-mother method was used to measure human milk intake. Energy, protein, lactose, and fat concentrations in milk were analyzed by standard techniques. Mean (+/- SD) human milk intakes were 885 +/- 145 and 869 +/- 150 g/d at 4 and 6 mo, respectively. Protein and lactose concentrations in milk were normal but fat and consequently energy concentrations were abnormally low. Energy intakes averaged 81 +/- 14 kcal.kg-1.d-1 at 4 mo and 72 +/- 14 kcal.kg-1.d-1 at 6 mo. Growth faltering by 6 mo was evidenced by the significant decline in growth velocities and National Center for Health Statistics Z scores. Weight gain at 6 mo was 8.1 +/- 3.5 g/d and length gain was 1.0 +/- 0.34 cm/mo. Weight-for-age and length-for-age Z scores were -0.81 +/- 0.94 and -1.51 +/- 0.83, respectively. Growth velocities were not significantly correlated with nutrient intakes. Growth faltering among the Otomi infants despite energy intakes comparable to those of breast-fed infants in more protected environments may have resulted from an increase in the need for nutrients or from a growth-limiting nutrient, other than energy, in their diet.