HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 90/4/1070    most recent ajcn.2009.28021v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Kramer, M. S Articles by Platt, R. W PubMed PubMed Citation Articles by Kramer, M. S Articles by Platt, R. W Agricola Articles by Kramer, M. S Articles by Platt, R. W

Health and development outcomes in 6.5-y-old children breastfed exclusively for 3 or 6 mo^1,2,3

¹ From the Departments of Pediatrics (MSK, BM, EF, J-PC, MD, and RWP), Epidemiology and Biostatistics (MSK, J-PC, and RWP), Psychology (FA), and Psychiatry (EF), McGill University Faculty of Medicine, Montreal, Canada; the Republican Scientific and Practical Center "Mother and Child," Minsk, Belarus (LM, NB, IM, and SI); the Faculty of Nursing, University of Toronto, Toronto, Canada (EH); and the Department of Obstetrics and Gynecology and Ontario Health Research Institute, University of Ottawa, Ottawa, Canada (BC).

² Supported by a grant from the Canadian Institutes of Health Research. RWP is a career investigator (Chercheur-boursier) and BM a Chercheur national, of the fonds de la recherche en santé du Québec (FRSQ). EF is a Tier 1 Canada Research Chair in Child Psychiatry. MSK, RWP, EF, BM, and MD are members of the Research Institute of the McGill University Health Centre, which is supported in part by the FRSQ.

³ Address correspondence to MS Kramer, The Montreal Children's Hospital 2300 Tupper Street (Les Tourelles) Montreal, Quebec H3H 1P3, Canada. E-mail: michael.kramer{at}mcgill.ca.

Background: Despite the current World Health Organization recommendation that infants be exclusively breastfed for 6 mo, this practice remains unusual in both developed and developing countries.

Objective: The objective was to compare health and development outcomes at age 6.5 y in children who were exclusively breastfed for 3 mo (EBF3) or for 6 mo (EBF6); in the EBF3 group, the children continued partial breastfeeding for 6 mo.

Design: This was a prospective cohort study nested within a large, cluster-randomized trial of a breastfeeding promotion intervention in the Republic of Belarus. Outcomes compared at 6.5 y included anthropometric measurements, systolic and diastolic blood pressure, intelligence quotient, teachers' ratings of academic performance, parent- and teacher-rated behavior, atopic symptoms, allergen skin-prick tests, and dental caries. All statistical analyses were adjusted for cluster- and individual-level covariates and for clustering of outcomes within the clinics at which the children were examined.

Results: The 2427 EBF3 and 524 EBF6 children who were followed up represented 84.7% and 89.4%, respectively, of those followed for the first year of life. The only significant differences observed between the 2 groups were in mean body mass index, triceps skinfold thickness, and hip circumference, all of which were higher in the EBF6 group.

Conclusions: We observed no demonstrable beneficial or adverse long-term effects on child health of exclusive breastfeeding for 6 mo. Higher adiposity measures in the EBF6 group probably reflect reverse causality rather than a causal effect of prolonged exclusive breastfeeding. Established benefits appear to be limited to the period of exclusive breastfeeding.