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There is documented evidence of increased risk of infant mortality in formula-fed versus breast-fed infants and young children. The potential danger especially in resource-poor settings with poor water and sanitation conditions is well known. In reducing risks associated with the sanitation of feeding equipment, bottle-feeding is often discouraged with cup and spoon promoted as better alternatives. To determine the characteristics of caregivers and households with bottle-fed young under-twos in a rural community of Kisumu East district, a cross-sectional descriptive survey using a structured questionnaire was carried out. The data were analyzed using SPSS version 17.0. Frequencies for non-continuous data were obtained and the relationship between the background variables and the bottle-feeding of the infant/child was established through the chi-square test. A total of 494 caregivers with young ones, under-twos, were interviewed. The findings from the study showed that of the 406 respondents addressing questions on bottle-feeding the previous night prior to the survey, 91 (22.4%) were practicing infant bottle-feeding. Answers to the question 'who assisted the mother during delivery', revealed that 88 children were bottle-fed, 38(43.2%) of whom were delivered under skilled attendance while out of the 314 children not bottle-fed, 145 (46.2%) were delivered under skilled attendance. Some of the indicators found to be significantly different included: main source of household income which was found to be significantly associated (p = 0.044) with bottle-feeding, child's age was significantly (P = 0.008) different with respect to bottle-feeding and breast-feeding initiation after birth was significantly (p = 0.004) associated with bottle-feeding. The tendency to bottle-feed was lower among those with complete immunization status compared to those with incomplete immunization. This association with immunization indicates that facility delivery coupled with faithfulness in visits throughout the immunization schedule, promotes contact with the health facility staff and potentially has a significant role in promoting good infant and child feeding practices. In conclusion, infant/young child bottle-feeding is still a public health issue in resource-poor settings. Promotion of safe infant/young child feeding practices for improving nutritional and health status of children especially in the resource-poor settings should be advocated especially where bottle-feeding is still in high use. There is need for community-based strategies to bring about a change that addresses the current prevalence of bottle-feeding found in the study area. Key words: Bottle-feeding, Caregivers, Exclusive breast-feeding, infant, INTRODUCTION Infant and Young Child Feeding (IYCF) comprises various dimensions, namely: the type, the quality, the texture, the nutrient density, the frequency of feeding and the diversity of the diet. [...]

A community initiative to promote breastfeeding may be highly effective at reducing rates of infant illness. Researchers compared illness rates in 977 infants born before a breastfeeding promotion program and 858 infants born during the program. The proportion of infants exclusively breastfed rose from 16% to 55% after the program. The incidence of infant pneumonia fell 32%, and the rate of gastrointestinal infection fell 15%, after breastfeeding was promoted. In communities where breastfeeding is not common, promotion of the practice may enhance child health., Objective. Although breastfeeding is associated with lower rates of a variety of infant illnesses, skeptics have suggested that much of the association is attributable to confounding, even after appropriate statistical adjustment. This article utilizes a novel design to investigate changes in infant illness at the community level after a successful breastfeeding promotion program. Methods. In this population-based cohort study, the medical records of all infants born in one Navajo community the year before a breastfeeding promotion program (n = 977) and the year during the intervention (n = 858) were reviewed. Outcomes assessed include changes after the intervention in: proportion breastfeeding and/or breastfeeding exclusively; incidence of common infant illnesses in the first year of life; and feeding-group specific incidence of illness. Results. The proportion of women breastfeeding exclusively for any period of time increased from 16.4% to 54.6% after the intervention. The percent of children having pneumonia and gastroenteritis declined 32.2% and 14.6%, respectively, after the intervention. Feeding-group specific rates of these illnesses were unchanged, indicating that the decline observed was attributable to the increased proportion of infants breastfeeding. In contrast, rates of croup and bronchiolitis increased after the intervention among those fed formula from birth, suggesting a viral epidemic which was limited to those never exclusively breastfed. Finally, sepsis declined in both formula-fed and breastfed infants after the intervention, suggesting that other factors affected this illness outcome after the intervention. Conclusions. Increasing the proportion of exclusively breastfed infants seems to be an effective means of reducing infant illness at the community level. The experimental design suggests that the increased incidence of illness among minimally breastfed infants is causally related to lack of breast milk, rather than being attributable to confounding. Pediatrics 1998;101:837-844; breastfeeding, infection, infant illness, causality, health promotion, respiratory tract infections, gastroenteritis. ABBREVIATION. IHS, Indian Health Service., Breastfeeding has been associated with lower rates of a variety of infant illnesses' including wheezing lower respiratory tract illnesses,[2] pneumonia[3] upper respiratory tract illnesses,[4] otitis media, [5,6] gastroenteritis,[4,7] meningitis,[8] and [...]

Breastfeeding may provide protective health benefits to urban poor infants. One hundred sixteen bottle-feeding or breastfeeding mothers supported by the Women, Infants, and Children program completed questionnaires detailing personal demographic and infant health information. Breastfed infants had fewer infections and other health complications than did bottle-fed infants. More breastfeeding mothers had higher incomes and they were more often older or white.

A study was conducted in Cebu City, Philippines, to examine the effects of the infant formula industry's marketing efforts on infant health via their influence on mothers' infant-feeding patterns. The study protocol involved measurement of marketing activity and monitoring of infant-feeding through the first six months of the infants' lives. The results show that pervasive marketing of infant formula and related products causes reduction in breast feeding. This could have negative effects on the health of infants, particularly those from poor families whose mothers do not have the education nor the resources to bottle-feed in the proper way.

An infant's intake of solid foods may be affected by exposure to the new food and breast feeding experience. Researchers assigned 36 infants to be fed either a salted or unsalted vegetable once a day for 10 days. They measured the infants' intake before, immediately after and one week after the 10-day exposure period. After 10 exposures, all infants significantly increased their consumption of vegetables. Infants exposed to salted vegetables increased their average intake from 28 to 63 grams (g), while those exposed to unsalted food increased from 36 g to 58 g. Breast-fed infants increased their average intake from 39 g to 72 g after the 10-day exposure period and to 94 g after one week's delay. In contrast, formula-fed infants showed a less dramatic increase from an average of 25 g to 46 g and remained stable after the delay. Adult ratings of infants' liking matched increased consumption of the vegetable by the infants., Objective. To examine the effects of dietary experience and milk feeding regimen on acceptance of their first vegetable by 4- to 6-months-olds infants. Design. Longitudinal study, of 26-days duration, observing infants aged 4 to 6 months at the start of the study. Random assignment to treatments, within-subject control. Setting. General community in a medium-sized mid-western town. Subjects. Thirty-six infants and their mothers. Subjects were solicited through birth records and advertisements in local newspapers. Interventions. infants were randomly assigned to be fed one vegetable on 10 occasions, either salted or unsalted peas or green beans, for a 10-day period. Outcome measures. Infant make of the vegetable consumed during the 10-day exposure period; intake of salted and unsalted versions: (1) before the 10-day exposure period, (2) immediately after the exposure period; and (3) after a 1-week period of delay. Intake of a control food was also measured before and after repeated consumption of the vegetable. Adult ratings of the infants&apos; videotaped responses during test feedings were also obtained before and after the exposure period. Results. After 10 opportunities to consume the vegetable, all infants significantly increased their intake (P < .001). Although they did not differ initially, infants fed breast milk showed greater increases in intake of the vegetable after exposure and had an overall greater level of intake than formula-fed infants. Adult ratings of the infants&apos; nonverbal responses correlated positively with infant intake. Conclusions. Infants increase their acceptance (reflected both in changes in intake and in behavioral response) of a novel food after repeated dietary exposure to that food. Relative to formula-feeding, breast-feeding may facilitate the acceptance of solid foods. Pediatrics 1994;93:271-277; Infants feeding, solid foods, breast-feeding.

More research is needed to determine what relationship exists between infant feeding practices and nursing caries. Nursing caries is the designation given to dental decay that affects the baby's incisors and primary molars. In a cross-sectional study in a hospital-based general pediatric clinic, nursing caries were found in 20% of the children, 90% of whom were bottle-feeding at 12 and 18 months of age. Although more infants with caries had been breast-fed, they had not breast-fed longer than the infants who did not have caries. There were no differences between the groups in topical fluoride use, dental hygiene practices or visits to the dentist. However, children with caries were less likely to drink fluoridated tap water. No direct relationship was found between feeding method and nursing caries, suggesting the need for well-designed prospective studies of the cause of early caries.

This paper discusses the literature dealing with breast-feeding in women with human immunodeficiency virus (HIV) infection. This review is used to develop a background for a quantitative assessment of factors determining whether breast-feeding or bottle-feeding will result in a lower overall mortality in areas of different HIV prevalence. An algebraic formula is presented that enables calculation of the mortality that would result in any population if the following variables are known or capable of estimation: portion of child-bearing women infected with HIV, portion of newborns infected with HIV at birth, relative mortality of breast-fed and bottle-fed infants that are not HIV infected, and transmissibility of HIV during breast-feeding. The information available for estimating these variables is incomplete. Nevertheless, boundaries can be set for each variable, based on information obtained locally or from the literature, to aid in objective evaluation of the risks of promoting bottle-feeding or breast-feeding in populations with different risk characteristics. Consideration of these factors indicates that the benefits of breast-feeding over bottle-feeding can substantially outweigh any putative risk of HIV transmission during breast-feeding unless the prevalence of HIV infection is quite high or the difference in mortality of breast-fed and bottle-fed infants is very low. Pediatrics 1992;89:290-296; human immunodeficiency virus, infant mortality, breast-feeding, bottle-feeding, pregnancy, mathematical modeling.

Infant health and survival are increasingly threatened by AIDS, particularly in countries where the main routes of human immunodeficiency virus (HIV) transmission are heterosexual and from mother to infant around the time of birth. An infant can contract AIDS before, during, or after birth from his infected mother; it is estimated that 24 to 46 percent of babies born to HIV-positive mothers are infected before or during birth. Experts are debating whether the remaining infants (54 to 76 percent) can be safely breast-fed. Cases have been reported in which HIV was apparently transmitted to an infant through breast feeding, and HIV has been found in human milk. In developed countries where safe, nutritious alternatives to breast-feeding are available, infected mothers should be advised not to breast-feed. The decision is not as simple in developing countries, where the safety of alternatives is questionable because of contamination of formula with unsafe water. The authors have analyzed the relative health risks of breast-feeding, bottle-feeding, and wet-nursing (hiring a woman other than the baby's mother to breast-feed) for infants of HIV-infected mothers. It is concluded that in developing countries, an HIV-infected mother should be advised to nurse if the child mortality rate from causes other than AIDS is 100 per 1,000 and the probability of HIV transmission via breast milk less than 0.12. This is based upon consideration of the health risks of wet-nursing as an alternative, which is safer than bottle-feeding. Recommendations have been made for different scenarios in which the child mortality, risk of HIV transmission, and health risk from bottle-feeding or wet-nursing are varied. The study represents the first attempt to quantify these risks to determine the safest feeding method for infants of mothers infected with HIV. (Consumer Summary produced by Reliance Medical Information, Inc.)

The health advantages of breast-feeding over formula-feeding have been investigated for many years. In developing countries, protection against infection is clearly evident in breast-fed infants. The same effect has not been so clearly observed in more developed countries, but a possible benefit may have been obscured by the methods by which infections in breast-fed children were studied. These methodological problems were addressed in this study by using very specific criteria for diagnosis of infections, adjusting the results for variables such as social class, closely monitoring the infants under study, and applying statistical strategies which were appropriate for this type of complex study. In Denmark, 500 infants were evaluated monthly for one year by means of a detailed questionnaire sent to the mothers; 73 percent of the forms were returned. The questions addressed current feeding method and recent illnesses. Infants who were mostly or exclusively breast-fed were compared with formula-fed babies in terms of the frequency of four types of infection: ear, upper respiratory, lower respiratory, and gastrointestinal. The results showed no substantial protective effect of breast-feeding against infection in a middle-class population in a developed country. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aims: To assess the effects of breast feeding habits on sudden infant death syndrome (SIDS). Methods: The analyses are based on data from the Nordic Epidemiological SIDS Study, a case-control [...]

Baby bottle tooth decay (BBTD) is a preventable dental disease characterized by a unique pattern of dental decay that affects the upper primary incisors followed by the primary molars[1-8]. BBTD […]

Introduction Diarrhoea remains one of the commonest illnesses among infants, and is also one of the major causes of mortality in developing countries (1). Infants who are not breast-fed exhibit [...], Reported are the results of a study in Sao Paulo, Brazil, to evaluate the bacterial contamination of the lacteal contents of feeding bottles prepared in urban households of low (LSE) and high (HSE) socioeconomic groups, involving 100 and 32 mothers of infants, respectively. Samples of the lacteal contents of the feeding bottles were cultured and the medians (25th and 75th percentiles) of the counts (bacteria per mi) were significantly higher in the LSE group: mesophilic bacteria, 555000 (17250-4350 000) in the LSE group and 1615 (20-500000) in the HSE group; coliforms, 2400 (19-150000) in the LSE group and 7 (0-7800) in the HSE group. Escherichia coli was isolated from 26% (26/100) of the samples from the LSE group and from 6% (2/32) of those from the HSE group (P = 0.03). In the HSE group, higher coliform counts were associated with foodhandlers other than the mother, lower levels of maternal education, the use of pasteurized milk, and the addition of ingredients other than milk. In the LSE group, feeding bottles prepared using tap water and those prepared for infants aged over 6 months had higher coliform counts. In general, the feeding bottles prepared in the households studied were heavily contaminated, especially in the LSE group.

Preventing Baby Bottle Tooth Decay in American Indian and Alaska Native Communities: A Model for Planning Synopsis Baby bottle tooth decay (BBTD) is a preventable dental disease which surveys have […]