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ORIGINAL RESEARCH COMMUNICATION |
1 From the Departments of Pediatrics (MSK, RWP, and J-PC) and Epidemiology and Biostatistics (MSK, TG, RWP, J-PC, SS, and TD), McGill University Faculty of Medicine, Montreal; the Centre for Research in Women’s Health (BC), Sunnybrook Women’s College Health Sciences Centre (BC), and Faculty of Nursing (EH), University of Toronto; the Departments of Maternal and Child Health (ZS) and Foreign Relations (IM), Belarussian Ministry of Health, Minsk, Belarus; and the Belarussian Maternal and Child Health Research Institute (ID, IV, GS, and NB), Minsk, Belarus.
Background: Opinions and recommendations about the optimal duration of exclusive breastfeeding have been strongly divided, but few published studies have provided direct evidence on the relative risks and benefits of different breastfeeding durations in recipient infants.
Objective: We examined the effects on infant growth and health of 3 compared with 6 mo of exclusive breastfeeding.
Design: We conducted an observational cohort study nested within a large randomized trial in Belarus by comparing 2862 infants exclusively breastfed for 3 mo (with continued mixed breastfeeding through 
6 mo) with 621 infants who were exclusively breastfed for 6 mo. Regression to the mean, within-cluster correlation, and cluster- and individual-level confounding variables were accounted for by using multilevel regression analyses.
Results: From 3 to 6 mo, weight gain was slightly greater in the 3-mo group [difference: 29 g/mo (95% CI: 13, 45 g/mo)], as was length gain [difference: 1.1 mm (0.5, 1.6 mm)], but the 6-mo group had a faster length gain from 9 to 12 mo [difference: 0.9 mm/mo (0.3, 1.5 mm/mo)] and a larger head circumference at 12 mo [difference: 0.19 cm (0.07, 0.31 cm)]. A significant reduction in the incidence density of gastrointestinal infection was observed during the period from 3 to 6 mo in the 6-mo group [adjusted incidence density ratio: 0.35 (0.13, 0.96)], but no significant differences in risk of respiratory infectious outcomes or atopic eczema were apparent.
Conclusions: Exclusive breastfeeding for 6 mo is associated with a lower risk of gastrointestinal infection and no demonstrable adverse health effects in the first year of life.
Key Words: Breastfeeding • gastrointestinal infection • respiratory infection • growth • atopic eczema
This article has been cited by other articles:
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  K. Freeman, K. A. Bonuck, and M. Trombley Breastfeeding and Infant Illness in Low-Income, Minority Women: A Prospective Cohort Study of the Dose-Response Relationship J Hum Lact, February 1, 2008; 24(1): 14 - 22. [Abstract] [PDF]
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 M. S Fewtrell, J. B Morgan, C. Duggan, G. Gunnlaugsson, P. L Hibberd, A. Lucas, and R. E Kleinman Optimal duration of exclusive breastfeeding: what is the evidence to support current recommendations? Am. J. Clinical Nutrition, February 1, 2007; 85(2): 635S - 638S. [Abstract] [Full Text] [PDF]
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 C. J. Chantry, C. R. Howard, and P. Auinger Full Breastfeeding Duration and Associated Decrease in Respiratory Tract Infection in US Children Pediatrics, February 1, 2006; 117(2): 425 - 432. [Abstract] [Full Text] [PDF]
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K. A. Bonuck, M. Trombley, K. Freeman, and D. McKee Randomized, Controlled Trial of a Prenatal and Postnatal Lactation Consultant Intervention on Duration and Intensity of Breastfeeding up to 12 Months Pediatrics, December 1, 2005; 116(6): 1413 - 1426. [Abstract] [Full Text] [PDF]
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 W. M. Slusser More Evidence In Support of AAP Recommendations on Breastfeeding AAP Grand Rounds, March 1, 2004; 11(3): 30 - 31. [Full Text] [PDF]
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