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Letters |

Health Benefits of Breastfeeding Promotion—Reply

Michael S. Kramer, MD
JAMA. 2001;285(19):2446-2447. doi:10.1001/jama.285.19.2446.
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In Reply: Dr Sargent and colleagues have made 2 errors in using the results of PROBIT to estimate the benefits of breastfeeding for infants in the United States. First, we did not compare breastfeeding vs not breastfeeding (as implied by Sargent et al), nor even more prolonged and exclusive breastfeeding vs shorter and less exclusive breastfeeding. Rather, we investigated the effect of an intervention to promote longer and more exclusive breastfeeding. Our experimental intervention resulted in 2 cohorts that differed in their average breastfeeding duration and degree. As discussed in greater detail in our article, more prolonged and exclusive breastfeeding must reduce morbidity among individual infants to a far larger extent than the average reduction observed for the entire experimental group when analyzed by intention to treat.

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