Krebs N F, Reidinger C J, Robertson A D, Hambidge K M
Department of Pediatrics, University of Colorado Health Sciences Center, Denver 80262.
J Pediatr. 1994 Jan;124(1):32-9. doi: 10.1016/s0022-3476(94)70251-9.
The objectives of this study were to examine the growth pattern of healthy infants who were fed human milk exclusively for > or = 5 months and its relationship to intakes of milk, energy, and zinc. Monthly anthropometric measurements were obtained on 71 infants through 7 months of age and on 43 through 9 months. Milk zinc concentrations were determined and milk intake was measured by 3-day test weighing. Mean (+/- SD) calculated energy intake from human milk was 106 +/- 20, 79 +/- 11, 70 +/- 10, and 57 +/- 12 kcal/kg per day at 2 weeks and 3, 5, and 7 months of age, respectively; intake from milk plus solids was 70 +/- 13 kcal/kg at 7 months. Zinc intakes from human milk were 2.3 +/- 0.68, 1.0 +/- 0.43, 0.81 +/- 0.42, and 0.52 +/- 0.31 mg/day at these points. The maximum mean weight-for-age percentile for both sexes was 62 at 2 months; the mean percentile declined to 33 by 7 months and to 25 by 9 months of age. Mean length-for-age percentile declined from 43 at 2 weeks of age to 28 and 26 by 7 and 9 months of age, respectively. Energy intake at 2 weeks of age was positively associated with the weight increment from 2 weeks to 7 months of age (p = 0.003) and with a change in weight-for-age z scores from 2 weeks to 3 months of age (p = 0.028). Mean energy intakes of healthy breast-fed infants are lower through the first 7 months of life than current recommendations. Zinc intakes of breast-fed infants are likely to be adequate, on average, through 5 months of breast-feeding but subsequently are marginal without the introduction of weaning foods. Revision of standards for growth based on observations in breast-fed infants may be appropriate, but the possibility of growth-limiting nutrient deficiencies should also be investigated.
本研究的目的是调查完全母乳喂养≥5个月的健康婴儿的生长模式及其与牛奶、能量和锌摄入量的关系。对71名7个月大的婴儿和43名9个月大的婴儿进行了每月一次的人体测量。测定了牛奶中的锌浓度，并通过3天试重法测量了牛奶摄入量。2周龄、3月龄、5月龄和7月龄时，母乳喂养婴儿平均（±标准差）每日每千克体重的能量摄入量分别为106±20、79±11、70±10和57±12千卡；7月龄时，牛奶加固体食物的能量摄入量为70±1千卡。这些时间点母乳喂养婴儿的锌摄入量分别为2.3±0.68、1.0±0.43、0.81±0.42和0.52±0.31毫克/天。男女的年龄别体重百分位数在2月龄时最高为62；到7月龄时平均百分位数降至33，9月龄时降至25。年龄别身长百分位数从2周龄时的43分别降至7月龄和9月龄时的28和26。2周龄时的能量摄入量与2周龄至7月龄的体重增加呈正相关（p = 0.003），与2周龄至3月龄的年龄别体重z评分变化呈正相关（p = 0.028）。健康母乳喂养婴儿在出生后的前7个月内的平均能量摄入量低于当前建议值。母乳喂养婴儿的锌摄入量在母乳喂养的前5个月平均可能充足，但随后如果不引入断奶食品则处于边缘水平。根据对母乳喂养婴儿的观察结果修订生长标准可能是合适的，但也应调查生长受限营养素缺乏的可能性。
