Protein and energy intake during weaning: I. Effects on growth

The growth and food consumption of 30 healthy infants from 4 to 6 months of age have been measured. Two groups were assigned randomly to either a formula with 1.9 g of protein and 72 kcal per 100 ml (F1) or 2.7 g of protein and 69 kcal per 100 ml (F2). A third group of infants were fed breast milk (0.96 g of protein and 65 kcal per 100 ml (HM)). All infants received supplementary food according to the same regimen and were fed ad libitum. The mean protein intake was 1.3, 2.6 and 3.6 g/kg/day in the HM-, F1- and F2-groups respectively. The corresponding mean energy intake was 80, 101 and 94 kcal/kg/day. The formula-fed infants had significantly higher protein and energy intakes when compared to the breast-fed group. No significant differences were found in the rate of growth of crown-heel length, head circumference or in weight gain. The differences in protein intake between the breast- and formula-fed infants without differences in growth indicate that the formulas may provide a protein intake in excess to the needs.     

Protein and Energy Intake during Weaning: I. Effects on Growth

ABSTRACT. The growth and food consumption of 30 healthy infants from 4 to 6 months of age have been measured. Two groups were assigned randomly to either a formula with 1.9 g of protein and 72 kcal per 100 ml (F₁) or 2.7 g of protein and 69 kcal per 100 ml (F₂). A third group of infants were fed breast milk (0.96 g of protein and 65 kcal per 100 ml (HM). All infants received supplementary food according to the same regimen and were fed ad libitum. The mean protein intake was 1.3, 2.6 and 3.6 g/kg/day in the HM-, F₁- and F₂-groups respectively. The corresponding mean energy intake was 80, 101 and 94 kcal/kg/day. The formula-fed infants had significantly higher protein and energy intakes when compared to the breast-fed group. No significant differences were found in the rate of growth of crown-heel length, head circumference or in weight gain. The differences in protein intake between the breast- and formula-fed infants without differences in growth indicate that the formulas may provide a protein intake in excess to the needs.     

Infant formula with protein-energy ratio of 1.7 g/100 kcal is adequate but may not be safe.

BACKGROUND: An adequate protein-energy ratio of infant formulas has been defined as one that permits growth similar to that of infants fed relatively generous protein-energy ratios, and serum concentrations of albumin and urea nitrogen no less than those observed in breast-fed infants. A safe ratio has been defined as one with no detectable adverse effects. The hypothesis was that a protein-energy ratio of 1.7 g/100 kcal is adequate and safe. METHODS: Healthy male infants were fed Formula 1.7, a milk-based formula, as the sole source of energy from the 8th to the 112th day of life. Weight, length, and energy intake were measured; serum albumin and urea nitrogen were determined; and the results were compared with data from appropriate reference groups of infants. RESULTS: Energy intake from 8 through 55 days was significantly higher than that of infants in the formula-fed reference group. Gain in weight was significantly more than that of the formula-fed reference group or of a breast-fed reference group, whereas gain in length was similar to that of the formula-fed reference group. Body mass index was significantly higher than that of either reference group, suggesting more fat accumulation in infants fed Formula 1.7. Plasma concentrations of albumin and urea nitrogen were similar to those of the breast-fed reference group. CONCLUSION: Infants fed Formula 1.7 received adequate intakes of protein. Because of the possibility that ad libitum feeding of diets with moderately inadequate protein-energy ratios is associated with increased food intake leading to excess weight gain, it is not possible to conclude that a protein-energy ratio of 1.7 g/100 kcal is safe.     

Indices of protein metabolism in term infants fed either human milk or formulas with reduced protein concentration and various whey/casein ratios

Hyperaminoacidemia is evident in infants fed either whey-dominant or casein-dominant formula containing 2.2 g protein/100 kcal. We assessed protein metabolism in infants fed formulas with reduced protein contents and various whey/casein ratios. Term infants (n = 40) received either human milk or formula containing 1.8 g protein/100 kcal and whey/casein ratios 18:82, 34:66, or 50:50. At ages 4 and 8 weeks, growth indices and mean serum concentrations of retinol binding protein, albumin, total protein, and serum urea nitrogen were similar, as were mean plasma concentrations of total amino acids, total essential amino acids, and their ratio. Compared with infants fed human milk, those fed formula had plasma concentrations similar for valine, lysine, arginine, tyrosine, histidine, threonine, and free and total cyst(e)ine; elevated for phenylalanine, methionine, and citrulline; and depressed for taurine and tryptophan. Except for leucine, mean plasma amino acid values varied similarly among formula groups despite differences in intakes. Our data indicate that feeding formulas providing 1.8 g protein/100 kcal results in many indices of protein metabolism characteristic of human milk feeding. However, certain differences are noted, suggesting the need for further manipulation of specific amino acid patterns of infant formulas.     

Milk protein quality in low birth weight infants: effects of protein-fortified human milk and formulas with three different whey-to-casein ratios on growth and plasma amino acid profiles.

Growth rates (weight, length, and head circumference) and selected biochemical indexes of protein metabolism (serum urea, acid-base status, and plasma amino acid concentrations) were determined in low birth weight (LBW) infants appropriate for gestational age (birth weight less than 1,650 g) fed three formulas differing only in the whey-to-casein ratios: 60/40, 50/50, and 35/65. A group of infants fed exclusively human milk protein (HMP)-fortified human milk was used as a control. All diets provided similar daily protein and energy intakes, which were 3.5 g/kg and 122 kcal/kg in the human milk-fed infants and 3.3 g/kg and 121 kcal/kg in the formula-fed infants. Neither weight gain nor rate of growth in length and head circumference differed between the feeding groups and reached intrauterine or better rates in all groups. Values for serum urea and acid-base status were normal and also did not differ among the groups. At the end of the study, plasma threonine concentrations were significantly higher in all formula-fed infants than in the infants fed human milk. The highest plasma threonine concentration was found in the infants receiving the whey-predominant formula. Plasma concentrations of valine, methionine, and phenylalanine were also significantly higher in all formula-fed groups when compared with the human milk group. Plasma total essential amino acid concentrations were also significantly higher in the formula-fed infants than in the human milk fed. The results show that protein quality does not affect growth rate or biochemical indexes of metabolic tolerance in LBW infants fed adequate protein and energy intakes.(ABSTRACT TRUNCATED AT 250 WORDS)     

Protein Intake during Weaning

ABSTRACT. Metabolic responses to different feeding regimens during the weaning period have not previously been studied. In this study 30 healthy infants aged 4–6 months were divided into three feeding regimens with 10 infants in each. The regimens were: Human milk (HM-group), formula F₁ with 1.9g protein/100 ml (F₁-group) or formula F² with 2.7 g protein/100 ml (F₂-group). All infants received the same supplementary food and were fed ad libitum. Concentrations of serum urea were significantly higher ( p <0.001) in the formula groups as compared to the breast-fed infants throughout the entire study period. Serum albumin concentrations were within normal limits in the breast-fed infants indicating adequate protein nutritional status. There were no differences in the concentrations of creatinine and total nitrogen in urine between the artificially fed and the breast-fed infants at the beginning of the study (4 months), but at 6 months these concentrations were significantly higher in the formula-fed infants ( p <0.001). The results suggest that formulas now in common use during weaning provide amounts of protein which produce metabolic manifestations implying excessive protein intakes.     

Food Intake and Growth of Infants between Six and Twenty-six Weeks of Age on Breast Milk, Cow's Milk Formula, or Soy Formula

ABSTRACT. In 59 normal infants attending well-baby clinics, food consumption was registered until 26 and growth until 52 weeks of age. They were either breast-fed or formula-fed with a cow's milk product or a soy protein product. The average consumption of breastmilk was 746, 796, 722 and 689 g/day at 6, 14, 22 and 26 weeks respectively. Bottle-fed infants received larger volumes, and at 6 and 14 weeks were the calculated total energy intakes significantly higher than in breast-fed infants. No differences were seen between the feeding groups with respect to length and the sum of four skin folds. The soy formula-fed children, who happened to be 200 g heavier at birth, had lower weight gains during the first 6 weeks than the other two groups. Thereafter, the average weights of the soy formula group did not differ from the other groups. At 3 months, the soy formula-fed children displayed a slower mineralisation and maturation of bone, but the difference was no longer significant when re-examined at 6 months. Formulas based on soy protein isolates seem to be acceptable as substitutes for cow's milk formulas in feeding normal infants.     

Milk Protein Intake in the Term Infant

ABSTRACT. Thirty healthy term infants were studied during the three first months of life. The infants were divided into three feeding groups consisting of 10 infants in each. The feeding regimens were: human milk by breast feeding, a formula (F-I) containing 1.2 g/100 ml of protein and a control formula (F-II) containing 1.6 g protein/100 ml. Both formulas were whey predominant and isocaloric. Protein intake was significantly higher with formula F-II when compared to the human milk group and to formula F-I. No significant differences with respect to weight, length and head circumference were found among the groups, but the rate of growth between 2 to 12 weeks was higher in the control formula (F-II) group. Serum albumin concentrations were normal and similar in all feeding groups. Blood urea nitrogen and urine total nitrogen concentration was significantly lower in the low protein formula I group when compared to the control formula II. After the fourth week of life the low protein formula infants had similar blood urea nitrogen and urine nitrogen concentrations as those of the breast-fed infants. The results indicate that current formulas in use provide excessive protein intakes after the first months of life.     

Milk protein intake in the term infant. I. Metabolic responses and effects on growth

Thirty healthy term infants were studied during the three first months of life. The infants were divided into three feeding groups consisting of 10 infants in each. The feeding regimens were: human milk by breast feeding, a formula (F-I) containing 1.2 g/100 ml of protein and a control formula (F-II) containing 1.6 g protein/100 ml. Both formulas were whey predominant and isocaloric. Protein intake was significantly higher with formula F-II when compared to the human milk group and to formula F-I. No significant differences with respect to weight, length and head circumference were found among the groups, but the rate of growth between 2 to 12 weeks was higher in the control formula (F-II) group. Serum albumin concentrations were normal and similar in all feeding groups. Blood urea nitrogen and urine total nitrogen concentration was significantly lower in the low protein formula I group when compared to the control formula II. After the fourth week of life the low protein formula infants had similar blood urea nitrogen and urine nitrogen concentrations as those of the breast-fed infants. The results indicate that current formulas in use provide excessive protein intakes after the first months of life.     

Formula intake of 1- and 4-month-old infants

This study was designed to estimate energy intake in exclusively formula-fed infants. Formula intake of twenty-four 1- and 4-month-old infants was studied for 5 consecutive days; six boys and six girls were in each age group. Intake was estimated by laboratory-determined weights of formula consumed, spilled, and regurgitated. Two additional methods were used to estimate intake in the first nine infants during the 1st day of observation: test-weighing the infant at each feeding and mother's weighing of formula consumed, regurgitated, and spilled at each feeding. No consistent differences were detected among methods, but test-weighing appeared to have the greatest feed-to-feed variability. Intake was estimated to be 747 +/- 100 g or 125.5 +/- 17 kcal/kg, and 958 +/- 131 g or 94.0 +/- 13 kcal/kg for 1- and 4-month-old infants, respectively. The day-to-day variability (expressed as the coefficient of variation) was 13 and 15% (CV, g/kg) for 1- and 4-month-old infants, respectively. Between-infant variability of intake was approximately 8% (CV, g/kg) for both age groups. Energy intakes of 1-month-old formula-fed infants were similar to published values of breast-fed infants of similar age, but the energy intakes of 4-month-old formula-fed infants were significantly higher than values published for 4-month-old breast-fed infants.     

Formula with reduced protein content: effects on growth and protein metabolism during weaning

A total of 20 healthy term infants between 4 and 6 months of age were randomly assigned to either a low protein formula (F1.3) containing 1.3 g protein/100 ml or a high protein formula (F1.8) containing 1.8 g protein/100 ml. Both formulas were isocaloric (72 kcal/100 ml) and had a whey-casein ratio of 50:50. Ten control infants were breast-fed (BF). The mean protein intakes (including supplementary foods) were 1.9 +/- 0.3, 2.6 +/- 0.2, and 1.3 +/- 0.2 g/kg/day, respectively. The mean concentrations of serum urea were 2.8 +/- 0.6 (F1.3), 4.1 +/- 0.6 (F1.8), and 2.2 +/- 0.8 mmol/liter (BF) at 6 months (F1.3 versus BF, NS, F1.8 versus BF, p less than 0.001). The urine excretion of nitrogen was similar in the F1.3 and BF groups being 81 and 78 mg/kg/day. In the F1.8-group nitrogen excretion was higher, 138 mg/kg/day. Plasma concentrations of albumin, prealbumin, and transferrin were normal and similar in the groups. Weight gain was significantly higher in the F1.8 group, 22.8 +/- 1.7 g/kg/wk when compared to the F1.3 and BF groups, 19.9 +/- 3.9 and 18.0 +/- 4.3 (p less than 0.01), respectively. These data indicate that a decreased protein-intake from formula during weaning results in many indices of protein metabolism and growth more similar to those found in BF infants than when conventional follow-up formulas are used.     

Tryptophan fortification of adapted formula increases plasma tryptophan concentrations to levels not different from those found in breast-fed infants.

Several recent studies have demonstrated significantly lower plasma total tryptophan concentrations in formula-fed than in breast-fed infants. We have measured preprandial plasma amino acid concentrations in infants breast-fed or fed a formula with a protein concentration of 1.57 g/dl and with a whey/casein ratio of 60:40 or a formula with a protein concentration of 1.37 g/dl and a whey/casein ratio of 40:60 and fortified with 10 mg/dl (15 mg/100 kcal) of tryptophan. Healthy term infants (10 per group) were either breast-fed from birth or randomly assigned to one of the two study formulas. At 4 and 12 weeks of age, anthropometric measurements were performed and blood samples were obtained. During the study period of 12 weeks, all infants showed normal growth (weight, length, and head circumference) and there were no statistically significant differences between the groups. The plasma concentrations of the essential amino acids phenylalanine, threonine, valine, and lysine were significantly lower in the breast-fed group than in both formula-fed groups. For tyrosine, methionine, leucine, histidine, isoleucine, and arginine, no significant differences could be found between the feeding groups. Concentration of total plasma tryptophan was significantly higher in the breast-fed group than in the group fed the tryptophan-unfortified formula, but no statistically significant difference could be found between the plasma tryptophan concentration in the breast-fed group versus the group fed the tryptophan-fortified formula. The results indicate that tryptophan fortification of adapted formula is necessary to achieve plasma total tryptophan concentrations similar to those found in breast-fed infants.(ABSTRACT TRUNCATED AT 250 WORDS)     

Growth, serum biochemistries, and amino acids of term infants fed formulas with amino acid and protein concentrations similar to human milk

We tested the hypothesis that amino acid intake from infant formulas modified to be similar to human milk would result in indices of protein metabolism more like those in human milk-fed infants. Formula-fed infants received for 12 weeks one of three isocaloric formulations of a whey-adapted formula that differed in protein concentration: 11, 13, or 15 g/L. Infants consumed similar volumes of formula or human milk. Serum urea nitrogen concentrations reflected the protein content of the diets. Plasma indices of protein nutritional status were normal and did not differ among groups. Growth rates of all infants were normal and similar. Serum indicators of protein nutritional status varied with age, which made comparisons of formula-fed infants with human milk-fed infants difficult. Plasma concentrations of leucine and isoleucine at 4 weeks of age were higher in infants fed the formula containing 15 g protein/L when compared with those of infants fed the other two formulas or human milk. At 8 and 12 weeks of age, all formula-fed infants had plasma amino acid profiles that did not differ significantly from each other except for isoleucine, which was lower in the 11-g/L group. We found that providing formulas with an amino acid pattern similar to that of human milk did not produce a plasma amino acid pattern identical to that of the breast-fed infant. This observation suggests that other factors, such as the hormonal response to feeding, differing nutritional bioavailability of amino acids from human and bovine milk proteins, and the changing quantity and type of amino acids with advancing lactation, influence plasma amino acid concentrations.     

Sodium and potassium metabolism in infancy]

BACKGROUND: Recommendations for the concentration of most nutrients in infant formulas are based on their concentration in human milk. Industry succeeded in adapting sodium and potassium content in infant formulas to concentration found in human milk. Whether this adaptation affects on infants' mineral balances was studied in breast-fed and artificially-fed infants. METHODS: Sodium and potassium balances were performed in 16 term male infants from their 3rd until their 17th week of life. The balances were performed at home and comprised up to five periods in intervals of three to four weeks. Each balance period consisted of subsequent three 24 h collections of milk, stool and urine samples. Ten infants were breast-fed, six received an adapted infant formula supplemented with copper, zinc and iron. RESULTS: The breast-fed infants got a mean intake of 1 mmol Na/kg b w x day and a mean intake of 1.8 mmol K/kg b w x day. Man retention was 0.4 mmol Na and 0.7 mmol K/kg b w x day. The formula-fed infants received 1.9 mmol Na/kg b w x day and 2.1 mmol K/kg b w x day. Na- and K-retention in this group was 0.5 and 0.6 mmol/kg b w x day respectively. Although sodium intake in the formula-fed infants was nearly twice as much as in the breast-fed infants the difference in sodium retention was only small (0.4 vs 0.5 mmol/kg b w x day). The formula-fed infants got more potassium than the breast-fed infants, but potassium retention was the same in both groups. CONCLUSIONS: With the adapted infant formula of this study the artificially fed infant was as well supplied with sodium and potassium as the breast-fed infant. A further reduction of the sodium concentration seems not to be useful.     

Energy expenditure and deposition of breast-fed and formula-fed infants during early infancy

The energy intake, expenditure, and deposition of 40 breast-fed and formula-fed infants were investigated at 1 and 4 mo of age to explore possible differences in energy utilization between feeding groups. Energy intake was calculated from 5-d test-weighing records or pre- and postweighing of formula bottles, in combination with bomb calorimetry of the milks. Total daily energy expenditure (TDEE) was determined by the doubly labeled water method. Sleeping metabolic rate (SMR) and minimal observable energy expenditure were measured by indirect calorimetry. Activity was estimated as the difference between TDEE and SMR. Energy deposition was estimated from dietary intake and TDEE. Energy intakes were significantly higher for the formula-fed than breast-fed infants at 1 mo (118 +/- 17 versus 101 +/- 16 kcal/kg/d) and 4 mo (87 +/- 11 versus 72 +/- 9 kcal/kg/d) (p less than 0.001). TDEE averaged 67 +/- 8 and 64 +/- 7 kcal/kg/d at 1 mo and 73 +/- 9 and 64 +/- 8 kcal/kg/d at 4 mo for the formula-fed and breast-fed infants, respectively, and differed between feeding groups (p less than 0.04). SMR and minimal observable energy expenditure (kcal/min) were higher among the formula-fed infants at 1 and 4 mo (p less than 0.005). The energy available for activity and the thermic effect of feeding did not differ between feeding groups. Rates of weight gain (g/d) and energy deposition (kcal/kg/d) tended to be greater among the formula-fed infants at 1 and 4 mo (p less than 0.006).(ABSTRACT TRUNCATED AT 250 WORDS)     

Growth and adiposity of term infants fed whey-predominant or casein-predominant formulas or human milk

Growth, estimated composition of weight gained, and stool patterns of term infants who were fed either a whey-predominant formula or a casein-predominant formula in a random design and of breast-fed infants were compared. All infants (N = 111) were healthy, singleton products of uncomplicated pregnancies. Birth weights and other anthropometric measures in the first few days of life were not different among the three feeding groups. Formula or breast milk was the infants' principal source of energy from birth to age 16 weeks. Average energy intakes of formula-fed infants and change of intakes with age were similar in both groups at all ages. Feeding groups were not significantly different at any age in weight, length, weight or length gain, head circumference, skinfold measurements, upper arm fat area and muscle area, or estimated total body fat. Stools of infants on the whey-predominant formula differed from both the breast-fed and casein-predominant formula groups.     

Protein intake in early infancy: effects on plasma amino acid concentrations, insulin metabolism, and growth

The effects of different protein intakes on wt gain, insulin secretion, and plasma concentrations of amino acids have been evaluated in a prospective study involving 30 normal term infants. The infants were studied from 4.0 to 6.0 mo of age. Ten infants were breast-fed (BF), the others were randomly divided into two groups of 10 infants. One group was fed a formula containing 1.3 g protein/100 mL (F 1.3), the other a formula with 1.8 g protein/100 mL (F 1.8). The formulas were isocaloric (72 kcal/100 mL), and the fat concentrations were 3.5 g/100 mL (F 1.3) and 3.2 g/100 mL (F 1.8). All infants received the same supplementary foods. The urinary C-peptide excretion in the infants fed the F 1.8-formula was 4.4 +/- 2.1 nmol/mmol creatinine or 19.4 +/- 12.9 nmol/m2, significantly higher than that in the infants fed the F 1.3-formula (2.6 +/- 1.5 and 7.9 +/- 5.1) or the BF infants (1.7 +/- 1.4 and 6.3 +/- 6.0). Gain in wt was 18.0 +/- 4.3, 19.9 +/- 3.9, 22.8 +/- 1.6 g/kg/wk and corresponded to protein intakes of 1.3 +/- 0.2, 1.9 +/- 0.3, and 2.6 +/- 0.2 g/kg/d, in the BF, F 1.3, and F 1.8 groups, respectively. Gain in length was 6.7 +/- 1.8 (BF-group), 6.2 +/- 2.5 (F 1.3-group), and 7.6 +/- 2.2 (F 1.8-group) mm/m/wk. Wt gain correlated with urinary C-peptide excretion at 6.0 mo (r = 0.51, p less than 0.01) and with protein intake (r = 0.43, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)     

Ernährung des Frühgeborenen in den USA

This delineation of nutritional practices pertaining to small premature infants (birth weight <1300 g) is largely based on the authors' experience at the University of Iowa. At Iowa, parenteral nutrition is routinely used in all small premature infants. It is nearly always started on the first day of life and is continued for an average of 20 days. Starting doses of amino acids and lipids are 1.5 and 1.0 g/kg/d, respectively. Enteral nutrition using expressed breast milk (about 85% of infants) or special formulas is initiated during the first few days of life and is advanced very cautiously. Full feedings are reached on average at 26 days of age. During the growth phase, breast milk is always fortified with a commercial fortifier. Because infants are frequently fluid-restricted, high caloric density feedings (90 kcal/dl or 100 kcal/dl, 3771 kJ/l or 4190 kJ/l) are frequently used. Regular monitoring of dietary intake and growth of all infants is performed by the neonatal dietitian.Average intakes of energy and protein as well as growth for 1994/95 and 1999 show substantial increses of energy and protein intakes as well as weight gain during the lastter period, especially during the first two weeks of life. After discharge from the hospital formula-fed infants receive specialized post-discharge formulas. However, for the infant going home breastfeeding no universally accepted method of nutrient supplementation is available.     

Effects of increased calcium and phosphorous formulas and human milk on bone mineralization in preterm infants

By photon absorptiometry, extrauterine bone mineralization was evaluated in preterm infants (less than 1,600 g birth weight) fed either a commercial premature formula containing 117 mg calcium, 58.5 mg phosphorus/100 kcal, the same formula containing higher phosphorus (82 mg/100 kcal), the same formula with higher calcium (140 mg Ca) and phosphorus (82 mg/100 kcal), or their own mother's milk. All infants had serum protein, albumin, calcium, phosphorus, bicarbonate, 25-hydroxyvitamin D, and alkaline phosphatase levels done at the start of the study and every 2 weeks until they weighed 1,900 g. At the start of the study, birth weight and gestational ages were similar in all four groups. There were no biochemical differences among the four groups except for a lower serum P in the human milk group. The human milk group had lower bone mineralization rate compared with the three formula groups. Bone mineral content was similar in the three formula-fed groups. However, only formulas containing 117 mg Ca and 58.5 mg P or 140 mg Ca and 82 P mg/100 kcal approximated intrauterine bone mineralization. Human milk fed infants did not approximate and were significantly different from the intrauterine rate.     

Nutrient intakes of formula-fed infants and infants fed cow's milk

Twenty-four-hour dietary intake data from the second National Health and Nutrition Examination Survey (NHANES II), 1976-1980, were analyzed to compare nutrient intakes among infants 7 to 12 months of age who were fed mixed diets containing solid foods and either infant formula or cow's milk. Solid foods fed to the infants in both groups were low in iron and linoleic acid, and high in sodium, potassium, and protein, relative to Recommended Dietary Allowances. Infants who were fed cow's milk received lower median intakes of iron (7.8 mg v 14.9 mg), linoleic acid (1.8 g v 6.1 g), and vitamin C (39 mg v 64 mg), and higher median intakes of protein (41 g v 25 g), sodium (1,000 mg v 580 mg), and potassium (1,630 mg v 1,020 mg) than formula-fed infants. Seventy-five percent of the infants fed cow's milk had iron intakes below the Recommended Dietary Allowance; 69% had sodium intakes above the range of estimated safe and adequate daily dietary intake. Linoleic acid provided less than 3% of energy intake for 74% of the infants fed cow's milk. Differences in nutrient intakes were due not only to different concentrations of nutrients in each of the milk feedings but also to the different amounts and types of solid foods fed to the two groups of infants.