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Lori B. Feldman-Winter, MD, Department of Pediatrics, The Children's Regional Hospital at Cooper, 401 Haddon Avenue, Room 366, Camden, NJ 08103, 856-757-7729, winterlb@umdnj.edu, Anne Merewood, MA, IBCLC, Division of General Pediatrics, Boston University School of Medicine, Maternity Building, 4th Floor, 91 East Concord St., Boston, MA 02118, and Suzanne G Haynes, PhD, Department of Health and Human Services, Office of Women's Health, Hubert-Humphrey Building Room 719 E, 200 Independence Avenue, S.W., Washington, D.C., DC 20201.
Background: The National Breastfeeding Awareness Campaign launched in June 2004, as the first national public health campaign for breastfeeding since 1911. Objectives: To: 1. Describe the science behind the Campaign’s 'risk-based' strategy; 2.Elucidate risks of not breastfeeding based on ear infections, respiratory illnesses; gastrointestinal disease and obesity; 3. Explore reasons for excluding epidemiological evidence on leukemia and diabetes; 4. To set new standards for breastfeeding research. Methods: To create a scientific basis for Campaign messages, an expert panel reviewed all breastfeeding-related studies in developed countries between January 1990 and March 2004 with at least 100 infants, clear definitions of breastfeeding duration, and analyzed for breastfeeding for 6 months or more. Studies were excluded for failure to adjust for key confounding variables. The risks of not breastfeeding for several diseases were calculated for the first time. Results. Based on studies validated by above criteria, risk ratios of not breastfeeding were: ear infections (1.6 – 2.4); hospitalizations for respiratory illnesses (1.3 – 2.2); gastrointestinal disease (1.8-1.9); obesity (1.2 – 3.0). 10 leukemia studies were reviewed, only 2 were well designed. 6 diabetes studies were reviewed, 4 showed a risk of not breastfeeding and 2 did not. Experts preferred to wait for results from the TRIGR controlled clinical trial. Risk ratios were not included in campaign messages because these data came from non-controlled studies. Conclusion. 1. Future research on outcomes related to not breastfeeding should be designed using controlled trials. 2. A standardized definition of exclusive breastfeeding is critical to future breastfeeding research.
Learning Objectives:
Keywords: Epidemiology, Breast Feeding
Related Web page: www.4woman.gov
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
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