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American Journal of Clinical Nutrition
-1998 67: 885-896

"Energy utilization and growth in breast-fed and formula-fed infants measured prospectively during the first year of life"
NC de Bruin, HJ Degenhart, S Gal, KR Westerterp, T Stijnen, and HK Visser; Sophia Children's Hospital, Department of Pediatrics, Erasmus University, Rotterdam, The Netherlands.

This study is the first to report approximations of energy requirements for male and female breast-fed and formula-fed infants based on individual estimates of total daily energy expenditure (TDEE) and energy deposition derived from total body fat (TBF) and fat-free mass (FFM) gain as determined by total-body electrical conductivity. In 46 healthy, full-term infants the effect of > or = 4 mo of exclusive breast-feeding compared with formula feeding on macronutrient and energy intake, TDEE, energy deposition, and growth were investigated prospectively. Metabolizable energy intake (MEI) was assessed from macronutrient intake by test weighing (MEI-TW) and from the sum of TDEE and energy deposition (MEI-Pred). At 1-2, 2-4, 4-8, and 8-12 mo of age MEI-Pred averaged 431 +/- 38, 393 +/- 33, 372 +/- 33, and 355 +/- 21 kJ x kg(-1) x d(-1) for boys, and 401 +/- 59, 376 +/- 25, 334 +/- 33, and 326 +/- 17 kJ x kg(-1) x d(-1) for girls. No significant difference between breast-fed and formula-fed infants was found with respect to weight, length, head circumference, TBF, FFM, and TDEE at all ages, or for gain in length, weight, TBF, and FFM. MEI-TW was significantly different between feeding groups at 1-4 mo of age (formula-fed being greater than breast-fed, P < 0.005). This feeding effect, however, was not significant for MEI-Pred (MJ/d). MEI-TW differed from MEI-Pred only in breast-fed infants at 1-4 mo (P < 0.05 at 2-4 mo). The data from this study indicate that energy requirements in infants are lower than the recommendations in guidelines currently in use.

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