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Breast-feeding, α1-Antitrypsin Deficiency, and Liver Disease?-Reply

John N. Udall Jr, MD, PhD
JAMA. 1985;254(21):3037. doi:10.1001/jama.1985.03360210050023.
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In Reply.—  Sveger's data confirm our findings: α1-AT-deficient infants who are breast-fed for more than one month are less likely to develop severe liver disease than infants breast-fed for less than one month. However, as Dr Sveger notes, additional studies are needed regarding the effect of early feeding patterns on the development of severe liver disease in children with α1-AT deficiency. This recommendation correlates closely with that of the 1984 Surgeon General's Workshop on Breastfeeding and Human Lactation: "We need a national data base on the initiation and the duration of lactation. Multicenter, longitudinal, and cross-sectional studies are needed to investigate benefits and contraindications of breastfeeding and to evaluate strategies and interventions to promote it. Interagency coordination of projects would ensure a unified approach to research questions and timely dissemination of research findings."1 Indeed, controlled prospective studies are required to document not only the effect


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