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Stool samples from 232 infants aged 7 days to 18 months were analyzed for alpha 1-antitrypsin and for occult blood by two techniques. Among the 450 stool samples, no correlation between positive tests for occult blood and the concentration of alpha 1-antitrypsin was found. The alpha 1-antitrypsin concentration in the stool decreased after the age of 6 months in both breast-fed (P less than 0.05) and formula-fed (P less than 0.001) groups. In the 7- to 30-day-old infants, breast-feeding was associated with both lower fecal alpha 1-antitrypsin (P less than 0.001) and less frequent positive tests for occult blood (P less than 0.02) than found in the formula-fed infants. Between 6 and 12 months of age, alpha 1-antitrypsin was lower in cow milk-fed infants than in those receiving either breast-feeding supplemented with formula (P less than 0.01) or soy formula (P less than 0.05). Age and feeding differences in the concentration of alpha 1-antitrypsin in the stool may reflect subtle changes in gastrointestinal tract function in infancy.

Either breast-feeding or the use of an iron-containing infant formula meets all of the nutritional needs of the infant for the first six months of life when available in amounts which result in normal growth. The goal of supplementary feeding is the development of lifelong eating patterns which will maintain optimal health. The introduction of supplementary foods is based upon both nutritional need and developmental readiness.

Using the recommendations of the Committe on Nutrition of the American Academy of Pediatrics for infant formulas as a scientific base, practical guidelines for feeding infants are given. Breast feeding or the use of a prepared formula meets these recommendations while evaporated milk, fresh cow's milk, and skimmed milk, despite widespread use for many years, do not. The feeding of strained foods and infants cereals should be begun when the infant has reached the stage of development appropriate for feeding from a spoon and swallowing nonliquid foods, usually between 3 and 6 months of age. Lifelong eating patterns begin during this period. Adjusting caloric intake to needs and learning to enjoy a variety of foods are major objectives of feeding practices.