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Anna Swisher
Austin, TX
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Intervention Improves Duration, Exclusivity of Breastfeeding During First
Year
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WESTPORT, CT (Reuters Health) Jan 23 - An intervention that promotes
breastfeeding significantly increases the chances that infants will continue
to be breastfed at age 6 months, resulting in improved infant health,
according to results of a trial conducted in the Republic of Belarus.

Dr. Michael S. Kramer of McGill University in Montreal and associates
randomized clusters of 31 maternal hospitals and polyclinics to infant
feeding as usual (control group) or an intervention based on the
Baby-Friendly Hospital Initiative, developed by the World Health
Organization and the United Nations Children's fund.

With the inclusion of 17,046 mother-infant pairs, the investigators report
in the January 24/31 issue of The Journal of the American Medical
Association that this is "the largest randomized trial ever undertaken in
the area of human lactation."

The intervention included an 18-hour lactation management training course
that emphasized maintenance of lactation, encouraged exclusive and prolonged
breastfeeding, and helped resolve common problems.

At 3 months, 73% of mothers in the intervention group and 60% in the control
group were still breastfeeding to some degree. Differences were more
substantial when the researchers compared the rate of exclusive
breastfeeding, which was 7 times higher in the intervention group than the
control group at 3 months, and more than 12 times higher in the intervention
group at 6 months.

The intervention also reduced the risk of gastrointestinal tract infection
during the first year by 40%, and the occurrence of atopic eczema by 46%.

The results cannot be used to directly predict what the intervention
outcomes would be in other countries, Dr. Kramer told Reuters Health.
However, he said, "clean water and adequate access to healthcare in Belarus
are similar to that in the US and other western countries. The effects would
almost certainly be larger in developing countries with lower standards of
sanitation and more crowding."

According to Dr. Kramer, his team is currently planning to re-evaluate the
children when they are 6 years old to assess allergy, growth, neurocognitive
development, blood pressure, and perhaps other cardiovascular risk factors.

"We believe that the Promotion of Breastfeeding Intervention Trial provides
an essential scientific underpinning for future breastfeeding promotion
interventions in both developed and developing country settings," Dr.
Kramer's group concludes.

JAMA 2001;285:413-420.

The actual study is available at JAMA's website:

http://jama.ama-assn.org/issues/current/rfull/joc00933.html

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