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ARTICLE |

Breast-feeding and Infectious Diarrhea

Bart Holland, PhD, MPH
JAMA. 1987;257(24):3361. doi:10.1001/jama.1987.03390240067013.
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To the Editor.—  Gordon1 raises the question of why breast-feeding is lifesaving in developing countries, and he terms it an "unanswered major issue." He implies that supine feeding is the problem, but neglects to mention the difficulties of maintaining a sanitary food supply in developing countries.Where sanitation is poor, non—breastfed infants are more frequently exposed to sources of infection than are breastfed infants. For example, a study in Gambia2 showed that supplementary foods provided to infants, whether traditional gruels or commercial infant formulas, "were heavily contaminated with potentially pathogenic microorganisms," because the foods were not freshly prepared. In Chile,3 80% of feeding bottles were found to harbor dangerously large numbers of bacteria. In a study in Uganda,4 bacterial counts were elevated in infant foods and on the surface of utensils used in preparation and feeding. In that study, 49% of infants whose mothers had attempted

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