Adequacy of Milk Intake During Exclusive Breastfeeding - A Longitudinal Study

This study, published in the October edition of Pediatrics, set about to test whether and how human lactation and breastfeeding practices can adapt to fulfill infant energy requirements during exclusive breastfeeding for 6 months.

The World Health Organization (WHO) recommends exclusive breastfeeding to 6 months, but this practice is rare. Exclusive breastfeeding often ceases because of a perceived insufficient milk supply, and there are concerns over whether exclusive breastfeeding is adequate to fulfill energy requirements to 6 months.

Initiation of exclusive breastfeeding (EBF) remains low in many parts of the world, and EBF according to the WHO recommendation is still rare. Many factors contribute to early introduction of complementary feeding, but the perception of insufficient milk supply remains a crucial issue to deal with if EBF toward the WHO recommendation is to be achieved. Moreover, the response of health professionals to perceived breast milk insufficiency can often be detrimental to breastfeeding (eg, recommending that mothers “top up” with formula). One review on perceived insufficient milk supply found no studies that linked this perception to inadequate milk energy supply from EBF. The present study also provided no indication that following the WHO recommendation was associated with insufficient milk supply, and the adequacy of EBF was further confirmed through normal infant growth because growth is a good indicator of whether energy needs are met.

The study followed 50 exclusively breast fed babies and their mothers. The behavioral ease with which mothers in the present study seemed to achieve EBF to 6 months offers some hope that more mothers might achieve EBF for a longer duration in the future if sufficient  breastfeeding support is available.Future studies can focus on how to improve support for increases in duration and exclusivity of EBF.

The study concludes that when mothers are supported and follow the WHO recommendation, milk intakes are high and increase throughout time to meet infant energy requirements during EBF to 6 months, and this can be achieved without major constraints on breastfeeding practices. Additional work would be required to determine the generalizability of these data to all populations. However, this new evidence should be helpful in the promotion of greater duration and exclusivity of breastfeeding in future.

Source: Pediatrics (American Academy of Pediatrics)

www.pediatrics.org/cgi/doi/10.1542/peds.2011-0914

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