Abstract

PIP: A review of various studies on breast milk suggests the need for more coordinated comparative studies into all aspects of human lactation in well-nourished and poorly nourished communities using similar sampling methods and analytic techniques. The following generalizations were also drawn from the review for practical action: 1) unsupplemented human milk is all that is required to nourish babies of well-nourished mothers for the 1st 6 months of life; 2) although the volume and composition of human milk in poorly nourished women is surprisingly good, it is often suboptimal in quantity and quality with lower values of fat, H20 soluble vitamins, vitamin A, and somewhat lower calcium and protein; 3) limited studies with supplementary feeding of poorly nourished lactating women (and common sense probabilities) have suggested the feasibility of improvement in volume of output and in nutritional quality of breast milk; 4) adequacy of breast milk as sole food for the baby is related to the mother's diet in pregnancy, to maternal puerperal calorie reserves, to fetal stores, to birthweight, and to iron obtained from placental transfusion. Breast milk produced in the so-called "late lactation' (e.g., 7 months to 2 years or more) is insufficient by itself for the rising nutrient needs (and declining stores) or the rapidly growing infant. The 2 main forms of interference with lactation performance (maternal reflexes and maternal nutrition) are also discussed.