Lönnerdal Bo
Department of Nutrition, University of California, Davis, CA, USA.
Nestle Nutr Workshop Ser Pediatr Program. 2008;62:189-98; discussion 198-203. doi: 10.1159/000146272.
The growth pattern of formula-fed infants is quite different from that of breastfed infants. There may be several reasons for this difference, ranging from different endocrine responses to feeding and the presence of growth factors in breast milk to different control of food intake, but it is highly likely that differences in nutrient composition of the food (breast milk or formula) have major effects on growth. In most countries infant formula is used more or less exclusively up to 6 months of age and as part of the diet up to 12 months of age and during this period its composition remains the same. In striking contrast, the nutrient composition of breast milk changes during lactation, most dramatically during early lactation, but with pronounced differences throughout lactation for many nutrients. It is a goal that the performance of formulafed infants should be as similar to that of breastfed infants as possible, and attempts have been made to modify the composition of infant formula to achieve this goal. However, there has been no systematic attempt to gradually change the composition of infant formula in a manner similar to the changing pattern of breast milk. This represents a technical and nutritional challenge, but is now possible.
配方奶喂养婴儿的生长模式与母乳喂养婴儿的生长模式截然不同。造成这种差异的原因可能有多种,从对喂养的不同内分泌反应、母乳中生长因子的存在到食物摄入量的不同控制,但食物(母乳或配方奶)营养成分的差异很可能对生长有重大影响。在大多数国家,婴儿配方奶在婴儿6个月大之前或多或少被单独使用,在12个月大之前作为饮食的一部分使用,在此期间其成分保持不变。与之形成鲜明对比的是,母乳的营养成分在哺乳期会发生变化,在哺乳早期变化最为显著,但许多营养成分在整个哺乳期都有明显差异。目标是使配方奶喂养婴儿的表现尽可能与母乳喂养婴儿相似,并且已经有人尝试改变婴儿配方奶的成分以实现这一目标。然而,尚未有人系统地尝试以类似于母乳变化模式的方式逐渐改变婴儿配方奶的成分。这是一项技术和营养方面的挑战,但现在是可行的。