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First Time Epidemiological Evidence: Beginning Breastfeeding From First Day of Life Reduces Infection Related Deaths in Newborns by 2.6 times.Enough scientific evidence is available for the benefits of exclusive breastfeeding. This is the first epidemiologic evidence of such a causal association between early breastfeeding and infection specific mortality in the newborn infants. Edmonds at al, in the October 2007 issue of the American Journal of Clinical Nutrition, (Am J Clin Nutr 2007;86: 1126 -31), show that those newborns in Ghana, who initiated breastfeeding within 1 hour were less likely to die of neonatal sepsis than those who didn't. It is intuitively correct but this is the first time a study has demonstrated this with good data and specifically infection specific mortality. In the study period, 140 neonates died from day 2 to day 28; 93 died of infection and 47 of non-infectious causes. Risk of infection deaths increased with increasing delay in initiation of breastfeeding from 1 hour to day 7; overall late initiation (after day 1) was associated with a 2.6-fold risk [adjusted odds ratio (adj OR): 2.61; 95% CI: 1.68, 4.04]. Additionally, partial breastfeeding during first month was associated with a 5.7-fold adjusted risk of death as a result of infectious disease (adj OR: 5.73; 95% CI: 2.75, 11.91) after adjusting with the effect of early breastfeeding. That means early as well as exclusive breastfeeding both are significantly associated with reduced infection-specific neonatal mortality in young infants.

These findings have important implications for neonatal health programs and policy. Authors have called for similar studies in other parts of the world; and concluded that breastfeeding promotion programs that focus on early initiation of breastfeeding and exclusive breastfeeding in the neonatal period can significantly reduce the burden of infectious disease-related mortality.

Comment: This is an important addition to existing scientific evidence on the role of breastfeeding in saving babies. Evidence is specific for deaths related to neonatal infections and is good enough to be reflected in policy and programs as majority of neonatal deaths are due to infections. It would be a challenge to see how programs can mainstream breastfeeding counseling and support interventions to help women to succeed both in early (within an hour or first day even) and exclusive breastfeeding (for the first six months of life). Needless to say, doing this will substantially reduce burden on health systems to treat newborn babies. Newborn health programs should lay focus on 'preventive care' approach more than the 'treatment' approach currently being followed.