[Effect of the baby friendly hospital initiative on
the duration of exclusive breastfeeding in Kinshasa: a cluster randomized trial]
Our main exposures were the following: (1) duration of any breastfeeding in months; (2)
duration of exclusive breastfeeding in months, defined as feeding breast milk but no solid foods or non — breast milk liquids (except water) to age 6 months; and (3) breastfeeding status at age 6 months, categorized as «formula only, never breast fed,» «formula only, weaned,» «mixed formula and breast milk,» and «breast milk only, no formula.»
In determining the optimal
duration of exclusive breastfeeding in specific contexts, it is important that functional outcomes, e.g. infant morbidity and mortality, also are taken into consideration.
Maternal and perinatal factors influencing
duration of exclusive breastfeeding in the first 6 months of life
Not exact matches
Purpose: The purpose
of this project was to determine if supplementing pregnant and lactating women with DHA and extending the
duration of exclusive breastfeeding through the first year
of life will improve neurological development
in infants.
Longer
duration of exclusive breastfeeding is especially important
in countries where clean water, healthy food and healthcare are more
of an issue, but ALL babies benefit the longer that mom continues to provide her milk.
The Lullaby Trust's Lucy Lyus, Research and Information Manager said
in response to the study: «We recommend that women
breastfeed their babies, if they can, as
breastfeeding for any
duration, whether
exclusive or
in combination with formula feeding, has been found to reduce the chance
of Sudden Infant Death Syndrome (SIDS).
Our use
of observational data reflects the existing literature on lactation and maternal health; apart from a single randomized trial examining the effect
of exclusive lactation
duration on maternal weight loss, 48 there are no published studies
of maternal health outcomes
in randomized trials
of breastfeeding.
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.
However, the organization also called for more research regarding the benefits
of 6 vs 4 months
of exclusive breastfeeding.25 Thus far, several studies
in industrialized countries revealed that a shorter
duration of breastfeeding increases the risk
of common infectious diseases, such as respiratory and gastrointestinal tract infections.8, 19,24,26, — , 32 However,
in these studies, various definitions
of the exclusiveness
of breastfeeding were used24, 27,28,30 or the combination
of duration and exclusiveness
of breastfeeding was not taken into account.8, 31
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 interventio
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 interventio
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 interventio
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 interventio
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 interventio
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 interventio
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 interventio
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 interventio
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 interventio
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 interventio
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 interventio
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 interventio
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 interventio
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 interventio
in countries where mothers stay
in the hospital for a shorter time, with early discharge likely to limit the influence of a hospital - based interventio
in the hospital for a shorter time, with early discharge likely to limit the influence
of a hospital - based intervention.
BFHI has been shown to be very effective
in increasing
breastfeeding initiation,
exclusive breastfeeding and
breastfeeding duration in many countries, as well as improving mother's health care experiences and reducing rates
of infant abandonment.12 Given the short and long - term benefits
of breastfeeding to the infant, mother and society, implementing BFHI — alongside with the other objectives stated
in the Global Strategy for Infant and Young Child Feeding - continues to have an important role to play
in health services worldwide.
In particular,
breastfeeding may be
of concern because it has been shown to be associated with both child's use
of antibiotics36, 37 and cow's milk allergy, although inconsistently so.38
In a large Finnish birth cohort, the median
durations of exclusive and total
breastfeeding were 1.4 months and 7.0 months, respectively, and the proportion
of breastfed infants decreased from 95 % at the age
of 1 month to 58 % at the age
of 6 months.39 Another limitation is our reliance on pharmacy records, which provides only a rough estimation
of drug use.
Integrated Management
of Childhood Illness (IMCI)- Part III - Chapter 11 -
Breastfeeding Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life (2002) Geneva, World Health Organization Full text [pdf 278kb] The optimal duration of exclusive breastfeeding: a systematic review Geneva, World Health Organization, 2001 Full text [pdf 1.06 Mb] Report of the expert consultation of the optimal duration of exclusive breastfeeding Report of an expert consultation Geneva, World Health Organization, 28 - 30 March 2001 Full text [pdf 122kb] The WHO Global Data Bank on Infant and Young Child Feeding Breastfeeding and Complementary Feeding Feeding Your Baby From Six Months To One Year Your guide to help you introduce food to your baby Adapted and reproduced with permission of Peel Public Health, Region of Peel A Practical Workbook to Protect, Promote and Support Breastfeeding in Community Based Projects Health Canada, Ottawa, 2002 This workbook is intended to assist the Canada Prenatal Nutrition Program (CPNP) or similar community based prenatal projects to identify strategies and specific actions to protect, promote and support breastfeeding in a population he
Breastfeeding Nutrient adequacy
of exclusive breastfeeding for the term infant during the first six months of life (2002) Geneva, World Health Organization Full text [pdf 278kb] The optimal duration of exclusive breastfeeding: a systematic review Geneva, World Health Organization, 2001 Full text [pdf 1.06 Mb] Report of the expert consultation of the optimal duration of exclusive breastfeeding Report of an expert consultation Geneva, World Health Organization, 28 - 30 March 2001 Full text [pdf 122kb] The WHO Global Data Bank on Infant and Young Child Feeding Breastfeeding and Complementary Feeding Feeding Your Baby From Six Months To One Year Your guide to help you introduce food to your baby Adapted and reproduced with permission of Peel Public Health, Region of Peel A Practical Workbook to Protect, Promote and Support Breastfeeding in Community Based Projects Health Canada, Ottawa, 2002 This workbook is intended to assist the Canada Prenatal Nutrition Program (CPNP) or similar community based prenatal projects to identify strategies and specific actions to protect, promote and support breastfeeding in a population he
breastfeeding for the term infant during the first six months
of life (2002) Geneva, World Health Organization Full text [pdf 278kb] The optimal
duration of exclusive breastfeeding: a systematic review Geneva, World Health Organization, 2001 Full text [pdf 1.06 Mb] Report of the expert consultation of the optimal duration of exclusive breastfeeding Report of an expert consultation Geneva, World Health Organization, 28 - 30 March 2001 Full text [pdf 122kb] The WHO Global Data Bank on Infant and Young Child Feeding Breastfeeding and Complementary Feeding Feeding Your Baby From Six Months To One Year Your guide to help you introduce food to your baby Adapted and reproduced with permission of Peel Public Health, Region of Peel A Practical Workbook to Protect, Promote and Support Breastfeeding in Community Based Projects Health Canada, Ottawa, 2002 This workbook is intended to assist the Canada Prenatal Nutrition Program (CPNP) or similar community based prenatal projects to identify strategies and specific actions to protect, promote and support breastfeeding in a population he
breastfeeding: a systematic review Geneva, World Health Organization, 2001 Full text [pdf 1.06 Mb] Report
of the expert consultation
of the optimal
duration of exclusive breastfeeding Report of an expert consultation Geneva, World Health Organization, 28 - 30 March 2001 Full text [pdf 122kb] The WHO Global Data Bank on Infant and Young Child Feeding Breastfeeding and Complementary Feeding Feeding Your Baby From Six Months To One Year Your guide to help you introduce food to your baby Adapted and reproduced with permission of Peel Public Health, Region of Peel A Practical Workbook to Protect, Promote and Support Breastfeeding in Community Based Projects Health Canada, Ottawa, 2002 This workbook is intended to assist the Canada Prenatal Nutrition Program (CPNP) or similar community based prenatal projects to identify strategies and specific actions to protect, promote and support breastfeeding in a population he
breastfeeding Report
of an expert consultation Geneva, World Health Organization, 28 - 30 March 2001 Full text [pdf 122kb] The WHO Global Data Bank on Infant and Young Child Feeding
Breastfeeding and Complementary Feeding Feeding Your Baby From Six Months To One Year Your guide to help you introduce food to your baby Adapted and reproduced with permission of Peel Public Health, Region of Peel A Practical Workbook to Protect, Promote and Support Breastfeeding in Community Based Projects Health Canada, Ottawa, 2002 This workbook is intended to assist the Canada Prenatal Nutrition Program (CPNP) or similar community based prenatal projects to identify strategies and specific actions to protect, promote and support breastfeeding in a population he
Breastfeeding and Complementary Feeding Feeding Your Baby From Six Months To One Year Your guide to help you introduce food to your baby Adapted and reproduced with permission
of Peel Public Health, Region
of Peel A Practical Workbook to Protect, Promote and Support
Breastfeeding in Community Based Projects Health Canada, Ottawa, 2002 This workbook is intended to assist the Canada Prenatal Nutrition Program (CPNP) or similar community based prenatal projects to identify strategies and specific actions to protect, promote and support breastfeeding in a population he
Breastfeeding in Community Based Projects Health Canada, Ottawa, 2002 This workbook is intended to assist the Canada Prenatal Nutrition Program (CPNP) or similar community based prenatal projects to identify strategies and specific actions to protect, promote and support
breastfeeding in a population he
breastfeeding in a population health context.
Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants1, providing protection from morbidity and mortality due to infectious diseases2 and chronic diseases later in life.3 Exclusive breastfeeding is recommended, starting within one hour of birth and for the first 6 months of life, with continued breastfeeding to 2 years of age and beyond.4 However, rates of initiation, exclusive breastfeeding and breastfeeding duration have fallen since the widespread introduction and promotion of breast - milk substitutes.5 Successful breastfeeding depends on a number of factors, including a re-normalisation of breastfeeding as the infant feeding method of choice through antenatal counselling and education and breastfeeding support to prevent and resolve breastfeeding
Breastfeeding is an unequalled way
of providing ideal food for the healthy growth and development
of infants1, providing protection from morbidity and mortality due to infectious diseases2 and chronic diseases later
in life.3
Exclusive breastfeeding is recommended, starting within one hour of birth and for the first 6 months of life, with continued breastfeeding to 2 years of age and beyond.4 However, rates of initiation, exclusive breastfeeding and breastfeeding duration have fallen since the widespread introduction and promotion of breast - milk substitutes.5 Successful breastfeeding depends on a number of factors, including a re-normalisation of breastfeeding as the infant feeding method of choice through antenatal counselling and education and breastfeeding support to prevent and resolve breastfeeding diff
Exclusive breastfeeding is recommended, starting within one hour of birth and for the first 6 months of life, with continued breastfeeding to 2 years of age and beyond.4 However, rates of initiation, exclusive breastfeeding and breastfeeding duration have fallen since the widespread introduction and promotion of breast - milk substitutes.5 Successful breastfeeding depends on a number of factors, including a re-normalisation of breastfeeding as the infant feeding method of choice through antenatal counselling and education and breastfeeding support to prevent and resolve breastfeeding
breastfeeding is recommended, starting within one hour
of birth and for the first 6 months
of life, with continued
breastfeeding to 2 years of age and beyond.4 However, rates of initiation, exclusive breastfeeding and breastfeeding duration have fallen since the widespread introduction and promotion of breast - milk substitutes.5 Successful breastfeeding depends on a number of factors, including a re-normalisation of breastfeeding as the infant feeding method of choice through antenatal counselling and education and breastfeeding support to prevent and resolve breastfeeding
breastfeeding to 2 years
of age and beyond.4 However, rates
of initiation,
exclusive breastfeeding and breastfeeding duration have fallen since the widespread introduction and promotion of breast - milk substitutes.5 Successful breastfeeding depends on a number of factors, including a re-normalisation of breastfeeding as the infant feeding method of choice through antenatal counselling and education and breastfeeding support to prevent and resolve breastfeeding diff
exclusive breastfeeding and breastfeeding duration have fallen since the widespread introduction and promotion of breast - milk substitutes.5 Successful breastfeeding depends on a number of factors, including a re-normalisation of breastfeeding as the infant feeding method of choice through antenatal counselling and education and breastfeeding support to prevent and resolve breastfeeding
breastfeeding and
breastfeeding duration have fallen since the widespread introduction and promotion of breast - milk substitutes.5 Successful breastfeeding depends on a number of factors, including a re-normalisation of breastfeeding as the infant feeding method of choice through antenatal counselling and education and breastfeeding support to prevent and resolve breastfeeding
breastfeeding duration have fallen since the widespread introduction and promotion
of breast - milk substitutes.5 Successful
breastfeeding depends on a number of factors, including a re-normalisation of breastfeeding as the infant feeding method of choice through antenatal counselling and education and breastfeeding support to prevent and resolve breastfeeding
breastfeeding depends on a number
of factors, including a re-normalisation
of breastfeeding as the infant feeding method of choice through antenatal counselling and education and breastfeeding support to prevent and resolve breastfeeding
breastfeeding as the infant feeding method
of choice through antenatal counselling and education and
breastfeeding support to prevent and resolve breastfeeding
breastfeeding support to prevent and resolve
breastfeeding breastfeeding difficulties.
The second measure was
duration in months
of exclusive breastfeeding.
In particular, there were significant adjusted associations between
duration of exclusive breastfeeding and high school outcomes measured at age 18.
Bennis, A., Laamiri, F.Z., Chebguiti, A.A., Aguenaou, H., Mrabet, M., Kharbach, A. and Barkat, A. (2017) Impact
of Educational Materials on the
Duration of Exclusive Breastfeeding Assured by Women Who Delivered at the Souissi Maternity Hospital
in Rabat.
An expert consultation was convened to review the scientific evidence on the optimal
duration of exclusive breastfeeding, formulate recommendation for practice on the optimal
duration of exclusive breastfeeding and develop recommendation for research need
in this area.
There is some evidence that
breastfeeding education and peer and professional support can increase the initiation
of breastfeeding (Balogun 2016), and there is good evidence that support interventions by professionals or peers are effective
in increasing the
duration of any and
exclusive breastfeeding for mothers
of healthy term singletons (McFadden 2017).
This review is one
in a series
of Cochrane reviews examining education and support interventions to promote the initiation
of breastfeeding and to increase the
duration of breastfeeding and
exclusive breastfeeding (Balogun 2016; Lumbiganon 2016; McFadden 2017).
In 2012, the Cochrane study (52 studies, 56,451 mother - infant pairs, 21 countries) found that postnatal support increases both the
duration of breastfeeding and
exclusive breastfeeding [17].
The
duration of exclusive breastfeeding was 7.58 days (SD 8.32, n = 6) compared with 33.14 days (SD 66.51, n = 7)
in the control group.
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.
Although professional lactation support can improve the
duration of overall breast feeding, its effect
in improving
exclusive breast feeding is unclear.11 18 22 Thus far, studies that report improvement
of rates
of exclusive breastfeeding have involved mainly community based peer counselling strategies.23 24 25 Even then, a randomised trial
in the UK recently cast doubt on the efficacy
of this approach.26 There are current recommendations from NICE for the UK - wide implementation
of the baby friendly initiative.4 5 6 The 2006 NICE costing report on routine postnatal care
of women and their babies estimates that efforts to improve rates
of breast feeding will result
in substantial cost savings for the NHS.6
Approximately one - third
of mothers
in our analysis strongly valued
exclusive breastfeeding, even though they have established intention to exclusively
breastfeed; unfortunately, many
of them still could not attain the recommended
duration of breastfeeding.
Reasons for this slow improvement among mothers
in the United States include: (a)
breastfeeding has not received sufficient national attention as a public health issue [5]; (b) inadequate attention to the importance
of the
duration of exclusive breastfeeding [3, 6]; and (c) inadequate research addressing
exclusive breastfeeding in the United States [3, 7].
In addition, mothers who are educated about the benefits
of exclusive breastfeeding are more likely to value
exclusive breastfeeding and may be more determined to
breastfeed for longer
durations [15, 26].
Investing
in programs that focus on maternal education
of exclusive breastfeeding benefits would help mothers attain their
breastfeeding goals and / or the expert recommended
exclusive breastfeeding durations.
While there is evidence for the effectiveness
of professional support
in prolonging
duration of breast feeding and increasing rates
of initiation
of breast feeding, the strength
of its effect on the rate
of exclusive breastfeeding is unclear.11 12
2 As formulated
in the conclusions and recommendations
of the expert consultation (Geneva, 28 - 30 March 2001) that completed the systematic review
of the optimal
duration of exclusive breastfeeding [see document A54/INF.DOC.
Fourth, higher quality maternal interactions have been shown to improve brain development at 5, 10 and 24 months.34 Fifth, there is growing evidence to suggest that the beneficial effects
of exclusive breastfeeding may be moderated by the infant's genome, 35,36 and the metabolism
of the fatty acids
in maternal breast milk.37 For example, Krol et al. 36 showed that infants exclusively
breastfed for a longer
duration (above the 50th percentile) showed a heightened sensitivity and interest
in a happy visual stimulus (eyes) than infants exclusively
breastfed for a shorter
duration (below the 50th percentile).
2 - 1 As formulated
in the conclusions and recommendations
of the Expert Consultation (Geneva, 28 - 30 March 2001) that completed the systematic review
of the optimal
duration of exclusive breastfeeding (see document A54/INF.DOC.
The relatively long
duration of exclusive and any
breastfeeding by the participants
in the DNBC permitted us to construct statistically adequate prediction models
of the potential contribution
of breastfeeding to the reduction
of PPWR.
Measured the
duration of any and
exclusive breastfeeding as the age
of the infant
in weeks when the participant completely stopped
breastfeeding and first introduced infant formula, respectively.
The latest systematic review
of the evidence on this issue was published
in 2009 («Optimal
duration of exclusive breastfeeding (Review)», Kramer MS, Kakuma R.
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).