FIGURE 4-2 Change in maternal skinfold thickness during lactation. Means with standard error of the mean are illustrated.

health care providers or others, and changing energy requirements and appetite (related in part to changing needs of the infant and changes in activity patterns). Very few investigators have tried to examine the stability of dietary intake during lactation, and most such studies have lacked the statistical power to distinguish among intakes at various stages.

The extent of lactation (whether the infant is breastfed exclusively, most of the time, or only once or twice a day) may have a greater impact on dietary intake than the stage of lactation does. For example, at 4 months post partum, an exclusively breastfeeding woman has much greater energy and nutrient needs than a woman at the same stage of lactation who is only partially breastfeeding. Except for those studies expressly limited to exclusively breastfeeding women,