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Subject:
From:
Magda Sachs <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 29 Jul 2003 12:05:06 +0100
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American Journal of Clinical Nutrition, Vol. 78, No. 2, 291-295, August 2003
© 2003 American Society for Clinical Nutrition </misc/terms.shtml>
 ORIGINAL RESEARCH COMMUNICATION
Infant growth and health outcomes associated with 3 compared with 6 mo of
exclusive breastfeeding1,2,3
Michael S Kramer, Tong Guo, Robert W Platt, Zinaida Sevkovskaya, Irina
Dzikovich, Jean-Paul Collet, Stanley Shapiro, Beverley Chalmers, Ellen
Hodnett, Irina Vanilovich, Irina Mezen, Thierry Ducruet, George Shishko and
Natalia Bogdanovich
1 From the Departments of Pediatrics (MSK, RWP, and J-PC) and Epidemiology
and Biostatistics (MSK, TG, RWP, J-PC, SS, and TD), McGill University
Faculty of Medicine, Montreal; the Centre for Research in Women’s Health
(BC), Sunnybrook Women’s College Health Sciences Centre (BC), and Faculty of
Nursing (EH), University of Toronto; the Departments of Maternal and Child
Health (ZS) and Foreign Relations (IM), Belarussian Ministry of Health,
Minsk, Belarus; and the Belarussian Maternal and Child Health Research
Institute (ID, IV, GS, and NB), Minsk, Belarus.
Background: Opinions and recommendations about the optimal duration of
exclusive breastfeeding have been strongly divided, but few published
studies have provided direct evidence on the relative risks and benefits of
different breastfeeding durations in recipient infants.
Objective: We examined the effects on infant growth and health of 3 compared
with 6 mo of exclusive breastfeeding.
Design: We conducted an observational cohort study nested within a large
randomized trial in Belarus by comparing 2862 infants exclusively breastfed
for 3 mo (with continued mixed breastfeeding through =" src="/math/ge.gif"
border=0 6 mo) with 621 infants who were exclusively breastfed for ="
src="/math/ge.gif" border=0 6 mo. Regression to the mean, within-cluster
correlation, and cluster- and individual-level confounding variables were
accounted for by using multilevel regression analyses.
Results: From 3 to 6 mo, weight gain was slightly greater in the 3-mo group
[difference: 29 g/mo (95% CI: 13, 45 g/mo)], as was length gain [difference:
1.1 mm (0.5, 1.6 mm)], but the 6-mo group had a faster length gain from 9 to
12 mo [difference: 0.9 mm/mo (0.3, 1.5 mm/mo)] and a larger head
circumference at 12 mo [difference: 0.19 cm (0.07, 0.31 cm)]. A significant
reduction in the incidence density of gastrointestinal infection was
observed during the period from 3 to 6 mo in the 6-mo group [adjusted
incidence density ratio: 0.35 (0.13, 0.96)], but no significant differences
in risk of respiratory infectious outcomes or atopic eczema were apparent.
Conclusions: Exclusive breastfeeding for 6 mo is associated with a lower
risk of gastrointestinal infection and no demonstrable adverse health
effects in the first year of life.

Magda Sachs
Breastfeeding Supporter,
BfN, The Breastfeeding Network
http://www.breastfeedingnetwork.org.uk/



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