Infant Feeding Comparisons: A Hazard to Infant Health?

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Abstract
Most investigators accept that infant feeding practices influence infant health in developing countries; however, it is widely believed that in developed countries, no difference in health is found between feeding groups when good hygiene is practiced. We question this conclusion, which may simply reflect poor research whose fundamental flaw is the lack of clear distinctions between feeding categories. Using forty-three research studies published in a variety of professional journals from 1934 through 1990, we review the feeding group definitions used and the findings derived. We then comment on the relationship between the feeding group comparisons and conclusions drawn from the findings. We conclude that disarray plagues most discussions of the relationship between infant feeding groups and other variables, such as maternal feeding choice and infant morbidity and mortality. As a result, nearly all findings deriving from such studies deserve serious challenge. We recommend insistence upon careful and consistent infant feeding categories in order to reduce the frequency with which methodologically flawed studies are published and subsequently influence clinical practice.