Research studies have produced conflicting results of the impact of breastfeeding on overweight/obesity. This study evaluated the impact of infant feeding on infant body composition. There were two groups of mother-infant pairs (exclusive breastfeeding [EBF; n = 27] and mixed feeding [MF; n = 13]) in this study. At baseline, participants were similar in their demographic characteristics except prepregnancy weight, where MF mothers tended to be heavier than their EBF counterparts (67.3 kg versus 59.9 kg; P = .034). Infant birth weight was slightly higher among the MF group than their EBF counterparts (3.5 kg versus 3.4 kg), although the differences were not statistically significant. At 3 months postpartum, mean infant FMI (4.1 kg/m(2) versus 3.8 kg/m(2)) and percent body fat (24.4% versus 23.1%) were slightly higher among EBF infants than MF infants. In terms of growth velocity, EBF infants gained weight faster than their MF counterparts, although the differences were not statistically significant. The findings from this study suggest that EBF may promote faster weight gain and increase in both fat mass index (FMI) and percent body fat in the early postpartum period in addition to the numerous health benefits enjoyed by the infant and the mother who exclusively breastfeeds her newborn.

OBJECTIVE:to compare the early breast-feeding behaviours of full-term newborns whose mothers had received epidural analgesia (EDA) during an uncomplicated labour, with a group of newborns whose mothers had not received EDA.

DESIGN AND SETTING:a retrospective comparative study design was used and the study was carried out in a labour ward in Stockholm, Sweden between January 2000 and April 2000. The ward has about 5500 deliveries per year.

PARTICIPANTS:all maternity records of women who had received EDA during labour (n=585) were included in the study. For each EDA record, a control record was selected, matched for parity, age and gestational age at birth. Women with emergency caesarean section, vacuum extraction/forceps, twin pregnancy, breech presentation or an intra-uterine death, as well as neonates with an Apgar score<7 at 5 mins were excluded. After exclusion, the study population consisted of 351 healthy women and babies in each group.

METHOD:logistic regression was performed. The dependent variables: (1) initiation of breast feeding after birth; (2) artificial milk given during hospital stay; and (3) breast feeding at discharge were studied in response to: (a) parity; (b) gestational age at birth; (c) length of first and second stage of labour; (d) administration of oxytocin; (e) administration of EDA; and (f) neonatal weight, as independent variables.

FINDINGS:significantly fewer babies of mothers with EDA during labour suckled the breast within the first 4 hours of life [odds ratio (OR) 3.79]. These babies were also more often given artificial milk during their hospital stay (OR 2.19) and fewer were fully breast fed at discharge (OR 1.79). Delayed initiation of breast feeding was also associated with a prolonged first (OR 2.81) and second stage (OR 2.49) and with the administration of oxytocin (OR 3.28). Fewer newborns of multiparae received artificial milk during their hospital stay (OR 0.58). It was also, but to a lesser extent, associated with oxytocin administration (OR 2.15). Full breast feeding at discharge was also positively associated with multiparity (OR 0.44) and birth weight between 3 and 4 kg (OR 0.42).

KEY CONCLUSIONS:the study shows that EDA is associated with impaired spontaneous breast feeding including breast feeding at discharge from the hospital. Further studies are needed on the effects of EDA on short- and long-term breast-feeding outcomes.

It has been shown that milk derived from mothers with term infants is not optimal for premature babies. There is also concern about the effect of heat sterilizing breast milk. At Baragwanath Hospital, the majority of mothers remain with and care for their premature babies. Over many years, pooled pasteurized breast milk has been fed to these babies before direct breast feeding is instituted. A study was done to compare feeding pooled pasteurized breast milk and untreated own mother's milk to very low birth weight babies. There was a significantly more rapid weight gain both in terms of regaining birth weight and, from this point, to reaching a weight of 1,800 g when using untreated own mother's milk. This occurred in spite of the fact that there was little difference, especially in terms of energy content, between the two types of breast milk. This was due to the fact that the pooled pasteurized milk was also largely obtained from mothers of premature babies. It is suggested from our data that slower weight gain in the group receiving the pooled pasteurized milk could be due to the pasteurization, which probably destroys heat-labile milk lipase.