Infant Feeding

Robert T. Hall; Robin E. Carroll

doi:10.1542/pir.21-6-191

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Robert T. Hall, MD^*
Robin E. Carroll, MS, RD^†

^*Professor of Pediatrics; Chief, Division of Human Development.
^†Assistant Professor of Pediatrics, University of Missouri Kansas City School of Medicine, Children’s Mercy Hospital, Kansas City, MO. Dr Hall and Ms Carroll receive grant support from Wyeth, Ross Nutritionals, and Mead-Johnson Companies.

OBJECTIVES

After completing this article, readers should be able to:

Delineate the optimum nutrition for infants through the first year of life.
Describe the formulas that can be used as adequate substitutes for term infants whose mothers cannot or choose not to breastfeed through the first year of life.
Explain the place of low-iron-containing formulas in infant feeding.
Explain the differences and implications of growth velocity in formula-fed and breastfed infants.
Explain the implications of adding solid foods to the diets of breastfed and formula-fed infants.

Breastfeeding

The American Academy of Pediatrics (AAP) has recommended exclusive breastfeeding during the first 6 months of life and continuation of breastfeeding for the second 6 months as optimum nutrition in infancy.(1) There are multiple reasons for this recommendation. First, human milk is the optimum nutrient for term and near-term infants with respect to protein, fat, and carbohydrate composition. Second, the anti-infective properties of human milk reduce the incidence of acute illnesses such as infectious diarrhea, pathogenic bacterial fecal flora, necrotizing enterocolitis, otitis media, lower respiratory tract infections, and urinary tract infections in infants. Third, it has been suggested that the incidence of immune-mediated diseases such as diabetes mellitus, Crohn disease, eczema, asthma, and allergic gastroenteritis is lower among breastfed infants. Fourth, psychological and long-term cognitive advantages have been observed in breastfed infants compared with formula-fed infants. It is believed that mother-infant bonding is enhanced during breastfeeding, and there are consistently improved scores on tests of cognitive development directly correlated with the duration of breastfeeding. However, it is clear that other factors associated with breastfeeding enhance infant development, including maternal socioeconomic status, the Home Inventory (a measure of the adequacy of the home environment), maternal educational level, and maternal intelligence quotient (IQ).(2)