Reilly, JJ; Wells, JCK; (2005) Duration of exclusive breast-feeding: introduction of complementary feeding may be necessary before 6 months of age. BRIT J NUTR , 94 (6) 869 - 872. 10.1079/BJN20051601.

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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 center dot 2-2 center dot 4 MJ/d (525-574 kcal/d), and mean energy requirement approximately 2 center dot 6-2 center dot 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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