Executive Summary

PEDIATRICS ◽  
1984 ◽  
Vol 74 (4) ◽  
pp. 579-583
Keyword(s):  
Developing Countries ◽  
Breast Milk ◽  
Infant Feeding ◽  
Breast Feeding ◽  
Maternal Employment ◽  
The United States ◽  
Attitudinal Factors ◽  
Rate Of Increase ◽  
Breast Feed ◽  
Breast Fed

Domestic Although the rate of breast-feeding is increasing in the United States, it appears that the rate of increase has been much slower among less well educated and economically disadvantaged women. Relatively little is known about the behavioral and attitudinal factors that affect the decisions to breast-feed or to stop if already breast-feeding. Breast-feeding does appear to decrease an infant's risk of gastrointestinal infection and otitis media. The effect of method of infant feeding on risk of other infections and allergic illness is less certain. International The rate of breast-feeding in developing countries appears to have declined, especially among urban women. Although some sociodemographic correlates of infant-feeding choice have been examined, little is known about the behavioral and attitudinal factors that influence choice and duration of infant-feeding practices. Milk insufficiency, maternal employment, and pregnancy frequently are given as reasons for terminating breast-feeding. Rates of gastrointestinal illness are lower among breast-fed infants and when such illness is an important cause of death, infant mortality from this cause appears to be reduced. A randomized clinical trial carried out among high-risk infants found a significantly lower rate of infections among those given breast milk than those fed with infant formula. The evidence of the effect of breast-feeding on respiratory tract and other infections from other studies was less clear. Direct comparison of the growth of predominately breast-fed v artificially fed infants in the same populations from developing countries generally show faster growth for the breast-fed infants for the first 6 months of life. After 6 months, severe growth faltering occurs regardless of the method of feeding. In communities where the nutritional adequacy of supplementary foods is poor, breast milk is an extremely important, high-quality food during the second half of infancy and beyond.

INTRODUCTION

PEDIATRICS ◽  
1984 ◽  
Vol 74 (4) ◽  
pp. 589-590
Keyword(s):  
United States ◽  
Developing Countries ◽  
Infant Feeding ◽  
Breast Feeding ◽  
Infant Health ◽  
Feeding Practices ◽  
The United States ◽  
Protective Effects ◽  
Infant Feeding Practices ◽  
Breast Feed

This report focuses on the recent scientific literature concerning infant feeding worldwide. The first four papers examine infant-feeding practices in the United States; the last five papers focus on such practices in developing countries. DOMESTIC REPORT The domestic section of the report examines the available literature from industrialized countries that may be relevant to the United States' situation. In brief, the findings of the domestic report are that the evidence is generally inconclusive that breast-feeding has a large, positive effect on infant health in the United States. Modest protective effects may exist with regard to gastroenteritis. The evidence is somewhat stronger among American Indian and Alaskan native populations in which risk of infant morbidity and mortality is high. Little information exists on the effects in disadvantaged urban groups. The available evidence concerning trends in infant-feeding practices indicates that the rate and duration of breast-feeding are increasing, especially among the more affluent groups. The evidence is less clear among the disadvantaged. In general, lower socioeconomic groups are less likely to breast-feed. INTERNATIONAL REPORT The international section of the report examines some of the central issues regarding methods of infant feeding in the developing world and discusses the implications of the findings. In developing countries, where infant mortality is much higher than in the United States, the potential for breast-feeding to be an important determinant of infant survival is much greater. Sanitation is likely to be poorer; traditional foods offered in lieu of breast milk are likely to be nutritionally deficient; and commercial formula—if available and used—is more likely to be inappropriately diluted and stored.

Trends in Breast-Feeding

PEDIATRICS ◽  
1984 ◽  
Vol 74 (4) ◽  
pp. 591-602
Author(s):  
Gerry E. Hendershot
Keyword(s):  
Infant Feeding ◽  
Breast Feeding ◽  
Market Research ◽  
The United States ◽  
Upward Trend ◽  
Disadvantaged Women ◽  
Breast Feed ◽  
Statistical Studies ◽  
Low Levels ◽  
Short Section

Starting from very high levels in the 1940s, breast-feeding declined steadily to low levels in the early 1970s, and then began an upward trend which has apparently continued until the present (Fig. 1). In the 1940s, breast-feeding was more common among disadvantaged women. The subsequent decline was also more rapid among the disadvantaged, however, so that by the early 1970s, disadvantaged women were considerably less likely than others to breast-feed. Because the increase since the early 1970s has not been so pronounced among the disadvantaged, they continue to have relatively low levels of breast-feeding. The causes of these trends and differentials are not well understood. These are the principal conclusions drawn from a review of statistical studies of trends and differentials in breast-feeding in the United States. The studies included national health surveys conducted by the federal government, market research surveys conducted by infant formula manufacturers, and infant feeding surveys conducted by medical researchers. The studies differed markedly in their methods—a fact that affects their validity, reliability, and comparability. The first section of this paper discusses these data sources and their limitations. The next two sections discuss the downward trend in breast-feeding from the 1940s to the early 1970s, and the upward trend since. Each of these sections examines demographic differences in these trends. A short section that addresses possible causes of the trends and differentials follows those two sections. SOURCES AND LIMITATIONS OF THE DATA The principal sources of data on trends and differentials in breast-feeding are national fertility surveys, market research surveys, and special purpose infant-feeding surveys.

Breast-feeding: motivation and outcome

1984 ◽  
Vol 16 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Donelda J. Ellis ◽  
Roberta J. Hewat
Keyword(s):  
British Columbia ◽  
Breast Milk ◽  
Infant Feeding ◽  
Influencing Factors ◽  
Breast Feeding ◽  
Post Partum ◽  
Hospital Records ◽  
Feeding Motivation ◽  
Breast Feed ◽  
Insufficient Milk

SummaryTo determine patterns of infant feeding and influencing factors, 131 women, interested in breast-feeding and giving birth in one hospital in British Columbia, Canada, were followed for 6 months post-partum. Data were collected from hospital records and each participant completed mail-in questionnaires when their babies were 1, 3 and 6 months old. At 6 months 3·9% were exclusively breast-feeding, 26·5% were feeding their infants breast-milk and semi-solids and 26·5% were combining breast-feeding with formula and/or semi-solids. Over 50% discontinued breast-feeding before their stated intentions. Most women had chosen to breast-feed because of benefits to the baby, and most gave up breastfeeding because of perceived insufficient milk.

Breast-Feeding Rates Among Black Urban Low-Income Women: Effect of Prenatal Education

PEDIATRICS ◽  
1990 ◽  
Vol 86 (5) ◽  
pp. 741-746 ◽  
Author(s):  
Naomi Kistin ◽  
Dessa Benton ◽  
Sita Rao ◽  
Myrtis Sullivan
Keyword(s):  
Breast Feeding ◽  
Low Income ◽  
Study Groups ◽  
The United States ◽  
Control Group ◽  
Feeding Rates ◽  
Prenatal Education ◽  
Breast Feed ◽  
Low Income Women ◽  
Breast Fed

Many factors are associated with low breast-feeding rates among black low-income women. This study examines whether, despite such factors, health professionals' prenatal education of black poor women is assoicated with increased breast-feeding rates. Black women born in the United States who attended a midwives prenatal clinic (N = 159) were randomly assigned to two types of prenatal education or were followed up in a control group. All women were interviewed on entry into the study and after delivery of their infants. Women assigned to group classes attended at least one session discussing myths, problems, and benefits of breast-feeding. Women assigned to individual prenatal counseling spoke with a pediatrician or nurse practitioner, who discussed breast-feeding topics similar to those covered in the classes. Women in the control group received no additional prenatal education. The three study groups had significantly different percentages of women who breast-fed (controls 22%, classes 46%, individual sessions 53%). Higher percentages of women in the study groups carried out their prenatal plans to breast-feed (controls 50%, classes 86%, individual sessions 62%) or breast-fed despite prenatal plans to bottle-feed (controls 10%, classes 26%, individual sessions 48%). After multivariable analysis controlling for age, prenatal pians to breast-feed, prior breast-feeding experience, perceived support for breast-feeding, education, gravidity, and employment plans, women in intervention groups had a higher likelihood of breast-feeding than control subjects. These findings suggest that an increase in relatively simple, not-too-time-consuming educational efforts in institutions and offices serving black low-income women might yield significant narrowing of the gap in breast-feeding rates between white affluent women and black low-income women.

Fluoxetine in breast-milk and developmental outcome of breast-fed infants

1998 ◽  
Vol 172 (2) ◽  
pp. 175-179 ◽  
Author(s):  
K. Yoshida ◽  
B. Smith ◽  
M. Craggs ◽  
R. Channi Kumar
Keyword(s):  
Breast Milk ◽  
Breast Feeding ◽  
Infant Development ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Limit Of Detection ◽  
Total Concentration ◽  
Antidepressant Drugs ◽  
Psychomotor Development ◽  
Breast Feed ◽  
Breast Fed

BackgroundSelective serotonin reuptake inhibitors are currently the most widely prescribed antidepressant drugs. There are only four published studies of breast-feeding mothers and their infants in which the mothers were taking fluoxetine.MethodFour mothers who took fluoxetine and their breast-fed infants were studied. Samples of plasma, breast-milk and urine were taken from the mothers and of plasma and urine from infants for assays of drug and metabolite concentrations. Bayley Scales of Infant Development were repeatedly used to assess cognitive and psychomotor development of the infants.ResultsFluoxetine and norfluoxetine were detected in all samples of maternal plasma (range of total concentration 138–427 ng/ml) and in breast-milk (range 39–177 ng/ml). Amounts of both fluoxetine and norfluoxetine in infants' plasma and urine were below the lower limit of detection. All infants were observed to be developing normally and showed no abnormal findings on neurological examination.ConclusionsMuch larger databases are needed but these four cases do not provide any evidence to suggest that women who are maintained on therapeutic doses of fluoxetine should discontinue breast-feeding their infants if they wish to breast-feed.

Mortality and Infectious Disease Associated with Infant-Feeding Practices in Developing Countries

PEDIATRICS ◽  
1984 ◽  
Vol 74 (4) ◽  
pp. 702-727 ◽  
Author(s):  
Janine M. Jason ◽  
Phillip Nieburg ◽  
James S. Marks
Keyword(s):  
Developing Countries ◽  
Infant Mortality ◽  
Protective Effect ◽  
Infant Feeding ◽  
Breast Feeding ◽  
Developed Countries ◽  
The United States ◽  
Less Developed Countries ◽  
Industrialized Countries ◽  
Infectious Illness

This review examines the available studies bearing on the relation between infant-feeding mode and infectious illness in the populations of less-developed countries. A companion critical review of studies of the relationship of infant-feeding methods and infection in industrialized countries has concluded that, although laboratory studies provide biologic plausibility for a lower infection rate in breast-fed infants, an effect, if present, is apparently modest.39 The strongest evidence for a protective effect of breast-feeding in industrialized countries is for gastrointestinal (diarrheal) illness. In this review of studies among populations in developing countries we found the evidence for an important protective effect of breast-feeding against infectious illness to be much stronger. This conclusion was reached despite serious problems in the design of many of the studies reviewed. One characteristic that distinguishes populations in less-developed countries from those of industrialized ones is the infant mortality. Even today, infant mortality for much of the world is up to ten times higher than infant mortality in the United States and Northern Europe.46 This undoubtedly reflects differences in sanitation, nutrition, housing, and other indicators of socioeconomic status. Much of the difference in rates of infant and child mortality and morbidity is attributable to high rates of infectious illness, especially gastrointestinal disease. Thus, in these populations, the positive effects of breast-feeding are of greater potential importance for the health of the infant population and should be easier to detect in clinical and epidemiologic studies. In this review we will address the following key questions: (1) whether the method of infant feeding (breast v other) is associated with differences in rates of mortality, both overall and infectious, and in rates of infectious morbidity in less-developed countries;

Infant-Feeding Practices and Their Relationship With Diarrheal and Other Diseases in Huascar (Lima), Peru

PEDIATRICS ◽  
1989 ◽  
Vol 83 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Kenneth H. Brown ◽  
Robert E. Black ◽  
Guillermo Lopez de Romaña ◽  
Hilary Creed de Kanashiro
Keyword(s):  
Breast Milk ◽  
Breast Feeding ◽  
Feeding Practices ◽  
Feeding Practice ◽  
Skin Infections ◽  
Prevalence Rates ◽  
Breast Feed ◽  
Increased Risk ◽  
Tract Infections ◽  
Breast Fed

Longitudinal studies of the feeding practices and morbidity from infectious diseases of 153 Peruvian newborns from an underprivileged, periurban community were completed during their first year of life. Feeding practices were assessed by monthly questionnaires, and illnesses were identified by thrice-weekly, community-based surveillance. All infants were initially breast-fed, but only 12% were exclusively breast-fed at 1 month of age. At 12 months of age, 86% of children still received some breast milk. Incidence and prevalence rates of diarrhea in infants younger than 6 months of age were less among those who were exclusively breast-fed compared with those who received other liquids or artificial milks in addition to breast milk. The diarrheal prevalence rates doubled with the addition of these other fluids (15.2% v 7.1% of days ill, P < .001). Infants for whom breast-feeding was discontinued during the first 6 months had 27.6% diarrheal prevalence. During the second 6 months of life, discontinuation of breast-feeding was also associated with an increased risk of diarrheal incidence and prevalence. Upper and lower respiratory tract infections occurred with lesser prevalence among exclusively breast-fed younger infants. The prevalences of skin infections by category of feeding practice were not as consistent, but exclusively breast-fed infants tended to have fewer skin infections during the initial months of life and older infants who continued to breast-feed had fewer infections than those who did not. None of the results could be explained by differences in the socioeconomic status of the infants' families.

Breast Versus Bottle: Correlates of Adolescent Mothers' Infant-Feeding Practices

PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 689-695
Author(s):  
Alain Joffe ◽  
Susan M. Radius
Keyword(s):  
Infant Feeding ◽  
Breast Feeding ◽  
Adolescent Mothers ◽  
Personal Experience ◽  
Total Sample ◽  
Social Environments ◽  
Pregnant Adolescents ◽  
Feeding Method ◽  
Breast Feed ◽  
Breast Fed

Since the 1970s, breast-feeding as the preferred method of infant feeding has increased in overall popularity. However, certain populations, particularly poor, young, black, and less-educated women, have been slow to adopt this method. This prospective study was undertaken to identify factors relating to the choice of infant-feeding method among inner-city adolescents. Two hundred fifty-four pregnant adolescents completed a questionnaire supplying information regarding attitudes toward and knowledge about breast-feeding, social support, personal experience, and other variables hypothesized to correlate with their choice of infant-feeding method. Of the total sample, 17% said they were "probably" or "definitely" going to breast-feed their babies. Analyses revealed adolescents most likely to intend to breast-feed were those who perceived more benefits to breast-feeding, who desired more knowledge about it, who were themselves breast-fed, who reported supportive social environments, and who perceived relatively fewer barriers to breast-feeding their infants. Specific interventions based upon these findings are proposed. We conclude that adolescent mothers are interested in breast-feeding their babies and that interventions are feasible to increase breast-feeding within this population.

Poverty, WIC, and Promotion of Breast-feeding

PEDIATRICS ◽  
1991 ◽  
Vol 87 (3) ◽  
pp. 399-400
Author(s):  
MICHAEL S. KRAMER
Keyword(s):  
United States ◽  
Developing Countries ◽  
Breast Feeding ◽  
Developed Countries ◽  
The United States ◽  
Morbidity And Mortality ◽  
Protective Effects ◽  
Infant Morbidity ◽  
Breast Fed ◽  
Poor Population

Among the health benefits of breast-feeding, one of the most important is a reduction in infant morbidity and mortality from infectious illnesses. The magnitude of the benefit, however, appears to be conditional on socioeconomic factors. For example, the protective effect is far more striking in developing countries than in developed countries.1,2 Even within developing country settings, poor sanitation, overcrowding, and other concomitants of severe poverty are associated with increased protective effects.3 In countries like the United States, with a sizable poor population, it seems reasonable to assume that infants born in poverty, who experience the highest rates of morbidity and mortality (especially in the postneonatal period), would benefit most from being breast-fed.

Influence of Infant Feeding Method on Postpartum Relapse of Mothers With MS

2002 ◽  
Vol 4 (4) ◽  
pp. 183-191 ◽  
Author(s):  
Elsie E. Gulick ◽  
June Halper
Keyword(s):  
Infant Feeding ◽  
Breast Feeding ◽  
Postpartum Period ◽  
Feeding Method ◽  
Immunomodulating Therapy ◽  
Breast Feed ◽  
Symptom Prevalence ◽  
Breast Fed ◽  
Relapse Rates ◽  
Do So

In an effort to determine relapse rates in breast-feeding and non—breast-feeding mothers with multiple sclerosis (MS) as well as differences in symptom prevalence between relapsing and non-relapsing mothers, weekly diaries through the first six postpartum months were kept by mothers to record the frequency and percentages of infant feeding by breast or formula and health problems that the mothers experienced. Of 140 mothers who breast-fed their infants, 35 (25%) experienced at least one neurologist-confirmed MS relapse during the first six months and 47 (33.6%) during the 12-month period; for non—breast-feeding mothers, 18 (51.4%) experienced relapse by six months and 22 (61.1%) by 12 months. MS relapse during pregnancy predicted increased relapse during the first three postpartum months while an increased percentage of infant feedings by breast predicted decreased relapse. Relapse the year before pregnancy and during pregnancy predicted increased relapse during the four- to six-month postpartum period. Length of time on immunomodulating therapy since delivery predicted increased relapse at seven to nine months. MS relapse during pregnancy predicted increased relapse at the 10- to 12- month period. For non—breast-feeding mothers none of the predictors of relapse were significant for the three-month period except use of immunomodulating therapy during the four- to six-month period when such use was associated with increased relapse. Relapsing compared with non-relapsing mothers reported significantly more MS-related symptoms during the three-month postpartum period. Decreased relapse rates during the first three months following delivery among breast-feeding mothers compared with non—breast-feeding mothers have implications for encouraging women with MS who wish to breast-feed their infants to do so, particularly if their pregnancy was free of relapse. Women with MS are also encouraged to postpone the initiation of immunomodulating therapy until three months following delivery or when breast-feeding is discontinued. (Int J MS Care. 2002; 4:183–191)

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