Bejegyzés

The Optimal Duration of Exclusive Breastfeding – A Systematic Review

MICHAEL S. KRAMER, MD, RITSUKO KAKUMA, MSc

World Health Organization, 2002

Abstract

Background: The longstanding debate over the optimal duration of exclusive breastfeeding has centered on the so-called “weanling’s dilemma” in developing countries: the choice between the known protective effect of exclusive breastfeeding against infectious morbidity and the (theoretical) insufficiency of breast milk alone to satisfy the infant’s energy and micronutrient requirements beyond 4 months of age. The debate over whether to recommend exclusive breastfeeding for 4–6 months vs “about 6 months” has recently become more intense.

Objectives: The primary objective of this review was to assess the effects on child health, growth, and development, and on maternal health, of exclusive breastfeeding for 6 months vs exclusive breastfeeding for 3–4 months with mixed breastfeeding (introduction of complementary liquid or solid foods with continued breastfeeding) thereafter through 6 months.
-> Olvasd el a teljes cikket. <-

Report of The Expert Consultation on The Optimal Duration of Exclusive Breastfeeding

World Health Organization, 2002

The objectives of the expert consultation were:

  • To review the scientific evidence on the optimal duration of exclusive breastfeeding;
  • To formulate recommendations for practice on the optimal duration of exclusive breastfeeding;
  • To formulate recommendations for research needs in this area.

Summary of the findings

A systematic review of current scientific evidence on the optimal duration of exclusive breastfeeding identified and summarized studies comparing exclusive breastfeeding* for 4 to 6 months, versus 6 months, in terms of growth, infant iron status, morbidity, atopic disease, motor development, postpartum weight loss, and amenorrhea. It should be noted that the review was based on two small controlled trials and 17 observational studies that varied in both quality and geographic provenance.
-> Olvasd el a teljes cikket. <-

Nutrient Adequacy of Exclusive Breastfeeding for The Term Infant During The First 6 Months of Life

NANCY F. BUTTE, PHD, MARDIA G. LOPEZ-ALARCON, MD, PHD, CUTBERTO GARZA, MD, PHD

World Health Organization, 2002

This review, which was prepared as part of the background documentation for a WHO expert consultation, evaluates the nutrient adequacy of exclusive breastfeeding for term infants during the first 6 months of life. Nutrient intakes provided by human milk are compared with infant nutrient requirements. To avoid circular arguments, biochemical and physiological methods, independent of human milk, are used to define these requirements.

In this review nutrient adequacy of exclusive breastfeeding is most commonly evaluated in terms of growth. Other functional outcomes, e.g. immune response and neurodevelopment, are considered when data are available.
-> Olvasd el a teljes cikket. <-

Effects of Exclusive Breastfeeding for Four versus Six Months on Maternal Nutritional Status and Infant Motor Development

Kathryn G. Dewey, Roberta J. Cohen, Kenneth H. Brown and Leonardo Landa Rivera

Journal of Nutrition. 2001;131:262-267.

Abstract

To examine whether the duration of exclusive breastfeeding affects maternal nutrition or infant motor development, we examined data from two studies in Honduras: the first with 141 infants of low-income primiparous women and the second with 119 term, low birth weight infants.

In both studies, infants were exclusively breastfed for 4 mo and then randomly assigned to continue exclusive breastfeeding (EBF) until 6 mo or to receive high-quality, hygienic solid foods (SF) in addition to breast milk between 4 and 6 mo. Maternal weight loss between 4 and 6 mo was significantly greater in the exclusive breastfeeding group (EBF) group than in the group(s) given solid foods (SF) in study 1 (-0.7 ± 1.5 versus -0.1 ± 1.7 kg, P < 0.05) but not in study 2.
-> Olvasd el a teljes cikket. <-

How exclusive is exclusive breastfeeding? A comparison of data since birth with current status data

Aarts C, Kylberg E, Hörnell A, Hofvander Y, Gebre-Medhin M, Greiner T.
Int J Epidemiol. 2000 Dec;29(6):1041-6.

Abstract

BACKGROUND: There is no accepted and widely used indicator for exclusive breastfeeding since birth. Indeed, the difference between ‘current status’ data on exclusive breastfeeding and data on ‘exclusive breastfeeding since birth’ is rarely recognized. We used data from a longitudinal study to examine this issue.

METHODS: A descriptive longitudinal, prospective study design was used in which 506 mother-infant pairs were included. The mothers completed daily recordings on infant feeding during the first nine months after birth. A research assistant conducted fortnightly home visits with structured interviews.
-> Olvasd el a teljes cikket. <-