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April 25, 2003

Exclusive Breastfeeding Training For Mothers Helps Reduce Diarrheal Disease Among Infants

Reducing diarrheal disease among infants in less-developed countries could be assisted with the implementation of straightforward community-based health programs that promote exclusive breastfeeding for the first six months after childbirth, according to a study published in the April 26, 2003, edition of The Lancet. Robert Black, MD, MPH, professor and chair of the School’s Department of International Health, Maharaj Bhan, MD, of the All India Institute of Medical Sciences in New Delhi, India and other colleagues assessed the feasibility, effectiveness, and safety of an educational intervention to promote exclusive breastfeeding in a rural Indian community.

The study found that exclusive breastfeeding rates were higher (79 percent) for mothers who received counseling compared with the control group (46 percent) not receiving counseling. Diarrhea was reduced by one-third among the infants who were breastfed during the first three months of age and by nearly 15 percent at six months of age. There were no differences between the two groups in length or weight of the infants, or among a subgroup of infants born at low-birth weight.

The World Health Organization (WHO) recommends exclusive breastfeeding until six months of age for infants in less-developed countries. Previous research suggests that exclusive breastfeeding for the first six months can protect against diarrheal disease, although there are concerns that exclusive breastfeeding could be associated with reduced infant growth.

For the study, researchers trained health-care workers to provide exclusive breastfeeding counseling within the existing health care infrastructure. Next, the researchers selected 1,115 new mothers at random to either receive the breastfeeding counseling or be part of the control group. The researchers say their findings are especially important since behavior change was achieved with an approach that is feasible on a large scale and can be implemented through current health and nutrition services.

Research was conducted by scientists at the Johns Hopkins Bloomberg School of Public Health, the Department of Pediatrics of the All India Institute of Medical Sciences, and the Department of Child and Adolescent Health and Development, World Health Organization.

The study was supported by the Johns Hopkins Family Health and Child Survival Cooperative Agreement and the World Health Organization Cooperative Agreement with funding from USAID.

Public Affairs Media Contacts for the Johns Hopkins Bloomberg School of Public Health: Tim Parsons or Kenna Brigham at 410-955-6878 or
Public Affairs Contact for the Department of International Health: Gina Coco at 410-614-5439 or