In particular, there were significant adjusted associations
between duration of exclusive breastfeeding and high school outcomes measured at age 18.
Third, to examine whether the effects of the duration of breastfeeding were a result of exclusive breastfeeding, the associations
between duration of exclusive breastfeeding and upper and lower respiratory and gastrointestinal tract infections were examined.
Not exact matches
Most studies have revealed protective effects
of breastfeeding on common infections in the first 8 to12 months
of life.8, 27,29,30 One study, which distinguished
between infectious diseases until and from the age
of 6 months, revealed results similar to those from our study.24 Although the authors used
exclusive breastfeeding for 3 months as the reference group,
exclusive breastfeeding for 6 months reduced the risk
of gastrointestinal tract infections
between the ages
of 3 and 6 months but not
between the ages
of 6 and 12 months.24 We can not explain why
breastfeeding duration was only associated with lower risks
of lower respiratory tract infection from 7 to 12 months.
Although not directly comparable, our findings are in broad agreement with those from routine data in Scotland that have indicated a positive association
between Baby Friendly accreditation, but not certification, and
breastfeeding at 1 week
of age.17 Our findings reinforce those
of Coutinho and colleagues who reported that high
exclusive breastfeeding rates achieved in Brazilian hospitals implementing staff training with the course content
of the Baby Friendly Hospital Initiative were short - lived and not sustained at home unless implemented in combination with post-natal home visits.35 Similarly in Italy, training
of staff with an adapted version
of the Baby Friendly course content resulted in high
breastfeeding rates at discharge, with a rapid decrease in the days after leaving hospital.36 In contrast, a cluster randomized trial in Belarus (PROBIT) found an association
between an intervention modelled on the Baby Friendly Initiative with an increased
duration of breastfeeding37 an association also reported from an observational study in Germany.38 Mothers in Belarus stay in hospital post-partum for 6 — 7 days, and in Germany for 5 days, with post-natal support likely to be particularly important in countries where mothers stay in the hospital for a shorter time, with early discharge likely to limit the influence
of a hospital - based intervention.
Although there were no important differences in
breastfeeding duration between groups, there was a considerably longer
duration of exclusive breastfeeding (which was defined as providing only breast milk for the previous 24 h, but did allow formula less than once per week) among women receiving the research bags (either alone or in combination with the research counseling [P < 0.01, 1 - tailed log rank test]-RRB- versus those not receiving research bags.
Unadjusted associations
between exclusive breastfeeding duration and prenatal value
of exclusive breastfeeding and other maternal characteristics among women who intended to exclusively breastfeeda
Unadjusted associations
between maternal value
of exclusive breastfeeding and
exclusive breastfeeding duration for at least 3 months and 6 months were examined using logistic regression.
Although some SIDS experts and policy - makers endorse pacifier use recommendations that are similar to those
of the AAP, 272,273 concerns about possible deleterious effects
of pacifier use have prevented others from making a recommendation for pacifier use as a risk reduction strategy.274 Although several observational studies275, — , 277 have found a correlation
between pacifiers and reduced
breastfeeding duration, the results
of well - designed randomized clinical trials indicated that pacifiers do not seem to cause shortened
breastfeeding duration for term and preterm infants.278, 279 The authors
of 1 study reported a small deleterious effect
of early pacifier introduction (2 — 5 days after birth) on
exclusive breastfeeding at 1 month
of age and on overall
breastfeeding duration (defined as any
breastfeeding), but early pacifier use did not adversely affect
exclusive breastfeeding duration.
We found little evidence that
between - study heterogeneity in estimates was explained by age at measurement
of blood pressure (p = 0.5), decade
of birth (p = 0.2), stipulation
of a minimum
duration of breastfeeding (p = 0.5), proportion
of the target population in the main analysis (p = 0.2), whether
breastfeeding was
exclusive for at least 2 months (p = 0.2), method
of blood pressure measurement (p = 0.4), or whether effect estimates controlled for socioeconomic factors (p = 0.9), maternal factors in pregnancy (p = 0.9), or current weight (p = 0.9).