Energy utilization and growth in breast-fed and formula-fed infants measured prospectively during the first year of life
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Published on: March 14, 2013
N C de Bruin1, H J Degenhart, S Gàl
1Sophia Children's Hospital, Department of Pediatrics, Erasmus University, Rotterdam, The Netherlands.
Insights
Infant energy requirements may be lower than current guidelines suggest. This study found no significant differences in growth or total daily energy expenditure between breast-fed and formula-fed infants.
Area of Science:
- Pediatrics
- Human Nutrition
- Infant Metabolism
Background:
- Accurate estimation of infant energy requirements is crucial for optimal growth and development.
- Existing guidelines for infant energy intake may not fully account for individual variations in expenditure and deposition.
- Understanding the differences between breast-feeding and formula feeding impacts nutritional recommendations.
Purpose of the Study:
- To approximate energy requirements for male and female infants (breast-fed and formula-fed).
- To compare total daily energy expenditure (TDEE) and energy deposition between feeding groups.
- To evaluate current infant energy intake recommendations based on new data.
Main Methods:
- Prospective investigation in 46 healthy, full-term infants over 12 months.
- Measurement of total body fat (TBF) and fat-free mass (FFM) gain using total-body electrical conductivity.
- Assessment of metabolizable energy intake (MEI) via test weighing (MEI-TW) and prediction from TDEE and energy deposition (MEI-Pred).
Main Results:
- No significant differences in weight, length, head circumference, TBF, FFM, or TDEE between breast-fed and formula-fed infants.
- MEI-Pred showed no significant feeding group differences, unlike MEI-TW at 1-4 months.
- Infant energy requirements approximated in this study were lower than current guideline recommendations.
Conclusions:
- Current infant energy intake recommendations may overestimate actual needs.
- Individualized assessment of TDEE and energy deposition provides a more accurate measure of infant energy requirements.
- Further research is warranted to refine energy intake guidelines for infants.
Abstract:
This study is the first to report approximations of energy requirements for male and female breast-fed and formula-fed infants based on individual estimates of total daily energy expenditure (TDEE) and energy deposition derived from total body fat (TBF) and fat-free mass (FFM) gain as determined by total-body electrical conductivity. In 46 healthy, full-term infants the effect of > or = 4 mo of exclusive breast-feeding compared with formula feeding on macronutrient and energy intake, TDEE, energy deposition, and growth were investigated prospectively. Metabolizable energy intake (MEI) was assessed from macronutrient intake by test weighing (MEI-TW) and from the sum of TDEE and energy deposition (MEI-Pred). At 1-2, 2-4, 4-8, and 8-12 mo of age MEI-Pred averaged 431 +/- 38, 393 +/- 33, 372 +/- 33, and 355 +/- 21 kJ x kg(-1) x d(-1) for boys, and 401 +/- 59, 376 +/- 25, 334 +/- 33, and 326 +/- 17 kJ x kg(-1) x d(-1) for girls. No significant difference between breast-fed and formula-fed infants was found with respect to weight, length, head circumference, TBF, FFM, and TDEE at all ages, or for gain in length, weight, TBF, and FFM. MEI-TW was significantly different between feeding groups at 1-4 mo of age (formula-fed being greater than breast-fed, P < 0.005). This feeding effect, however, was not significant for MEI-Pred (MJ/d). MEI-TW differed from MEI-Pred only in breast-fed infants at 1-4 mo (P < 0.05 at 2-4 mo). The data from this study indicate that energy requirements in infants are lower than the recommendations in guidelines currently in use.
