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 24 May 2018

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News

Community-based promotion of breastfeeding and diarrheal illness

Promotion of exclusive breastfeeding until age 6 months, in a developing country, reduces the risk of diarrhea and growth faltering, finds an international team of researchers.

News image

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Exclusive breastfeeding is recommended until age 6 months.

In this study, researchers assessed the feasibility, effectiveness, and safety of education to promote exclusive breastfeeding for this length of time in India.

The results of the team's study are published in the latest issue of the Lancet.

Exclusive breastfeeding at 3 months:
- intervention = 79%
- control = 48%
Lancet

The team developed the educational intervention through formative research.

They pair-matched 8 communities, and then randomized 1 of each pair to receive the intervention, and the other no intervention (control).

The researchers trained health and nutrition workers in the intervention communities to counsel mothers for exclusive breastfeeding at multiple opportunities.

Overall, 1115 infants, born in the 9 months after training, were enrolled in the study. Of these, 552 were in the intervention group and 473 were in the control group.

The research team assessed feeding at age 3 months, plus anthropometry and of diarrhea prevalence at age 3 months and 6 months.

All analyses were by intention to treat.

The team assessed 483 infants in the intervention group at 3 months, and 412 in the control group. They assessed 468 in the intervention group and 412 in the control at 6 months.

The researchers found that exclusive breastfeeding rates were 79% in the intervention and 48% in the control communities (odds ratio 4.02), at 3 months.

Furthermore, the 7-day diarrhea prevalence was lower in the intervention group, than in the control at 3 months (0.64), and 6 months (0.85).

However, mean weights and lengths, and the proportion with weight-for-height or height-for-age Z scores of ≤ 2 did not differ between groups, at ages 3 and 6 months.

The effect of intervention on exclusive breastfeeding, diarrheal morbidity, and anthropometry at 6 months in low-birthweight babies was similar to that for all births.

Dr Nita Bhandari's team concluded, "Promotion of exclusive breastfeeding until age 6 months in a developing country through existing primary health-care services is feasible, reduces the risk of diarrhea, and does not lead to growth faltering".

Lancet 2003; 361: 1418-23
28 April 2003

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