Growth of breast-fed and formula-fed infants.

Growth and nutrition during infancy are being viewed with renewed interest because of the possibility that they may be linked to cardiovascular and metabolic health in later life. Of particular interest are differences between breast- and formula-fed infants with regard to nutrient intake and growth because breastfeeding has been shown to be associated with a reduced risk of obesity in later life. During the first 6-8 weeks of life there is little difference in growth (gain in weight and length) between breast- and formula-fed infants. However, from about 2 months of age to the end of the first year of life formula-fed infants gain weight and length more rapidly than breast-fed infants. There are no consistent differences in adiposity during the first 4-5 months of life, but during the later part of the first year of life the preponderance of the evidence suggests that breast-fed infants are leaner than formula-fed infants. Formula-fed infants at 4-5 months of age show higher plasma levels of insulin-like growth factor-1 (IGF-1), insulin and certain amino acids than breast-fed infants. Whereas the protein intake of breast-fed infants decreases with age and closely matches the requirements for protein during the early months of life, the protein intake of formula-fed infants exceeds requirements after the first 1-2 months of life. The data are consistent with the hypothesis that differences in protein intake are mainly responsible for differences in growth between breast- and formula-fed infants. Differences in energy intake probably are responsible for differences in adiposity observed in older infants.