Breast is still best, though breast-fed infants may show initial slower weight gain

Breast-feeding confers unique immunological, psychological, growth and developmental benefits, and has been recommended by the American Academy of Pediatrics as the exclusive food source for U.S. infants for up to 6 months after birth. In The American Journal of Clinical Nutrition, Hediger et al. used data from the third National Health and Nutrition Examination Survey (1988-1994) to study the effect breast-feeding had on subsequent growth patterns in infants and children ages 4-71 months. They found that over the long term, exclusive breast-feeding for the first four months of life does not affect growth, though a short-term lag in weight gain occurs over the first 8-11 months.

The study sample consisted of 5594 white, black and Mexican-American infants, of whom 21% were exclusively breast-fed for 4 months, 10% partially breast-fed for 4 months, 24% breast-fed for less than 4 months, and 45% never breast-fed. Infants who were exclusively breast-fed for at least 4 months weighed an average of 0.2 kg less at 8-11 months than infants who were not exclusively breast-fed. By ages 12-23 months, the discrepancy in infant weight and weight-for-length for the exclusively breast-fed infants had disappeared. Similarity in growth status between breast-fed and other infants persisted until the children had reached age 5. Because of concern that mothers might be advised mistakenly to supplement with formula or stop breast-feeding to encourage infant weight gain, the World Health Organization has proposed developing new international infant growth references using breast-fed infants as the norm.

In examining the demographics and maternal factors of the study, the authors found that infants and children who were exclusively breast-fed for at least four months were more likely to be white, born to older mothers (over 35) who were nonsmokers living in the west census region, and had a high education level. Never breast-fed infants and children were more likely to b

Contact: Beth M. Wettergreen
American Journal of Clinical Nutrition

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