Helen, the key to this baby's weight loss may be the fact that the mother is
giving her baby 5 ounces of water mixed with juice each day.  This is
displacing the breastmilk the baby would normally be consuming.  There is
research showing that the introduction of complementary foods does not
change the total caloric intake of infants.  The fruit juice is doing
nothing to promote healthy growth in the infant and may in fact be
contributing to a decreased milk supply in the mom.  Babies under one year
typically do not need to be supplemented with water.

Sara Dodder Furr
LLL Leader
Lincoln, Nebraska

***References***
Lancet. 1994 Jul 30;344(8918):288-93.
Effects of age of introduction of complementary foods on infant breast milk
intake, total energy intake, and growth: a randomised intervention study in
Honduras.

Cohen RJ, Brown KH, Canahuati J, Rivera LL, Dewey KG.

Department of Nutrition, University of California, Davis 95616-8669.

In developing countries, the age at which breastfed infants are first given
complementary foods is of public health importance because of the risk of
diarrhoeal disease from contaminated weaning foods, and the potential risk
of growth faltering if foods are inappropriately delayed. To evaluate
whether there are any advantage of complementary feeding prior to 6 months,
low-income primiparous mothers who had exclusively breastfed for 4 months
were randomly assigned to one of 3 groups: continued exclusive breastfeeding
to 6 months (EBF) (n = 50); introduction of complementary foods at 4 months
with ad libitum nursing from 4-6 months (SF) (n = 47); and introduction of
complementary foods at 4 months, with maintenance of baseline nursing
frequency from 4-6 months (SF-M) (n = 44). Baby foods in jars were provided
to the SF and SF-M groups from 4 to 6 months. Subjects were visited weekly
and provided with lactation guidance; at 4, 5, and 6 months measurements
were made of infant intake and breast milk composition. At 4 months, breast
milk intake averaged 797 (139) g per day (no difference among groups).
Between 4 and 6 months, breast milk intake was unchanged in EBF infants (+6)
but decreased in the SF (-103), and SF-M (-62) groups (p < 0.001). Change in
total energy intake (including solid foods) and infant weight and length
gain did not differ significantly between groups. Weight and length gain
from 4-6 months were comparable to those of breastfed infants in an affluent
USA population. The results indicate that breastfed infants self-regulate
their total energy intake when other foods are introduced. As a result,
there is no advantage in introducing complementary foods before 6 months in
this population, whereas there may be disadvantages if there is increased
exposure to contaminated weaning foods.


From Pediatr Clin North Am. 2001 Feb;48(1):87-104.
Nutrition, growth, and complementary feeding of the breastfed infant.

Dewey KG.

Department of Nutrition, University of California, Davis, Davis, California,
USA. [log in to unmask]

Although additional research is needed on many of the issues discussed
herein, the following conclusions are well substantiated by the evidence
available to date: Breast milk alone can meet nutrient needs during the
first 6 months, with the possible exception of vitamin D in certain
populations and iron in infants of relatively low birth weight.
Complementary foods offered before 6 months of age tend to displace breast
milk and do not confer any growth advantage over exclusive breastfeeding.
Breast milk continues to provide substantial amounts of key nutrients well
beyond the first year of life, especially protein, fat, and most vitamins.
Breastfed infants tend to gain less weight and usually are leaner than are
formula-fed infants in the second half of infancy. This difference does not
seem to be the result of nutritional deficits but rather infant
self-regulation of energy intake. New growth charts based on infants
breastfed throughout the first year of life are being developed by WHO. The
nutrients most likely to be limiting in the diets of breastfed infants are
minerals, such as iron, zinc, and calcium. Using the following guidelines
can help to ensure that the nutrient needs of the breastfed child are met:
Continue to breastfeed as often as the infant desires. Aim for a variety of
complementary foods, with fruits, vegetables, and animal products (e.g.,
meat, fish, poultry, or egg) offered daily. Iron-fortified cereals and meats
can provide adequate iron. Calcium can be obtained from cheese, yogurt, and
other dairy products (although fresh cow's milk is not recommended before 12
mo). Avoid giving too much juice. Be alert to any signs that the child's
appetite, growth, or development is impaired. When in doubt, a balanced
vitamin-mineral supplement is advisable. Make mealtimes enjoyable.

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