Energy cost of lactation, and energy balances of well-nourished Dutch lactating women: reappraisal of the extra energy requirements of lactation.

At 9 wk postpartum the difference in energy intake of 40 lactating (2440 +/- 430 kcal/d) and 16 nonlactating women (1680 +/- 400 kcal/d) was 760 kcal/d but decreased to 550 kcal/d when adjusted for habitual intakes and body weight. Energy cost of lactation amounted to 650 kcal/d (breast-milk production, 745 +/- 130 g/d). When compared with nonlactating counterparts, the lactating women mainly achieved energy balance by eating more. Sixteen of the 40 lactating women were also studied at 56 wk. Their cost of lactation at 5-13 wk was 630 kcal/d (breast-milk production, 720 +/- 124 g/d); these women met their energy cost of lactation by eating more (415 kcal/d); by tissue mobilization (35 kcal/d), and by reducing energy expenditure (180 kcal/d). The present study helps in the understanding of how well-nourished women with an adequate lactational performance may cope in everyday life with the energy stress of lactation, and suggests that current recommendations of energy needs during lactation are too high.