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Health See other Health Articles Title: Supplementation Does Not Benefit Healthy Breast-Fed Infants December 8, 2011 — Current research supports the World Health Organization's recommendation for exclusive breast feeding for the first 6 months after birth, according to a Cochrane Review that was designed to assess the benefits and harms of supplementation for full-term healthy breast-fed infants up to 6 months of age. The systematic literature review included 6 trials (814 infants) and was published online December 7 and in the December issue of the Cochrane Library. The review included randomized or quasi-randomized controlled trials in infants younger than 6 months of age and compared exclusive breast-feeding vs breast-feeding with any additional food or fluids. All of the studies were conducted many years ago (1982 - 1999). There was a significant difference favoring exclusive breast-feeding over fluid supplementation up to and including week 20 (risk ratio, 1.45; 95% confidence interval, 1.05 - 1.99). The review also raised concerns that the addition of glucose water at 70 mL/kg/day might displace nutrients provided by breast milk. Three trials examined infant morbidity and found a statistically, but not clinically, significant difference in temperature at 72 hours (mean difference 0.10°; 95% confidence interval, 0.01° - 0.19°) in glucose-supplemented infants compared with exclusively breast-fed infants. In addition, serum glucose levels were higher in glucose-supplemented infants at 24 hours, but not at 48 hours (−0.24 mmol/L; 95% confidence interval, −0.51 to 0.03). In addition to finding no benefit from fluid supplementation of newborns or infants (up to age 6 months), the review found possible negative effects on the duration of breast-feeding from the brief use of additional water or glucose water. The studies were independently selected for inclusion in the review by 2 authors, and 3 authors extracted the data and assessed the risk for bias. The review was performed because although the World Health Organization and other organizations recommend exclusive breast-feeding for 6 months, the addition of other fluids or foods is common in many countries and communities. This practice suggests perceived benefits of early supplementation or lack of awareness of the possible risks. Although the review focused on the effects on the infant during the first 6 months of life, the authors noted that supplementation with nonhuman milk may have effects on the developing gastrointestinal, metabolic, and immune systems that persist through childhood and beyond. The review also did not include the effect of an artificial teat on infant sucking skills or its role as a potential source of infection. The review was also limited in that it only looked at effects on the infants and did not include the possible effects of supplementation on the mother. These could include engorgement, mastitis, earlier return to fertility, nutritional status, maternal use of time, and maternal mental health and financial effects. The authors have disclosed no relevant financial relationships. Cochrane Library. Published online December 7, 2011. Abstract Poster Comment: Natural as good or better and less costly. Post Comment Private Reply Ignore Thread
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