Unsupplemented breastfeeding in the maternity ward. Positive long-term effects

Feeding routines in the maternity ward were investigated in 204 mother-infant pairs before and in 203 after a change towards earlier, more frequent breastfeeding and elimination of routine substitute feeds. In the intervention group, the volume of breast-milk increased, while the use of formula and sugar solution decreased correspondingly. The infants in the intervention group lost more weight during the first 2-3 days (6.4% versus 4.6%), but regained their birth weight faster than the supplemented control group. The incidence of hyperbilirubinemia was not significantly different in the two groups. No cases of hypoglycemia were diagnosed. At 6 months, 87% of the infants in the intervention group were still fed at the breast, compared with 66% in the control group. The weight curves were comparable up to 9 months, when intervention group infants were found to weigh slightly less. These follow-up results must be interpreted with some caution due to the low but comparable response rate of the two groups. Thus the intervention study demonstrated that healthy, full-term infants usually have no need for supplements to their mothers' milk provided they have had a satisfactory start in life with early and frequent feeds at the breast. The follow-up study indicated that a more "physiological" start of breastfeeding may have had a positive long term effect on the overall duration of the lactational period.