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Plasma osmolality and feeding practices of healthy infants in first three months of life

D P Davies

    British Medical Journal
    |May 12, 1973
    PubMed

    Insights

    Infant feeding practices impact plasma osmolality. Artificial formulas and early solids, compared to breast milk, increase hyperosmolar plasma risk in infants due to excessive solute intake.

    Area of Science:

    • Neonatal nutrition
    • Pediatric nephrology
    • Infant physiology

    Background:

    • Infant kidney function is immature at birth.
    • Maintaining plasma tonicity is crucial for infant health.
    • Dietary solute load significantly influences infant hydration status.

    Purpose of the Study:

    • To investigate the relationship between infant feeding methods and plasma osmolality.
    • To assess the risk of hyperosmolar plasma in infants based on diet.
    • To evaluate the impact of artificial milk formulas and early solid food introduction on infant hydration.

    Main Methods:

    • Plasma osmolality was measured in 60 healthy infants aged 1 to 3 months.
    • Infants were categorized into three groups based on diet: breast-fed, artificial formula-fed, and formula-fed with solids.
    • Osmolality values were compared across the different feeding groups.

    Main Results:

    • Breast-fed infants (Group A) had a mean plasma osmolality of 284.3 mOsm/L, with no hyperosmolar cases.
    • Infants on artificial formula alone (Group B) showed a mean of 293.8 mOsm/L, with 11.1% hyperosmolar cases.
    • Infants on formula with solids (Group C) had the highest mean osmolality (297.1 mOsm/L) and 40.5% hyperosmolar cases.

    Conclusions:

    • Early introduction of solid foods and reliance on artificial milk formulas increase dietary solute load.
    • This excessive intake challenges the immature infant kidney's ability to maintain plasma tonicity.
    • High plasma osmolality poses a significant risk to infant hydration, especially with minimal water loss.

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