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Continuing the Discussion on Adequate Nutrient Intakes for Infancy

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The article by Thurnham et al1 in Sight and Life 3 | 2012 reviews the evidence around breast milk volumes, nutrient composition and recommendations for infants under six months of age. The review covers a vast landscape and summarizes pertinent in- formation as to volume, energy and micronutrient needs, and adequacy of intake through breastfeeding and breast milk. In addition to useful information on milk volumes and energy, an important conclusion made by the authors is the identification of Group 2 nutrients whose concentrations are unaffected by maternal intake, and can lead to maternal depletion. This is a key step in addressing the adequacy of intake in the first six months of life. The review highlights two areas that merit further work. Firstly, there exists a real need to develop sensitive and reliable methods for estimating breast milk intake in a range of settings. The continued reliance on test-weighing and the variability in measurements in ambulatory settings makes this a less-than- optimal method for assessing breast milk volume. Although there are established stable isotope techniques for measuring breast milk intake 2,3 these are onerous and not widely available. Secondly, information on breast milk intake and quality in malnourished populations is also outdated, and few studies have been conducted in populations with high rates of HIV infection or among wasted women with a body mass index < 18.5 kg / m2. While studies do suggest that the volume of breast milk produced may not be affected during acute infection, milk composition is known to change during this state.4 Although the effects of marginal maternal malnutrition on breast milk composition and quality are well-recognized,5 these effects may be exaggerated among populations with more severe forms of maternal wasting and concomitant infections such as HIV.

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Year 2013
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DOI https://doi.org/10.52439/YRKK9447
DOI Number 10.52439/YRKK9447
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