title: Early initiation of breastfeeding and the risk of infant diarrhea in rural Egypt.
abstract: BACKGROUND
  Initiation of breastfeeding shortly after delivery may enhance breastfeeding's protective effect against diarrhea because of the protective properties of human colostrum contained in early breast milk.
  
  
  OBJECTIVE
  To evaluate whether initiation of breastfeeding within the first 3 days of life, when breast milk contains colostrum, was associated with a lower rate of diarrhea in rural Egyptian infants during the first 6 months of life.
  
  
  METHODS
  Infants initially breastfed (n = 198) were monitored prospectively with twice-weekly home visits to ascertain dietary practices and diarrheal illnesses.
  
  
  RESULTS
  The burden of diarrhea during the first 6 months of life in the cohort was high: seven episodes per child-year of follow-up. Only 151 (76%) infants initiated breastfeeding during the first 3 days of life ("early initiation"). Infants in whom breastfeeding was initiated early had a 26% (95% CI: 2%,44%) lower rate of diarrhea than those initiated late. The protective association between early initiation and diarrhea was independent of the pattern of postinitiation dietary practices and was evident throughout the first 6 months of life.
  
  
  CONCLUSIONS
  Early initiation of breastfeeding was associated with a marked reduction of the rate of diarrhea throughout the first 6 months of life, possibly because of the salutary effects of human colostrum. These data highlight the need for interventions to encourage early initiation of breastfeeding in less developed settings.
authors.affiliation: National Institute of Child Health and Human Development, Bethesda, Maryland 20892, USA. clemensj@exchange.nih.gov
authors.forename: J
authors.initials: J
authors.lastname: Clemens
authors.forename: R A
authors.initials: RA
authors.lastname: Elyazeed
authors.forename: M
authors.initials: M
authors.lastname: Rao
authors.forename: S
authors.initials: S
authors.lastname: Savarino
authors.forename: B Z
authors.initials: BZ
authors.lastname: Morsy
authors.forename: Y
authors.initials: Y
authors.lastname: Kim
authors.forename: T
authors.initials: T
authors.lastname: Wierzba
authors.forename: A
authors.initials: A
authors.lastname: Naficy
authors.forename: Y J
authors.initials: YJ
authors.lastname: Lee
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data; D015331:Cohort Studies; D003126:Colostrum / Q000276:immunology; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000517:prevention & control*; D004534:Egypt; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D012423:Rural Health; D016019:Survival Analysis; D013997:Time Factors