Breastfeeding,
why...
Betran
AP, de Onis M, Lauer JA, Villar J. Ecological study
of effect of breastfeeding on infant mortality in Latin
America. BMJ 2001;323:303
To estimate
the effect of exclusive breastfeeding and partial breastfeeding
on infant mortality from diarrhoeal disease and acute
respiratory infections in Latin America, national data
on infant mortality and breastfeeding were analysed. About
55% of these deaths are preventable by exclusive breastfeeding
among infants aged 0-3 months and partial breastfeeding
throughout the remainder of infancy. Among infants aged
0-3 months, 66% of deaths from these causes are preventable
by exclusive breastfeeding; among infants aged 4-11 months,
32% of such deaths are preventable by partial breastfeeding.
Overall, 13.9% of infant deaths from all causes are preventable
by these breastfeeding patterns. The annual number of
preventable deaths is about 52,000 for the region. Interventions
to promote exclusive breastfeeding should target younger
infants.
Forste
R, Weiss J, Lippincott E. The decision to breastfeed
in the United States: does race matter? Pediatrics
2001;108:291-6
Black women
in the USA are less likely to breastfeed than non-black
women, and the primary reason for not breastfeeding is
that they "prefer to bottle-feed." This is the
result of a study carried out to estimate the effect of
maternal and birth characteristics on the decision to
breastfeed and to look at breastfeeding practices and
their association to racial differences in infant mortality.
After controlling for socio-economic background and birth
characteristics, race remained a strong predictor of breastfeeding.
Analyses of infant mortality indicated that breastfeeding
and low birth weight account for the race difference in
infant mortality. Efforts to increase breastfeeding in
black communities should help narrowing the racial gap
in infant mortality.
Arifeen
SE, Black RE, Caulfield LE, Antelman G, Baqui AH. Determinants
of infant growth in the slums of Dhaka: size and maturity
at birth, breastfeeding and morbidity. Eur J Clin
Nutr 2001;55:167-78
To investigate
the influence of size at birth, breastfeeding and morbidity
on growth during infancy in poor areas of urban Bangladesh,
a cohort of 1654 newborn infants was followed until 12
months of age in slum areas of Dhaka; 1207 infants completed
the follow-up. A positive impact of exclusive breastfeeding
in the first 3-5 months on infant growth was detectable
at 12 months of age. Although the bigger babies in the
sample tended to grow relatively even bigger, exclusive
breastfeeding appeared to counteract this pattern. Reported
diarrhoea was associated with lower body weights and lengths
even after adjusting for feeding patterns. The sustained
effect on growth and the even more beneficial effect in
lighter infants are compelling reasons for promotion of
exclusive breastfeeding in early infancy.
Villamor
E, Mbise R, Spiegelman D, Ndossi G, Fawzi WW. Vitamin
A supplementation and other predictors of anemia among
children from Dar Es Salaam, Tanzania. Am J Trop
Med Hyg 2000;62:590-7
The association
of anemia with socio-economic factors, malaria, HIV infection,
and nutritional status was examined among 687 children
admitted to hospital with pneumonia. At baseline, haemoglobin
concentration was positively associated with the number
of possessions in the household, maternal level of education
and quality of water supply, and inversely related to
malaria infection after controlling for potential confounding
variables. Children infected with HIV experienced a significant
fall in mean haemoglobin levels over time. The risk of
developing severe anemia (< 7 g/dL) during follow-up
was lower for children who were breastfed for longer than
18 months as compared to those with less than 6 months
of breastfeeding. Children with repeated diagnoses of
malaria had 4.1 times the risk of developing severe anemia
than did children without the diagnosis. Vitamin A supplements
were associated with an overall non-significant reduction
of 14% in the risk of developing severe anemia. The authors
conclude that malaria, HIV infection, low socio-economic
status, and short duration of breastfeeding are strong
and independent determinants of anemia in this population.
Gdalevich
M, Mimouni D, Mimouni M. Breastfeeding and the risk
of bronchial asthma in childhood: a systematic review
with meta-analysis of prospective studies. J Pediatr
2001;139:261-6
The authors
carried out a systematic review of prospective studies
that evaluated the association between exclusive breastfeeding
during the first 3 months and asthma. Twelve studies that
met pre-stated inclusion criteria were identified with
a Medline search from 1966 to 1999. Overall, the risk
of asthma was reduced by 30% (95% CI: 19% to 40%) with
exclusive breastfeeding. The effect was greater (48%)
in studies of children with a family history of atopy
(rhinitis, eczema, asthma and other allergic reactions)
than in studies of a combined population (27%). This review
confirms that exclusive breastfeeding during the first
months is associated with lower asthma rates during childhood.
The effect, achieved through modulation of the immune
system by breast milk, avoidance of allergens, or a combination
of these and other factors, strengthens the advantage
of exclusive breastfeeding, especially if a family history
of atopy is present.
Karunasekera
KA, Jayasinghe JA, Alwis LW. Risk factors of childhood
asthma: a Sri Lankan study. J Trop Pediatr
2001;47:142-5
A case-control
study was carried out to evaluate the genetic and environmental
risk factors of childhood asthma in a group of Sri Lankan
children. Three hundred cases (admitted with symptoms
of asthma) and 300 age-matched controls were compared.
Parental asthma, asthma in a sibling and in a relative,
parental allergic rhinitis, discontinuation of breastfeeding
after 6 months in infancy, bronchiolitis in infancy, living
in a dusty environment, and a father with primary education
compared to secondary education were independently associated
with an increased risk of asthma. This study reinforces
the view that asthma has many causes. As a preventive
measure, continuation of breastfeeding beyond 6 months
is important.
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