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Nutrition During Lactation (1991)

Chapter: A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality

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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

Appendix A

Appendix A presents a compilation of abstracts of studies that address relationships of the mode of infant feeding with the infant's subsequent survival. Abstracts are presented in either tabular or narrative form and are arranged chronologically by type of study (mortality rates, relative risk, or both; case fatality; and miscellaneous). Table A-1 presents a chronological listing of the data and indicates the location of each abstract.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

TABLE A-1 Chronological Listing of Estimated Relative Risk (RR) of Mortality in Industrialized Countries Among Children Fed Formula Only or Formula Plus Human Milk Compared with Breastfed Infants and Childrena

 

RRb

Type of Study and Abstract Providing Detailed Description

 

Period and Site of Study

Bottle

Mixed

Reference

1869–1910, Three German states

NAc

NA

Correlation, A-21

Knodel and van de Walle, 1967

1885–1886 Berlin, Germany

4.0– 10.8d

NA

Mortality rates, A-1

Thiemich and Bessau, 1930; reviewed in Mannheimer, 1955

1895–1896 Berlin, Germany

4.1– 14.2d

NA

Mortality rates, A-1

Thiemich and Bessau, 1930; reviewed in Mannheimer, 1955

1900–1903, Derby, England

2.83

1.41

Mortality rates, A-2

Howarth, 1905

1900–1904,  Kingdom of Bavaria, Germany

NA

NA

Correlation, A-22

Greenwood and Brown, 1912

1901–1905, Finsbury, London

27.5

9.8

Case-control, A-3

Newman, 1906

NRe Liverpool, England

2.71f, 2.49g

1.59f, 0.92g

Mortality rates, A-4

Armstrong, 1904

1903–1905, Brighton, England

35.1

3.1

Case-control, A-5

Newsholme, 1906, reviewed in Newman, 1906

1906, Berlin, Germany

2.6– 10.9d

NA

Mortality rates, A-1

Thiemich and Bessau, 1930; reviewed in Mannheimer, 1955

1910, Boston, Mass.

6.06

NA

Mortality rates, A-6

Davis, 1913

1924–1929, Chicago, Ill.

5.6

4.6

Mortality rates, A-7

Grulee et al., 1934, 1935

NR, Birmingham, England

4.59

1.55

Case-fatality, A-17

Smellie, 1939

NR, Toronto, Canada

0.89

0.65

Case-fatality, A-18

Ebbs and Mulligan, 1942

1936–1942, Liverpool, England

5.62

2.52

Mortality rates, A-8

Robinson, 1951

1941–1942, Belfast, Ireland

5.15– 13.72d

NA

Mortality rates, A-9

Deeny and Murdock, 1944

1943–1947, Stockholm, Sweden

1.34– 1.75f

0.63– 0.66f

Mortality rates, A-10

Mannheimer, 1955

1942 and 1943, Isleworth, England

1.96

NA

Case-fatality, A-19

Gaidner, 1945

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

1943–1946, Louisville, Ky.

NA

NA

Case-fatality, A-20

Prince and Bruce, 1948

1946, Great Britain

1.7h

NA

Mortality rates, A-11

Douglas, 1950

1956–1971, Copenhagen, Denmark

NA

NA

Case-control, A-12

Biering-Sorensen et al., 1978

1959–1966, United States

NA

NA

Mortality rates, A-13

Naeye et al., 1976

1962, Canada

2.03

NA

Mortality rates, A-14

Department of National Health and Welfare, Canada, 1963, as quoted in Gerard and Tan (1978)

1973–1979, Sheffield, England

NA

NA

Postnatal intervention, A-15

Carpenter et al., 1983

NR, United States

NA

NA

Case-control, A-16

Arnon et al., 1982

a The bases for the estimates of relative risk are shown in Abstracts A-1 through A-19. Relative risks computed for these studies represent somewhat different comparisons. For example, mortality might be compared for infants at different ages or for infants hospitalized with diarrhea.

b Relative risk for breastfed infants = 1.0.

c NA = Data not available for estimating relative risk.

d Range covers values from 1 to 12 months of age.

e NR = Period not reported.

f To age 1 year.

g To age 2 weeks.

h To age 2 years, comparison of infants breastfed for 8 weeks or longer with those breastfed for less than 8 weeks.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

MORTALITY RATES AND RELATIVE RISK OF MORTALITY

ABSTRACT A-1 Infant Deaths/1,000 Births and Relative Risk (RR) of Death, by Feeding Method and Month of Age, Berlin, Germany, Between 1885 and 1906a,b

 

 

Number of Infant Deaths/1,000 Births by Feeding Method

Years

Age of Mortality, mo

Breast

Bottle

RRc

1885–1886

1

22.4

142.0

6.3

 

2

9.0

82.7

9.2

 

3

6.8

72.2

10.6

 

4

6.4

61.8

9.7

 

5

5.3

57.1

10.8

 

6

4.9

50.7

10.3

 

7

4.7

46.5

9.9

 

8

4.5

40.8

9.1

 

9

5.3

33.3

6.3

 

10

5.4

29.5

5.5

 

11

6.3

24.9

4.0

 

12

NAd

NA

NA

1895–1896

1

19.6

111.9

5.7

 

2

7.3

58.7

8.0

 

3

4.3

49.7

11.6

 

4

3.6

46.6

12.9

 

5

2.6

37.0

14.2

 

6

2.5

31.0

12.4

 

7

2.5

27.7

11.1

 

8

2.3

24.1

10.5

 

9

2.0

21.3

10.7

 

10

3.8

19.1

5.0

 

11

3.1

16.7

5.4

 

12

3.6

14.6

4.1

1906

1

22.4

59.1

2.6

 

2

7.9

31.3

4.0

 

3

4.3

27.3

6.3

 

4

2.4

22.1

9.2

 

5

1.7

18.5

10.9

 

6

2.2

16.1

7.3

 

7

1.4

14.1

10.1

 

8

1.8

12.2

6.8

 

9

2.1

10.2

4.9

 

10

1.5

9.2

6.1

 

11

1.3

8.0

6.2

 

12

1.5

8.0

5.3

a From Thiemich and Bessau (1930), as quoted in Mannheimer (1955).

b Data on feeding practices were collected for all deaths and during census for survivors.

c Relative risk for breastfed infants = 1.0.

d NA = Not available.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

ABSTRACT A-2 Infant Deaths/1,000 Births and Relative Risk (RR) of Mortality by Feeding Method, Derby, England, 1900 to 1903a

 

Number of Infant Deaths/1,000 Births (RR) by Feeding Method

Specific Causes of Mortality

Breast

Bottle

Mixed

All causes

69.8

197.5 (2.83)b

98.7 (1.41)

Respiratory diseases

14.1

26.5 (1.84)

12.6 (0.88)

Gastrointestinal diseases

9.9

57.8 (5.84)

25.0 (2.53)

Marasmus

12.5

39.4 (3.15)

18.8 (1.50)

Tuberculosis

3.4

13.5 (3.97)

5.6 (1.65)

Convulsions

15.0

25.9 (1.73)

20.9 (1.39)

a From Howarth (1905).

b Relative risk for breastfed infants = 1.

COMMENTS: Feeding history was obtained during infant's life; of the 8,343 infants studied, 63.3% were breastfed, 27.3% were mixed fed, and 19.5% were formula fed.

ABSTRACT A-3 Feeding Practices and Relative Risk (RR) of Death from Diarrhea in a Case-Control Study of Infants Aged 0 to 3 Months, Finsbury, London, England, 1901 to 1905a

 

Infants Fed by Each Method, %

Feeding Method

Infants Who Died (N = 118)

Surviving Infants (N = 1,822)

RR

Breast

22.0

80.8

1.0

Bottle

52.5

7.0

27.5

Mixed

25.4

9.5

9.8

a From Newman (1906).

COMMENTS: Fascinating review of evidence to 1906, including lowered infant mortality during closing of Lancashire mills secondary to cutoff of cotton during American Civil War.

ABSTRACT A-4 Infant Deaths/1,000 Births and Relative Risk (RR) of Mortality by Feeding Method, Liverpool, Englanda,b

 

Number of Infant Deaths/1,000 Births (RR), by Feeding Method

Specific Ages of Mortality

Breast

Bottle

Mixed

Up to age 1 yr

84

228 (2.71)b

134 (1.59)

Age 1–2 yr

40

99 (2.49)

36 (0.92)

a From Armstrong (1904). Period of study not reported.

b Relative risk for breastfed infants = 1.

COMMENTS: Data from 1,000 children of 224 mothers attending the Infirmary for Children; 68.9% were breastfed, 18.4% were bottle fed, and 12.7% were mixed fed to age 6 months.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

ABSTRACT A-5 Feeding Practices and Relative Risk (RR) of Epidemic Diarrhea Infant Death in a Case-Control Study in Brighton, England, 1903 to 1905a

 

Infants Fed by Each Method, %

Feeding Method

Infants Who Died (N = 121)

Surviving Infants (N = 1,259)

RR

Breast

6.5

62.3

1.0

Bottle

80.3

21.9

35.1

Mixed

5.0

15.3

3.1

Unknown

8.2

0.5

NAb

a From Newsholme (1906), as reviewed in Newman (1906).

b NA = Not applicable.

ABSTRACT A-6 Deaths/1,000 Births and Relative Risk (RR) of Mortality for Infants Aged 2 Weeks to 1 Year, by Feeding Method, Boston, 1910 a

 

Number of Infant Deaths/ 1,000 Births, by Feeding Method

Cause of Mortality

Breast

Bottle

RRb

All causes

36

218

6.06

Diarrhea

9

98

12.25

a From Davis (1913). A case-control study of 1,600 deaths, plus mail questionnaires from mothers of 736 controls. It was unclear how mixed feeding was classified.

b Relative risk for breastfed infants = 1.

ABSTRACT A-7 Death Rates/1,000 Births and Relative Risk (RR) of Death for 20,061 Infants up to 1 Year of Age Served by Welfare Clinics in Chicago, 1924 to 1929a

Feeding Method

Death Rate/ 1,000 Births

RR

Breast

1.5

1.0

Bottle

8.4

5.6

Mixed

6.9

6.9

a From Grulee et al. (1934, 1935).

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

ABSTRACT A-8 Death Rates/1,000 Births and Relative Risk (RR) of Death for 3,266 Infants Aged 7 Months or Less, Liverpool, England, 1936 to 1942a

Feeding Method

Mortality/1,000 to Age 7 Months

RR

Breast

10.2

1.0

Bottle

57.3

5.62

Mixed

25.7

2.52

a From Robinson (1951).

COMMENTS: Excludes infants with birth weights of <2 kg (4.4 lb) who were ''weakly" or whose clinic visits were discontinued before age 7 months. Mortality was attributed almost entirely to infections.

ABSTRACT A-9 Infant Deaths/1,000 Births and Relative Risk (RR) of Death, by Feeding Method and Age, Belfast, Ireland, June 1941 to June 1942a

 

Number of Infant Deaths/1,000 Births by Feeding Method

Age of Mortality, mo

Breast

Bottle

RRb

<1

7.5

103.0

13.72

1–2

5.0

38.0

7.68

2–3

3.4

43.5

12.76

3–6

5.7

43.4

7.57

6–12

7.1

36.8

5.15

a From Deeny and Murdock (1944). Results were estimated from authors' data. Based on 554 infant deaths plus 477 survivors (every fifth child during first 6 months of age).

b Relative risk for breastfed infants = 1.0.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

ABSTRACT A-10 Deaths/1,000 Births and Relative Risk (RR) of Death for 67, 738 Infants Who Survived the First Month, by Feeding Method, Age, and Cause of Death, 1943 to 1947, Stockholm, Swedena

 

Death Rate/1,000 Births (RR) by Feeding Method

Age or Cause of Mortality

Breastb

Bottle

Mixed

Age 2–12 mo

4.63

8.12 (1.75)

3.08 (0.66)

Age 3–12 mo

3.19

6.48 (2.03)

2.90 (0.91)

Congenital disease

NRc

NR (1.73)

NR

Infections

NR

NR (1.28)

NR

Respiratory disease

NR

NR (2.55)

NR

Intestinal disease

NR

NR (6.79)

NR

Other causes

NR

NR (4.79)

 

a From Mannheimer (1955).

b Relative risk for breastfed infants = 1.0.

c NR = Not reported.

COMMENTS: RRs were 3.66 and 4.32 for infants fed cow's milk exclusively from age 2 months. The apparent advantage of mixed feeding lasted less than 4 months. The apparent disadvantage of bottle feeding decreased after 6 months and was gone after 9 months. Compared with breastfed infants, a smaller proportion of bottle-fed infants received care at child welfare centers (64 and 48%, respectively). Rates were lower for mixed-fed than for breastfed infants in all categories except intestinal disease, for which they were equal. Excess deaths in the bottle-fed group were observed only among infants weighing >2,500 g at birth. Feeding method was unrelated to income.

ABSTRACT A-11 Death Rates/1,000 Births for 4,669 Infants Aged 8 Weeks to 2 Years and Relative Risk (RR) of Death by Duration of Breastfeeding, Great Britain, March 1946a

Duration of Breastfeeding, wk

Death Rate/1,000

RR

<8

18.5

1.7

≥8

10.9

1.0

a From Douglas (1950). Excludes infants from the upper classes.

COMMENTS: Among the upper classes, mortality was only slightly increased among those breastfed <8 weeks.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

ABSTRACT A-12 Case-Control Study of Feeding Methods of Infants Developing Sudden Infant Death Syndrome (SIDS) and Control Infants, Copenhagen, 1956 to 1971a

 

Feeding Method,b % (no.) of Infants

Study Group

Breast

Bottle

Mixed

Cases

60.2 (74)

20.3 (25)

19.5 (24)

Controls

79.2c (412)

7.7 (40)

13.1 (68)

a From Biering-Sørensen et al. (1978).

b Feeding histories were derived from the notes of health visitors for both the sudden infant deaths and a selection of infants used as controls.

c p < .0005.

COMMENTS: Odds ratio for bottle feeding versus any breastfeeding at 2 weeks of age = 3.06. Authors review past work on SIDS and breastfeeding. Given that breastfeeding rates declined from 1956 to 1971, but SIDS incidence did not, authors conclude relationship is not causal.

ABSTRACT A-13 Naeye and colleagues (1976) investigated feeding methods in a study of 125 infants with sudden infant death syndrome (SIDS) and 375 controls, using data from the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke, 1959 to 1966. The odds ratio for bottle feeding compared with breastfeeding was 1.30. Infants with SIDS had frequent neonatal problems, including abnormal suck, need for gavage feeding, and late initiation of bottle feeding, suggesting that the choice of feeding method may have been secondary to neonatal problems.

ABSTRACT A-14 Deaths/1,000 Births and Relative Risk (RR) of Death for 3,684 Infants Aged 1 to 12 Months, by Feeding Method, American Indians in Canada, 1962a

 

Deaths/1,000 Births, by Feeding Method

Cause of Death

Breast

Bottle

RRb

All causes

26.6

53.8

2.03

Gastrointestinal or respiratory disease

3.9

32.7

8.29

a From Department of National Health and Welfare Canada (1963), as quoted in Gerard and Tan (1978).

b Relative risk for breastfed infants = 1.0.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

ABSTRACT A-15 Carpenter and colleagues (1983) used a complex analytic method in their investigation of infant death rates between 1973 and 1979 in Sheffield, England. During that time there was a program of postnatal intervention by health visitors for high-risk infants in Sheffield. Postneonatal mortality (deaths to infants 28 days to 1 year of age) fell far more steeply in the study group than it did in all of England and Wales. Among "preventable" deaths, rates fell from 5.2 to 1.9 per 1,000 births. (Among the study group, intention to breastfeed rose from 40 to 70%.) The authors attributed 24% of the fall in the death rate, or 0.8 deaths/1,000 births, to increased rates of breastfeeding.

ABSTRACT A-16 Feeding Methods of Infants Hospitalized with Infant Botulism, Infants with Sudden Infant Death Syndrome (SIDS), and Control Infants in California (1976 to 1979) and Elsewhere in the United States Through 1978a

 

 

Feeding Methods in Study Population, %

Condition

Subject

Breast

Formula

Mixed

Infant

Cases (N = 50)

66.0b

24.0c

10.0d

botulism

Controls (N = 125)

43.2b

33.6c

23.2d

SIDS

Cases (N = 10)

0

80.0

20.0

 

Controls (N = 20)

30.0

35.0

35.0

a From Arnon et al. (1982).

b Current breastfeeding.

c Never breastfed.

d Past breastfeeding.

Case Fatality Studies

ABSTRACT A-17 Case Fatality and Relative Risk (RR) of Death by Method of Infant Feeding Among Infants Hospitalized with Diarrhea, Birmingham, Englanda

Feeding Method

Number of Infants Hospitalized

Number of Infant Deaths/1,000 Cases

RR

Breast

12

167

1.0

Bottle

209

766

4.59

Mixed

154

259

1.55

a From Smellie (1939). Of the 500 hospitalized infants, 375 were younger than 9 months of age.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

ABSTRACT A-18 Case Fatality and Relative Risk (RR) of Death Among 1,500 Infants Hospitalized with Infections, by Method of Infant Feeding, Toronto, Canadaa

Feeding Method

Number of Infants Hospitalized

Infant Deaths/ 1,000 Cases

RR

Breast

227

185

1.0

Bottleb

836

164

0.89

Mixed

437

121

0.65

a From Ebbs and Mulligan (1942).

b Never breastfed.

COMMENTS: This study is exceptional, given that higher case-fatality rates were observed among breastfed infants. The reported results may imply lower case fatalities in bottle- and mixed-fed infants but could have arisen in other ways. For example, severity of infection was lower among breastfed infants: only the most severe cases might have been hospitalized. Furthermore, the results do not imply that death rates were higher among breastfed infants: if the incidence among them was lower, the opposite could have been true. Finally, the attending clinician may have been loathe to hospitalize breastfed infants, and this also would have possibly selected for higher severity among the breastfed infants.

ABSTRACT A-19 Case Fatality and Relative Risk (RR) of Death of 216 Infants Hospitalized with Diarrhea, by Duration of Breastfeeding, Isleworth, England, 1942 and 1943a

Duration of Breastfeeding, mo

No. of Infant Deaths/1,000 Cases

RR

>1

300

1.00

<1

550

1.86

a From Gairdner (1945).

ABSTRACT A-20 Prince and Bruce (1948) investigated case fatalities among 570 infants hospitalized with diarrhea in Louisville, Ky., from 1943 to 1946. Although the overall case fatality was 11%, there were no deaths among infants still breastfed at the time of admission.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

MISCELLANEOUS STUDIES

ABSTRACT A-21 Indices of Breastfeeding Correlated with Infant Mortality in Three German States, by Location, 1869 to 1910a

 

 

 

Correlation Coefficients Between Infant Mortality and the Breastfeeding Index (number of cases)

Breastfeeding Index

Period of Breastfeeding Index

Period of Infant Mortality

State

Rural

Urban

Total

Proportion ever breastfed

1904–1906

1869–1878

Bavaria

-.80 (88)

-.87 (15)

-.81

 

1901–1905

Bavaria

-.76 (91)

-.7 (17)

-.76

 

1878–1882

Baden

-.54 (47)

NRb

-.54 (52)

Proportion  breastfed ≥6 mo

1911

1873–1875

Hessen

-.59 (19)

NR

-.55 (24)

 

1906–1910

Hessen

-.62 (19)

NR

-.61 (24)

Duration of breastfeeding

1904–1906

1869–1878

Bavaria

-.83 (76)

-.92 (14)

-.83; -.70

 

1901–1905

Bavaria

-.71 (79)

-.68 (16)

 

a From Knodel and van de Walle (1967).

b NR = Not reported.

ABSTRACT A-22 In a reanalysis of data of Groth and Hahn (1910), Greenwood and Brown (1912) reported a correlation of .76 ± 0.03 between the bottle-feeding rates and infant death rates from 92 districts of the Kingdom of Bavaria, Germany, between 1900 and 1904.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

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Naeye, R.L., B. Ladis, and J.S. Drage. 1976. Sudden infant death syndrome: a prospective study. Am. J. Dis. Child. 130:1207-1210.

Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
×

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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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Suggested Citation:"A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality." Institute of Medicine. 1991. Nutrition During Lactation. Washington, DC: The National Academies Press. doi: 10.17226/1577.
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On the basis of a comprehensive literature review and analysis, Nutrition During Lactation points out specific directions for needed research in understanding the relationship between the nutrition of healthy mothers and the outcomes of lactation. Of widest interest are the committee's clear-cut recommendations for mothers and health care providers.

The volume presents data on who among U.S. mothers is breastfeeding, a critical evaluation of methods for assessing the nutritional status of lactating women, and an analysis of how to relate the mother's nutrition to the volume and composition of the milk.

Available data on the links between a mother's nutrition and the nutrition and growth of her infant and current information on the risk of transmission through breastfeeding of allergic diseases, environmental toxins, and certain viruses (including the HIV virus) are included. Nutrition During Lactation also studies the effects of maternal cigarette smoking, drug use, and alcohol consumption.

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