Problems with Human Milk and Infant Formulas

Abstract

EXAMPLES OF PROBLEMS WITH HUMAN MILK Nutritional Problems The adequacy of breast milk as the sole food for the baby is related to the mother's diet during pregnancy and lactation, to maternal calorie reserves in the form of subcutaneous fat, to fetal stores (mainly hepatic), and to birth weight. Although human milk is commonly believed to be a complete, perfect food for infants, deficiencies of vitamin K, vitamin D, and iron may develop in normal, full-term infants breast-fed by apparently healthy women consuming conventional diets. Other nutrient deficiencies may occur in breast-fed infants as a consequence of special conditions existing in the infant, the mother, or both. Normal infants consuming human milk or commercially prepared formulas will receive adequate vitamin K, except in the immediate neonatal period. Because this initial vitamin K deficiency does not become manifest until two or three days after birth, all full-term infants should receive 0.5 to 1 mg of water-soluble vitamin K preparation at delivery.31 Because human milk provides less vitamin K than fortified formulas do, and because breast-fed infants consume relatively small amounts of milk during the first few days of life, vitamin K deficiency in the newborn period is more common is breast-fed than in formula-fed infants.43,69 Thus, parenteral administration of a water-soluble vitamin K preparation to the newborn soon after birth is particularly desirable for breast-fed infants. A report42 that human milk contains appreciable but variable amounts of a water-soluble vitamin D sulfate suggests that the vitamin D content of human milk may be greater than was previously recognized.