NUTRIENT ADEQUACY OF EXCLUSIVE BREASTFEEDING FOR THE TERM INFANT DURING THE FIRST SIX MONTHS OF LIFE

NUTRIENT ADEQUACY OF EXCLUSIVE BREASTFEEDING FOR THE TERM INFANT DURING THE FIRST SIX MONTHS OF LIFE DEPARTMENT OF NUTRITION FOR HEALTH AND DEVELOPMENT DEPARTMENT OF CHILD AND ADOLESCENT HEALTH AND DEVELOPMENT WORLD HEALTH ORGANIZATION The World Health Organization was established in 1948 as a specialized agency of the United Nations serving as the directing and coordinating authority for international health matters and public health. One of WHO’s constitutional functions is to provide objective and reliable information and advice in the field of human health, a responsibility that it fulfils in part through its extensive programme of publications. The Organization seeks through its publications to support national health strategies and address the most pressing public health concerns of populations around the world. To respond to the needs of Member States at all levels of development, WHO publishes practical manuals, handbooks and training material for specific categories of health workers; internationally applicable guidelines and standards; reviews and analyses of health policies, programmes and research; and state-of-the-art consensus reports that offer technical advice and recommendations for decision-makers. These books are closely tied to the Organization’s priority activities, encompassing disease prevention and control, the development of equitable health systems based on primary health care, and health promotion for individuals and communities. Progress towards better health for all also demands the global dissemination and exchange of information that draws on the knowledge and experience of all WHO’s Member countries and the collaboration of world leaders in public health and the biomedical sciences. To ensure the widest possible availability of authoritative information and guidance on health matters, WHO secures the broad international distribution of its publications and encourages their translation and adaptation. By helping to promote and protect health and prevent and control disease throughout the world, WHO’s books contribute to achieving the Organization’s principal objective — the attainment by all people of the highest possible level of health. NUTRIENT ADEQUACY OF EXCLUSIVE BREASTFEEDING FOR THE TERM INFANT DURING THE FIRST SIX MONTHS OF LIFE NANCY F. BUTTE, PHD USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA MARDIA G. LOPEZ-ALARCON, MD, PHD Nutrition Investigation Unit, Pediatric Hospital, CMN, Mexico City, Mexico CUTBERTO GARZA, MD, PHD Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA GENEVA WORLD HEALTH ORGANIZATION 2002 WHO Library Cataloguing-in-Publication Data Butte, Nancy F. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life / Nancy F. Butte, Mardia G. Lopez-Alarcon, Cutberto Garza. 1.Breastfeeding 2.Milk, Human – chemistry 3.Nutritive value 4.Nutritional requirements 5.Infant I.Lopez-Alarcon, Mardia G. II.Garza, Cutberto III.Expert Consultation on the Optimal Duration of Exclusive Breastfeeding (2001 : Geneva, Switzerland) IV.Title. ISBN 92 4 156211 0 (NLM Classification: WS 125) © World Health Organization 2002 All rights reserved. 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The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The named authors alone are responsible for the views expressed in this publication. Designed by minimum graphics Printed in France REFERENCES Contents Abbreviations & acronyms v Foreword vii Executive summary 1 1. Conceptual framework 3 1.1 Introduction 3 1.2 Using ad libitum intakes to assess adequate nutrient levels 3 1.3 Factorial approaches 4 1.4 Balance methods 5 1.5 Other issues 6 1.5.1 Morbidity patterns 6 1.5.2 Non-continuous growth 6 1.5.3 Estimating the proportion of a group at risk for specific nutrient deficiencies 6 1.5.4 Summary 7 2. Human-milk intake during exclusive breastfeeding in the first year of life 8 2.1 Human-milk intakes 8 2.2 Nutrient intakes of exclusively breastfed infants 8 2.3 Duration of exclusive breastfeeding 8 2.4 Summary 14 3. Energy and specific nutrients 15 3.1 Energy 15 3.1.1 Energy content of human milk 15 3.1.2 Estimates of energy requirements 15 3.1.3 Summary 15 3.2 Proteins 16 3.2.1 Dietary proteins 16 3.2.2 Protein composition of human milk 16 3.2.3 Total nitrogen content of human milk 17 3.2.4 Approaches used to estimate protein requirements 17 3.2.5 Protein intake and growth 20 3.2.6 Plasma amino acids 21 3.2.7 Immune function 21 3.2.8 Infant behaviour 22 3.2.9 Summary 22 iii ... - tailieumienphi.vn