Health benefits of training mothers in developing countries to
exclusively breastfeed for 6 months
Reducing diarrhoeal disease among infants in less-developed countries could
be assisted by the imple-mentation of straightforward community-based health
programmes to promote exclusive breastfeeding for six months after childbirth,
conclude authors of a study in this week's issue of The Lancet.
The WHO recommend exclusive breastfeeding until six months of age for infants
in less-developed coun-tries; previous research has suggested that exclusive
breastfeeding for the first six months can protect against diarrheal disease,
although there are concerns that exclusive breastfeeding could be associated
with reduced infant growth. Dr. Robert Black of the Department of International
Health Johns Hopkins Bloomberg School of Public Health, Dr. Maharaj Bhan of the
All India Institute of Medical Sciences, New Delhi, India and other colleagues
assessed the feasibility, effectiveness, and safety of an educational
intervention to promote exclusive breastfeeding for this length of time in a
rural Indian community.
Health-care workers were trained to give exclusive breastfeeding counseling
within the existing health-care infrastructure, and mothers of 1115 infants born
within nine months of this training were randomly allocated to an intervention
or control group.
Exclusive breastfeeding rates were higher (79%) for mothers given counseling
compared with the control group (46%); diarrhea was reduced by a third in the
intervention group at three months and by around 15% at six months. There were
no differences between length and weight of infants between the two groups,
overall, and in the subgroup of low-birthweight infants.
Maharaj Bhan comments: "Our findings indicate that promotion of exclusive
breastfeeding until age 6 months in a developing country setting through
existing primary-health-care services is feasible, does not lead to growth
faltering, and reduces the risk of diarrhea. Additionally, educational
intervention greatly improved the rates of exclusive breastfeeding, as
previously indicated by the results of two community-based trials, which
assessed the use of peer counselors, and several hospital and clinic based
programs. Our findings are, however, especially important since behavior change
was achieved with an approach that is feasible on a large scale and is
sustainable, because it was implemented through the routine health and nutrition
services."
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