PEDIATRICS Vol. 74 No. 4 October 1984, pp. 615-638
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Review of the Epidemiologic Evidence for an Association Between Infant Feeding and Infant Health

Mary Grace Kovar Dr PH, Mary K. Serdula MD, James S. Marks MD, MPH, and David W. Fraser MD

The approach in this paper is to investigate the health impact of feeding infants breast milk or its substitutes in the United States and other industrialized countries today. This report is limited to an evaluation of epidemiologic and clinical studies of human populations conducted in the United States and other industrialized countries and published since 1970.

QUESTIONS ADDRESSED

This review addresses five questions on breast-feeding:

1. Is breast-feeding associated with lower post-neonatal mortality than alternative forms of feeding?

2. Is breast-feeding associated with lower infectious disease-specific morbidity than alternative forms of feeding?

3. Is breast-feeding associated with lower rates of allergic disease-specific morbidity than alternative forms of feeding?

4. Is breast-feeding associated with malnutrition as indicated by either unusually rapid growth or faltering growth?

5. Is breast-feeding associated with bonding or with better psychological and intellectual development?

QUESTIONS NOT ADDRESSED

The decision to focus on specific questions meant that several issues could not be addressed. For example, the relationship between breast-feeding and fertility, the possible impact of breast-feeding on the mother's health, and the possible impact of a mother's health condition or her use of drugs on infant feeding are not discussed, nor are medical characteristics of the infant that might make breast-feeding difficult or inadvisable. Thus, several factors that should be taken into consideration in evaluating whether breast-feeding should be encouraged or discouraged in specific circumstances are not discussed in this section.

Biochemical and immunologic laboratory studies and animal studies have also not been reviewed. Such studies are potentially valuable, and the decision to exclude them should in no way be interpreted as failure to recognize their importance.




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