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06-06-2011 | General practice | Article

Study highlights risks of inadequate breastfeeding in neonates


Free abstract

MedWire News: Breastfeeding during the initial 3 days of life has a significant impact on the degree of jaundice, the amount of body weight lost (BWL), and the frequency of urine and stool passage in neonates, show Taiwanese study results.

Infants who are exclusively formula-fed have better outcomes in all of these parameters compared with their peers who are exclusively breastfed, indicate the findings.

Shu-Jen Chen, from Taipei Veterans General Hospital, and co-workers evaluated the influence of breastfeeding on 313 mother-neonate pairs during the infants' first week of life, at their institution, which promotes the World Health Organization's "Baby-Friendly Hospital Initiative." The initiative includes provision of breastfeeding classes, 24-hour rooming-in, and encouragement of exclusive breastfeeding.

In all, 161 babies were exclusively breastfed, 80 received breast and formula feeds (mixed-fed), and 72 received exclusively formula.

Infants were checked for total serum bilirubin (TSB levels) at 3-4 days after birth to rule out, and if necessary, follow-up for jaundice (at least 8 mg/dl). Average TSB levels at 3 days were 11.4, 10.0, and 8.7 mg/dl in the breastfeeding, mixed, and formula-fed groups, respectively.

The corresponding visible jaundice rates for these groups were 93.1%, 88.5%, and 66.2% and the difference between exclusively breastfed and exclusively formula-fed infants was statistically significant.

Average BWLs at 2 and 3 days old were significantly different according to feeding methods, with more breastfed babies than mixed-fed and formula-fed babies experiencing losses of greater than 10% (deemed physiologically unacceptable in neonates), at 10%, 3.8%, and 0%, respectively.

Nonetheless, the study authors suggest that "if infants have appropriate breastfeeding, there is no need to worry about their growth, including transient BWL."

Multiple comparison analysis showed that the average frequency of stool and urine passage at 2 and 3 days old was significantly decreased in the breastfed-only group compared with the mixed-fed and formula-fed groups.

However, after day 3 of life, stool passage and urination both increased gradually and surpassed that of formula-fed infants by day 6 after birth, remark Chen et al in the journal Pediatrics and Neonatology.

"Whether it is a natural course for the exclusively breastfed infants merits further study because the frequency of both stool passage and urination for the formula-fed infants is not the standard against which to measure that for the exclusively breastfed infants," they add.

"Maternal breastfeeding education and careful follow-up of breastfed infants are two crucial interventions required to help prevent inadequate breastfeeding," conclude the authors.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Sarah Guy

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