Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1994 May 28;308(6941):1403–1406. doi: 10.1136/bmj.308.6941.1403

Prolonged breast feeding, diarrhoeal disease, and survival of children in Guinea-Bissau.

K Mølbak 1, A Gottschau 1, P Aaby 1, N Højlyng 1, L Ingholt 1, A P da Silva 1
PMCID: PMC2540341  PMID: 8019249

Abstract

OBJECTIVE--To analyse the impact of breast feeding on diarrhoeal disease and survival in children above 1 year of age in Guinea-Bissau, west Africa. DESIGN--A community study of an open cohort followed up weekly by interviews over 15 months. Data on feeding practices, anthropometry, and survival were recorded for three years. SETTING--301 randomly selected houses in a semiurban area in the capital, Bissau. SUBJECTS--849 children aged less than 3 years. MAIN OUTCOME MEASURES--Incidence and duration of diarrhoea, weight for age, and death of a child. RESULTS--The incidence of diarrhoea was higher in weaned children than in partially breast fed children, both in 1 year olds (relative risk 1.41; 95% confidence interval 1.23 to 1.62) and in 2 year olds (1.67; 1.29 to 2.15). The mean duration of an episode of diarrhoea was 5.3 days in breast fed children compared with 6.3 days in weaned children (P = 0.001). Independent of the age of weaning, a similar increase was found in an analysis comparing, for each child, the rate and duration of diarrhoea one month before and one month after weaning. Children with low weight for age were breast fed longer than the better nourished children (P = 0.02). Children aged 12-35 months who were not breast fed had a 3.5 times higher mortality (1.4 to 8.3) than breast fed children. CONCLUSIONS--The beneficial effects of breast feeding are not restricted to infancy. Though children who are partially breast fed after infancy may have a lower state of nutrition than the weaned ones, the benefit in terms of lower morbidity may be more important for child survival in places with a high morbidity from diarrhoea and with high mortality.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brakohiapa L. A., Yartey J., Bille A., Harrison E., Quansah E., Armar M. A., Kishi K., Yamamoto S. Does prolonged breastfeeding adversely affect a child's nutritional status? Lancet. 1988 Aug 20;2(8608):416–418. doi: 10.1016/s0140-6736(88)90411-4. [DOI] [PubMed] [Google Scholar]
  2. Briend A., Wojtyniak B., Rowland M. G. Breast feeding, nutritional state, and child survival in rural Bangladesh. Br Med J (Clin Res Ed) 1988 Mar 26;296(6626):879–882. doi: 10.1136/bmj.296.6626.879. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brown K. H., Black R. E., Lopez de Romaña G., Creed de Kanashiro H. Infant-feeding practices and their relationship with diarrheal and other diseases in Huascar (Lima), Peru. Pediatrics. 1989 Jan;83(1):31–40. [PubMed] [Google Scholar]
  4. Clemens J. D., Stanton B., Stoll B., Shahid N. S., Banu H., Chowdhury A. K. Breast feeding as a determinant of severity in shigellosis. Evidence for protection throughout the first three years of life in Bangladeshi children. Am J Epidemiol. 1986 Apr;123(4):710–720. doi: 10.1093/oxfordjournals.aje.a114291. [DOI] [PubMed] [Google Scholar]
  5. Dettwyler K. A. Breastfeeding and weaning in Mali: cultural context and hard data. Soc Sci Med. 1987;24(8):633–644. doi: 10.1016/0277-9536(87)90306-6. [DOI] [PubMed] [Google Scholar]
  6. Feachem R. G., Koblinsky M. A. Interventions for the control of diarrhoeal diseases among young children: promotion of breast-feeding. Bull World Health Organ. 1984;62(2):271–291. [PMC free article] [PubMed] [Google Scholar]
  7. Goldman A. S., Goldblum R. M., Garza C., Nichols B. L., Smith E. O. Immunologic components in human milk during weaning. Acta Paediatr Scand. 1983 Jan;72(1):133–134. doi: 10.1111/j.1651-2227.1983.tb09679.x. [DOI] [PubMed] [Google Scholar]
  8. Habicht J. P., DaVanzo J., Butz W. P. Does breastfeeding really save lives, or are apparent benefits due to biases? Am J Epidemiol. 1986 Feb;123(2):279–290. doi: 10.1093/oxfordjournals.aje.a114236. [DOI] [PubMed] [Google Scholar]
  9. Huttly S. R., Blum D., Kirkwood B. R., Emeh R. N., Feachem R. G. The epidemiology of acute diarrhoea in a rural community in Imo State, Nigeria. Trans R Soc Trop Med Hyg. 1987;81(5):865–870. doi: 10.1016/0035-9203(87)90055-1. [DOI] [PubMed] [Google Scholar]
  10. Mata L. J., Kronmal R. A., García B., Butler W., Urrutia J. J., Murillo S. Breast-feeding, weaning and the diarrhoeal syndrome in a Guatemalan Indian village. Ciba Found Symp. 1976;(42):311–338. doi: 10.1002/9780470720240.ch17. [DOI] [PubMed] [Google Scholar]
  11. Mølbak K., Aaby P., Ingholt L., Højlyng N., Gottschau A., Andersen H., Brink L., Gansted U., Permin A., Vollmer A. Persistent and acute diarrhoea as the leading causes of child mortality in urban Guinea Bissau. Trans R Soc Trop Med Hyg. 1992 Mar-Apr;86(2):216–220. doi: 10.1016/0035-9203(92)90580-6. [DOI] [PubMed] [Google Scholar]
  12. Mølbak K., Højlyng N., Ingholt L., Da Silva A. P., Jepsen S., Aaby P. An epidemic outbreak of cryptosporidiosis: a prospective community study from Guinea Bissau. Pediatr Infect Dis J. 1990 Aug;9(8):566–570. doi: 10.1097/00006454-199008000-00008. [DOI] [PubMed] [Google Scholar]
  13. Value of prolonged breastfeeding. Lancet. 1988 Oct 1;2(8614):788–789. [PubMed] [Google Scholar]
  14. Victora C. G., Smith P. G., Vaughan J. P., Nobre L. C., Lombardi C., Teixeira A. M., Fuchs S. M., Moreira L. B., Gigante L. P., Barros F. C. Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil. Lancet. 1987 Aug 8;2(8554):319–322. doi: 10.1016/s0140-6736(87)90902-0. [DOI] [PubMed] [Google Scholar]
  15. Victora C. G., Vaughan J. P., Martines J. C., Barcelos L. B. Is prolonged breast-feeding associated with malnutrition? Am J Clin Nutr. 1984 Feb;39(2):307–314. doi: 10.1093/ajcn/39.2.307. [DOI] [PubMed] [Google Scholar]
  16. Wyatt R. G., Garcia B., Cáceres A., Mata L. J. Immunoglobulins and antibodies in colostrum and milk of Guatemalan mayan women. Arch Latinoam Nutr. 1972 Dec;22(4):629–644. [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES