Document Detail

Breastfeeding and infant size: evidence of reverse causality.
MedLine Citation:
PMID:  21430194     Owner:  NLM     Status:  MEDLINE    
Infants who receive prolonged and exclusive breastfeeding grow more slowly during the first year of life than those who do not. However, infant feeding and growth are dynamic processes in which feeding may affect growth, and prior growth and size may also influence subsequent feeding decisions. The authors carried out an observational analysis of 17,046 Belarusian infants who were recruited between June 1996 and December 1997 and who participated in a cluster-randomized trial of a breastfeeding promotion intervention. To assess the effects of infant size on subsequent feeding, the authors restricted the analysis to infants breastfed (or exclusively breastfed) at the beginning of each follow-up interval and examined associations between weight or length at the beginning of the interval and weaning or discontinuation of exclusive breastfeeding by the end of the interval. Smaller size (especially weight for age) was strongly and statistically significantly associated with increased risks of subsequent weaning and of discontinuing exclusive breastfeeding (adjusted odds ratios = 1.2-1.6), especially between 2 and 6 months, even after adjusment for potential confounding factors and clustered measurement. The authors speculate that similar dynamic processes involving infant crying, other signs of hunger, and supplementation/weaning undermine causal inferences about the "effect" of prolonged and exclusive breastfeeding on slower infant growth.
Michael S Kramer; Erica E M Moodie; Mourad Dahhou; Robert W Platt
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2011-03-23
Journal Detail:
Title:  American journal of epidemiology     Volume:  173     ISSN:  1476-6256     ISO Abbreviation:  Am. J. Epidemiol.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-27     Completed Date:  2011-06-21     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  7910653     Medline TA:  Am J Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  978-83     Citation Subset:  IM    
Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, Canada.
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MeSH Terms
Body Size / physiology*
Breast Feeding*
Child Development / physiology*
Follow-Up Studies
Infant Nutritional Physiological Phenomena*
Republic of Belarus
Time Factors
Young Adult
Grant Support
MOP 53155//Canadian Institutes of Health Research; R01 HD050758/HD/NICHD NIH HHS
Comment In:
Am J Epidemiol. 2011 May 1;173(9):984-7; reply 988-9   [PMID:  21430191 ]

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