Calories in Breastmilk and Infant Calorie Requirements Written by dr. Dyah Febriyanti, IBCLC Calories in Breastmilk Breast milk contains 87% water, 3.8% fat, 1.0% protein, and 7% lactose1. Fat and lactose are the main sources of calories in breast milk, about 50-65% and 35-40%. Lactose is the main form of ‘sugar’ in breast milk. Breast milk contains about 7g/dL lactose.2 The fat in breast milk remains stable, about 3,4-4,5%, starting from 21 days after delivery. The breast milk calories from fats, lactose, and a little from protein, are about 65-70 ccal/dL3. Average caloric content in breast milk is 67 ccal /dL 4. Calories in breastmilk (average) : 67 ccal/dL The composition of breast milk is dynamic. It depends on babies’ requirements and growth. Compared to the preterm milk, full term breast milk contains less fat and water. Fats in breast milk also depend on a mother’s body mass index, pregnancy weight gain, parity, menstruation, and breastfeeding frequency.3 Otherwise, fats and lactose in breast milk production have an effect on the mother’s weight. Breastfeeding mothers tend to lose the pregnancy weight easier.5 A breastfeeding mother with overproduction tends to have the breast milk containing less fats, protein and higher lactose. The calories in a normal supply mother who only breastfeeds are higher than those of a mixed-feeding mother6. The mother’s diet has no effect on the amount of fats and lactose in the breast milk, but has an effect on the type of fats in breastmilk4. In other words, the caloric content in breastmilk is not dependent on the mother’s diet, unless she is malnourished. Starvation and dehydration will decrease the breastmilk volume. In the first month, the caloric content in the preterm milk and full term milk is shown below7: Preterm milk Full term milk 3-5 days 58 ccal/dL 48 ccal/dL 8-11 days 71 ccal/dL 59 ccal/dL 15-18 days 71 ccal/dL 62 ccal/dL 26-29 days 70 ccal/dL 62 ccal/dL Infant Calorie Requirements Somebody’s energy needs are pictured by the amount of ‘calorie’ needed by a unit of the body weight. Kilocalorie is a measurement used for energy produced by food. Technically, a kilocalorie is the amount of energy required to increase the temperature of 1 kilogram water as much as 10C 8. The common indicator showing if an infant gets enough calories per day is weight gain, length, and head circumference. Calorie requirements of 0-1 year old infant is about 100–120 ccal/kg/day. 9 Estimated calorie requirements (based on age) are shown below:4 0-3 months = (89 x weight [kg] – 100) + 175 4-6 months = (89 x weight [kg] – 100) + 56 7-12 months = (89 x weight [kg] – 100) + 22 13-35 months = (89 x weight [kg] – 100) + 20 When a baby starts being given the complementary feeding, the main calorie source is breast milk, and then it is reduced gradually. About 24 months, the main calorie source is food. Recommended calorie intakes for a breastfed baby are4: Age Estimated calories per day (ccal) Calories from milk (ccal) Calories from food (ccal) 6-8 months 682 486 196 9-11 months 830 375 455 12-24 months 1.092 313 779 Estimated calories requirements of infants: 8 Male Age (months) Weight reference (kg) Estimated calories (kCal/day) 1 4,4 472 2 5,3 567 3 6,0 572 4 6,7 548 5 7,3 596 6 7,9 645 7 8,4 668 8 8,9 710 9 9,3 746 10 9,7 793 11 10 817 12 10,3 844 Female Age (months) Weight reference (kg) Estimated calories (kCal/day) 1 4,2 438 2 4,9 500 3 5,5 521 4 6,1 508 5 6,7 553 6 7,2 593 7 7,7 608 8 8,1 643 9 8,5 678 10 8,9 717 11 9,2 742 12 9,5 768 Taken from: United States Department of Agriculture, 2009 SOURCES Martin, Ling dan Blackburn. Review of Infant Feeding: Key Features of Breast Milk and Infant Formula. Nutrients 2016, 8, 279 World Health Organization. 2009. Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals. Ballard, Olivi., dan Morrow,Ardythe L. Human Milk Composition: Nutrients and Bioactive Factors. Pediatr Clin North Am. 2013 60(1) International Lactation Consultant Association. 2013. Core Curriculum for Lactation Consultant 3rd Edition. Jones & Bartlett Learning. p340 Baker, J.L et al. 2008. Breastfeeding Reduces Postpartum Weight Retention. Am Soc Clin Nutr 2008 vol. 88 (6) 1543-1551 Prentice, Philippa dkk. 2016. Breast milk nutrient content and infancy growth. Acta Pædiatrica 2016 105, pp. 641–647 Riordan & Wambach. 2016. Breastfeeding and Human Lactation, enhanced 5th Jones & Bartlett Learning. p 419-468 United States Department of Agriculture. 2009. Infant Nutrition and Feeding: A Guide for Use in the WIC and CSF Program. Hlm 12-14 Al-Salem. 2014. An Illustrated Guide to Pediatric Surgery. Springer International Publishing Switzerland. hlm 5-7