Do not know if this was posted in August.
Judy Ritchie

http://www.ajcn.org/cgi/content/abstract/78/2/291

American Journal of Clinical Nutrition, Vol. 78, No. 2, 291-295, August
2003
© 2003 American Society for Clinical Nutrition 
 

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 6 mo)
with 621 infants who were exclusively breastfed for 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. 
 

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