Conclusions and comments

1. Total energy intakes of both fully breast-fed and mixed-fed infants were considerably below the internationally recommended levels. They were, however, identical with energy intakes calculated from recent Swedish studies on breast-fed children and with those from the much earlier and classical investigations of Wallgren (Acta Paediat Scand., 32: 778, [1944-1945] ).

TABLE 1. Energy Intakes Adjusted for Body Weight in Breast-fed Babies (values are means + S.D.)

Mean age (months)	No.	Weight (kg)	Energy intake/kg body wt. (kcals)
1.26	20	4.42 ± 0.63	115 ± 18
2.31	20	5.42 ± 0.73	101 ± 13
3.41	20	6.17 ±0.83	90 ± 12
4.49	20	6.80 ± 0.86	86 ± 14
5.62	20	7.35 ± 0.87	85 ± 13
6.66	16	7.75 ± 0.81	84 ± 12

FIG. 2. Weight, Triceps Skin-fold, and Length of 20 Breast-fed Babies Compared with Tanner Whitehouse Standards. For weight and length, the standards represented are the 75th, 50th, and 25th centiles; for triceps skin-folds, the 50th, 25th, and 10th.

2. Initial growth was good, but after about three months the lower average intakes began to be associated with a general deviation away from the Tanner-Whitehouse growth standards. However, these standards are higher than other standards.

3. From the present data, it would seem reasonable to conclude that the present FAD/WHO recommended energy intakes for young infants are too high. Up to three months of age, the recent UK Department of Health and Social Security (DHSS) values probably represent a more realistic estimate of the true needs of the average child. Whether even the DHSS recommendations are excessive from then onward depends on the interpretation placed on the anthropometric findings and the standards used.

4. A very careful and long-term evaluation would be required to decide whether deviations in growth of the magnitude found really did reflect processes disadvantageous to the child. The safer conclusion is the DHSS recommendation that dietary energy intake should remain at 100 kcal/kg after three months of age and throughout the rest of infancy.

Acknowledgements

We thank the mothers for their co-operation in this study, Mrs. J. Evans for the anthropometric measurements, Miss J.J. Whichelow for the recruitment of the mothers, and Dr. N.R.C. Roberton and the staff at the Cambridge Maternity Hospital. The study was financially supported by the Department of Health and Social Security.