Continued breastfeeding and child growth in the second year of life: a prospective cohort study in western Kenya

Background The value of postinfancy breastfeeding for growth and nutritiona l status is debated. We have investigated this issue in a longitudinal stud y. Methods We prospectively followed up a cohort of 264 children in western Ke nya for 6 months (mean age 14 months [range 9-18] at baseline) to investiga te the nature of the association between breastfeeding and growth. Only 14 (5.3%) children had been weaned at baseline, and 173 (65.5%) were still bre astfed at follow-up. For analysis, children were classified into three grou ps of breastfeeding duration as a proportion Of the total follow-up period (0-49%, n=42; 50-99%, n=49; and 100%, n=173). Findings In general linear models multivariate analysis, children in the lo ngest-duration breastfeeding group gained 3.4 cm (p=0.0001) and 370 g (p=0. 005) more than those in the shortest duration group, and 0.6 cm (p=0.0015) and 230 g (p=0.038) more than children in the intermediate group. The stron gest association between breastfeeding and linear growth was observed in ho useholds that had no latrine and daily water use of less than 10 L per pers on. Interpretation Our findings support WHO's recommendation to continue breast feeding for at least 2 years, especially in settings with poor sanitation a nd inadequate water supply.