| Popis: |
Debate continues over how long mothers should exclusively breastfeed their infants. Some believe that breast milk alone is inadequate nutrition after 3 or 4 months. In many developing countries, however, weaning foods arealso inadequate and sometimes contaminated. Data from the Promotion of Breast-feeding Intervention Trial (PROBIT), a large randomized trial from Belarus, was used in a secondary cohort analysis to compare 2862 infants who were exclusively breastfed for 3 months, mixed with solid food through 6 months or longer, with 621 infants who received only breast milk for at least the first 6 months of life. Birth weight, length, and head circumference did not differ significantly in the 2 study groups at the outset. Maternal age and the number of other children also were similar, but mothers who did not breastfeed exclusively for 3 months were less well-educated than the others and likelier to have smoked while pregnant. Weight gain from 3 to 6 months was slightly greater in infants who were exclusively breastfed for 3 months than in the 6-month group (difference of 29 g per month). The same was the case for gain in length (difference of 1.1 mm). The 6-month group, however, gained length more rapidly from ages 9 to 12 months (difference of 0.9 mm per month). Head circumference was larger at age 12 months in the infants receiving only breast milk for the first 6 months (difference, 0.19 cm). Gastrointestinal infections (but not those requiring hospitalization) were significantly less frequent at age 3 to 6 months in the 6-month group, even after controlling for geographic origin, urban versus rural location, maternal educational level, and birth weight. The adjusted odds ratio was 0.61. In contrast, there were no significant group differences in the risk of respiratory infection, atopic eczema, 2 or more episodes of wheezing, or 1 or more episodes of otitis media These findings support the current World Health Assembly recommendation that mothers exclusively breastfeed their infants for 6 months. Gastrointestinal infections are less frequent than when exclusive breastfeeding is limited to 3 months, and there are no apparent adverse effects on health in the first 12 months of life. |
