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  • Title: Is prolonged breast-feeding associated with malnutrition?
    Author: Victora CG, Vaughan JP, Martines JC, Barcelos LB.
    Journal: Am J Clin Nutr; 1984 Feb; 39(2):307-14. PubMed ID: 6695831.
    Abstract:
    The association between duration of breast-feeding and nutritional status was studied in a population-based sample of 802 children aged 12 to 35.9 months in Southern Brazil during 1982. The prevalence of malnutrition (low weight for age, length for age, and weight for length) was smallest in those children breast-fed for 3 to 6 months, but after this age nutritional status appeared to be worse in those breast-fed for longer. Children still being breast-fed at the time of the survey presented with a significantly higher prevalence of low weight for length than those who had been totally weaned, and those receiving breast-plus bottle-feeding presented with intermediate levels. This association could not be explained by a number of possible confounding variables using a multiple logistic regression analysis. These results are also consistent with a controlled trial on supplementary feeding in the Sudan. The association between duration of breast feeding and nutritional status was studied in a population-based sample of 802 children aged 12 to 35.9 months in Southern Brazil during 1982. The prevalence of malnutrition (low weight for age, length for age, and weight for length) was smallest in those children breastfed for 3 to 6 months, but after this age nutritional status appeared to be worse in those breastfed longer. Children still being breastfed at the time of the survey presented with a significantly higher prevalence of low weight for length than those who had been totally weaned; those receiving breast plus bottle feeding presented with intermediate levels. This association could not be explained by a number of possible confounding variables using a multiple logistic regression analysis. These variables are: 1) age of the child, divided into 8 3-month categories--associated both with prevalence of malnutrition and breastfeeding; 2) district of residence; 3) family income; 4) ethnic background (Portuguese, Italian, Black, or mixed); 5) type of family (nuclear or extended); 6) maternal education; 7) employment status of head of the family; 8) previous hospitalization due to infectious disease; 9) birth order; and 10) sex. Variables 3 to 7 were included to account for the social class differences in breastfeeding and nutrition. These results are also consistent with a controlled trial on supplementary feeding in the Sudan. This trial was carried out to assess the nutritional impact of a take home supplementary feeding program. The effect of dried skimmed milk was compared to that of local beans in children aged 6 to 26 months. The impact was measured by the average weight and height gain per month. The results suggest that children who were breastfed and received dried skim milk gained significantly more weight per month than those breastfed but given only beans.
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