To whomever it may concern:
The article by Wright C et al concerning weight gain
(How Does Maternal and Child Feeding Behavior Relate to
Weight Gain and Failure to Thrive? Data From a
Prospective Birth Cohort, PEDIATRICS Vol. 117 No. 4
April 2006, pp. 1262-1269) is carefully presented, however,
it did not include two important independent variables that are well
documented to be associated with weight gain:
birth weight and breastfeeding. The fetal growth
velocity theory should at least be considered in the discussion, but I am
more surprised to note the lack of control for feeding pattern, with
breastfeeding occurring in 25% of the population under study.
In addition to the volumous published literature on the timing,
patterns, maternal perceptions, and growth differences seen with
breastfeeding vs cows milk formula, I would like to mention two
unpublished but relevant findings from breastfeeding research we carried
out in Chile: (with Drs. A Perez, V Valdes, and Lic. E Pugin, at the
Catholic University of Chile, Santiago) we found that maternal or
physician perception of faltering among breastfed infants in the first few
months led to supplementation, but not to
catch-up in terms of reference growth percentiles - these infants
continued to grow at a lower percentile of reference. In a separate
study(with Dr. Pablo
Lavin of University of Chile) we found that changes
in milk let-down that occur between 11-14
months were understood by mothers as a lessened milk supply, and led to
maternal-led feeding behavior change and associated consequences.
Finally, it is not at all clear that the prevalence of illness was
accounted for, which, if differing between groups, would also impact on
growth. Lack of attention to these issues leave the reader wondering if
the the findings are sound.
Thank you for the opportunity to raise these issues in
response to the published article.
Sincerely,
Miriam H Labbok, MD, MPH
FACPM, IBCLC, FABM
Professor of the Practice of Public Health
Director, Center for Infant and Young Child Feeding and
Care
Department of Maternal and Child Health
School of Public Health, CB#7445
The University of North Carolina at Chapel Hill
Chapel Hill, NC 27599-7445
Tel: 919-966-0928
Fax: 919-966-0458
labbok@unc.edu
www.sph.unc.edu/mhch/ciycfc
(associated blog -
http://enablingbreastfeeding.blogspot.com)
The Center for Infant and Young Child Feeding and Care
in the School of Public Health at UNC-Chapel Hill was
established in 2006 and exists to further statewide,
national and global understanding and support for the
mother/child dyad as key to the achievement of optimal
infant and young child feeding and associated
reproductive health.
Conflict of Interest:
None declared
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