Continued breastfeeding and child growth in the second year of life: a prospective cohort study in western Kenya.
BACKGROUND
The value of postinfancy breastfeeding for growth and nutritional status is debated. We have investigated this issue in a longitudinal study.


METHODS
We prospectively followed up a cohort of 264 children in western Kenya for 6 months (mean age 14 months [range 9-18] at baseline) to investigate the nature of the association between breastfeeding and growth. Only 14 (5.3%) children had been weaned at baseline, and 173 (65.5%) were still breastfed at follow-up. For analysis, children were classified into three groups of breastfeeding duration as a proportion of the total follow-up period (0-49%, n=42; 50-99%, n=49; and 100%, n=173).


RESULTS
In general linear models multivariate analysis, children in the longest-duration breastfeeding group gained 3.4 cm (p=0.0001) and 370 g (p=0.005) more than those in the shortest duration group, and 0.6 cm (p=0.0015) and 230 g (p=0.038) more than children in the intermediate group. The strongest association between breastfeeding and linear growth was observed in households that had no latrine and daily water use of less than 10 L per person.


CONCLUSIONS
Our findings support WHO's recommendation to continue breastfeeding for at least 2 years, especially in settings with poor sanitation and inadequate water supply.
Onyango
A W
AW
Department of Nutrition, WHO, Geneva, Switzerland.
Esrey
S A
SA
Kramer
M S
MS
D001827:Body Height; D001835:Body Weight; D001942:Breast Feeding; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007630:Kenya; D008137:Longitudinal Studies; D008297:Male; D009752:Nutritional Status; D011446:Prospective Studies; D012959:Socioeconomic Factors; D014886:Weaning