The AI for young infants is generally taken to be the average intake by full-term infants who are born to healthy, well-nourished mothers and who are exclusively fed human milk. The extent to which intake of a nutrient from human milk may exceed the actual requirements of infants is not known, and ethics of experimentation preclude testing the levels known to be potentially inadequate. Using the infant exclusively fed human milk as a model is in keeping with the basis for earlier recommendations for intake (e.g., Health Canada, 1990; IOM, 1991). It also supports the recommendation that exclusive intake of human milk is the preferred method of feeding for normal full-term infants for the first 4 to 6 months of life. This recommendation has been made by the Canadian Paediatric Society (Health Canada, 1990), the American Academy of Pediatrics (AAP, 1997), the Institute of Medicine (IOM, 1991), and many other expert groups, even though most U.S. babies no longer receive human milk by age 6 months.
In general, this report does not cover possible variations in physiological need during the first month after birth or the variations in intake of nutrients from human milk that result from differences in milk volume and nutrient concentration during early lactation.
In keeping with the decision made by the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, specific DRIs to meet the needs of formula-fed infants have not been proposed in this report. The use of formula introduces a large number of complex issues, one of which is the bioavailability of different forms of the nutrient in different formula types.
To derive the AI for infants ages 0 through 6 months, the mean intake of a nutrient was calculated based on (1) the average concentration of the nutrient from 2 to 6 months of lactation using consensus values from several reported studies, if possible, and (2) an average volume of milk intake of 0.78 L/day. This volume was reported from studies that used test weighing of full-term infants. In this procedure, the infant is weighed before and after each feeding (Butte et al., 1984; Chandra, 1984; Hofvander et al., 1982; Neville et al., 1988). Because there is variation in both the composition of milk and the volume consumed, the computed value represents the mean. It is expected that infants will consume increased volumes of human milk during growth spurts.