PubMed · 5879136
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N P Masse. 1965. [Maternal feeding].. https://pubmed.ncbi.nlm.nih.gov/5879136/
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OBJECTIVE: To assess the impact of a continuing medical education program based on the WHO's 10 steps to successful breast-feeding. STUDY DESIGN: An observational before-and-after study at a teaching hospital. Data for two random samples of 50 women before and 50 after the intervention were collected from medical records and completed by a mail questionnaire. RESULTS: Seventy-six percent of mothers initiated breast-feeding in the two samples. The median duration of breast-feeding was 12 weeks and did not differ between the before and after groups. The percentage of newborns separated from their mother more than 4h a night decreased substantially after the intervention (13% versus 52% before the intervention, P<0.01). In-hospital formula provision also decreased after the intervention (63% of newborns versus 82% before intervention, P=0.07). CONCLUSION: This pilot study has enabled authors to document the feasibility of evaluating the impact of continuing education of maternity ward staff.
The aim of this study was to examine prospectively the relation between duration of breast feeding and cognitive outcomes. A cohort study of 2860 children enrolled before birth provided data from 2393 term infants of English-speaking mothers. Of these, complete infant feeding data in the first year of life and verbal cognitive IQ (Peabody Picture Vocabulary Test - PPVT-R) were available for 1450 children at 6 years, and a performance subtest (Perceptual organisation WISC - Block Design) for 1375 children at 8 years. Full breast feeding was categorised as none,> 0 to < 4 months, 4-6 months and> 6 months. Associations between breast-feeding duration and PPVT-R at 6 years and Block Design at 8 years were estimated before and after adjustment for gender, gestational age, maternal age, maternal education, parental smoking and the presence of older siblings. The early cessation of full breast feeding was associated with reduced verbal IQ and the performance subtest. In unadjusted analysis, mean standardised PPVT-R scores were 6.44 points greater (P < 0.0001) in children fully breast fed for> 6 months compared with those never breast fed. After adjustment, mean PPVT-R scores were 3.56 points higher in children fully breast fed for> 6 months compared with those children never breast fed (P = 0.003). Similarly, Block Design scores were higher in those fully breast fed for> 6 months compared with those never breast fed in unadjusted (P = 0.001) but not adjusted analyses (P = 0.223). Interactions between maternal education (four levels) and breast feeding demonstrated a positive association of maternal education on verbal IQ (F = 2.64; P = 0.005) in children breast fed for longer but not on performance (F = 0.74; P = 0.67). The early introduction of milk other than breast milk was associated with reduced verbal IQ after adjustment for social and perinatal confounders. Although these effects were interacting with maternal education, they may act through undefined mechanisms in human milk.
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