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Duration of exclusive breast-feeding: introduction of complementary feeding may be necessary before 6 months of age

  • John J. Reilly (a1) and Jonathan C. K. Wells (a2)
Abstract

The WHO recommends exclusive breast-feeding for the first 6 months of life. At present, <2 % of mothers who breast-feed in the UK do so exclusively for 6 months. We propose the testable hypothesis that this is because many mothers do not provide sufficient breast milk to feed a 6-month-old baby adequately. We review recent evidence on energy requirements during infancy, and energy transfer from mother to baby, and consider the adequacy of exclusive breast-feeding to age 6 months for mothers and babies in the developed world. Evidence from our recent systematic review suggests that mean metabolisable energy intake in exclusively breast-fed infants at 6 months is 2·2–2·4 MJ/d (525–574 kcal/d), and mean energy requirement approximately 2·6–2·7 MJ/d (632–649 kcal/d), leading to a gap between the energy provided by milk and energy needs by 6 months for many babies. Our hypothesis is consistent with other evidence, and with evolutionary considerations, and we briefly review this other evidence. The hypothesis would be testable in a longitudinal study of infant energy balance using stable-isotope techniques, which are both practical and valid.

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Copyright
Corresponding author
*Corresponding author: Dr John J. Reilly, fax +44 141 201 9275, email jjr2y@clinmed.gla.ac.uk
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
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