***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective of the study was to increase breastfeeding initiation and duration rates among postcesarean women by implementing a culturally appropriate breastfeeding intervention . This study was a prospect i ve population -based , controlled evaluation of a breastfeeding intervention consisting of 570 Jewish and Muslim postcesarean women who had delivered healthy , term infants at an Israeli hospital . Women in the control group ( n = 264 ) received st and ard hospital care and women in the intervention group ( n = 306 ) received early , culturally sensitive , postcesarean breastfeeding guidance . Surveys regarding breastfeeding duration practice s were conducted at 10 and 16 weeks postpartum . Overall and exclusive 4-month breastfeeding duration rates were significantly higher for the intervention group as compared to the control group for the Jewish women at 10 and 16 weeks postpartum . Since few Muslim women ceased breastfeeding , only exclusive breastfeeding rates were evaluated . At 10 and 16 weeks , significantly more Muslim women in the intervention group were exclusively breastfeeding as compared to the control group , although rates dramatically declined by 16 weeks . Despite the challenges to breastfeeding posed by cesarean delivery , early and appropriate breastfeeding guidance facilitated successful outcomes for both Jewish and Muslim women Objective To assess whether exclusive and prolonged breast feeding reduces the risk of childhood asthma and allergy by age 6.5 years . Design Cluster r and omised trial . Setting 31 Belarussian maternity hospitals and their affiliated polyclinics . Participants A total of 17 046 mother-infant pairs were enrolled , of whom 13 889 ( 81.5 % ) were followed up at age 6.5 years . Intervention Breastfeeding promotion intervention modelled on the WHO/UNICEF baby friendly hospital initiative . Main outcome measures International study of asthma and allergies in childhood ( ISAAC ) question naire and skin prick tests of five inhalant antigens . Results The experimental intervention led to a large increase in exclusive breast feeding at 3 months ( 44.3 % v 6.4 % ; P<0.001 ) and a significantly higher prevalence of any breast feeding at all ages up to and including 12 months . The experimental group had no reduction in risks of allergic symptoms and diagnoses or positive skin prick tests . In fact , after exclusion of six sites ( three experimental and three control ) with suspiciously high rates of positive skin prick tests , risks were significantly increased in the experimental group for four of the five antigens . Conclusions These results do not support a protective effect of prolonged and exclusive breast feeding on asthma or allergy . Trial registration Current Controlled Trials IS RCT N37687716 CONTEXT The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother 's behavior or her interaction with the infant . OBJECTIVE To assess whether prolonged and exclusive breastfeeding improves children 's cognitive ability at age 6.5 years . DESIGN Cluster-r and omized trial , with enrollment from June 17 , 1996 , to December 31 , 1997 , and follow-up from December 21 , 2002 , to April 27 , 2005 . SETTING Thirty-one Belarussian maternity hospitals and their affiliated polyclinics . PARTICIPANTS A total of 17,046 healthy breastfeeding infants were enrolled , of whom 13,889 ( 81.5 % ) were followed up at age 6.5 years . INTERVENTION Breastfeeding promotion intervention modeled on the Baby-Friendly Hospital Initiative by the World Health Organization and UNICEF . MAIN OUTCOME MEASURES Subtest and IQ scores on the Wechsler Abbreviated Scales of Intelligence , and teacher evaluations of academic performance in reading , writing , mathematics , and other subjects . RESULTS The experimental intervention led to a large increase in exclusive breastfeeding at age 3 months ( 43.3 % for the experimental group vs 6.4 % for the control group ; P < .001 ) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months . The experimental group had higher means on all of the Wechsler Abbreviated Scales of Intelligence measures , with cluster-adjusted mean differences ( 95 % confidence intervals ) of + 7.5 ( + 0.8 to + 14.3 ) for verbal IQ , + 2.9 ( -3.3 to + 9.1 ) for performance IQ , and + 5.9 ( -1.0 to + 12.8 ) for full-scale IQ . Teachers ' academic ratings were significantly higher in the experimental group for both reading and writing . CONCLUSION These results , based on the largest r and omized trial ever conducted in the area of human lactation , provide strong evidence that prolonged and exclusive breastfeeding improves children 's cognitive development . TRIAL REGISTRATION is rct n.org Identifier : IS RCT N37687716 BACKGROUND Insulin , growth hormone ( GH ) , and growth factors ( insulin-like growth factors [ IGFs ] and their binding proteins [ IGFBPs ] ) are known to influence fetal growth and also the synthesis /secretion of the recently discovered hormones leptin and ghrelin . METHODS In 153 delivering mothers and their offspring at birth , we prospect ively investigated the association between mothers ' and babies ' serum concentrations of ghrelin , leptin , insulin , IGF-1 , and IGFBP-3 and neonatal anthropometric characteristics and the growth of the fetus . We also tried to put babies ' serum glucose and GH measurements in this context . RESULTS Birth weight ( BW ) , birth length , head circumference , and ponderal index ( PI ) were positively associated with cord IGF-1 , IGFBP-3 , and leptin and negatively associated with GH . BW was independently associated with maternal stature and prepartum weight , birth length with maternal stature , PI with maternal insulin and prepartum weight , and head circumference with maternal ghrelin . Compared with preterm infants whose development was appropriate for gestational age ( AGA ) , preterm growth-restricted babies displayed alteration in GH-IGF axis ( increased GH and low IGF-1 and IGFBP-3 concentrations ) , low leptin and glucose concentrations , and increased ghrelin concentrations . In large-for-gestational-age ( LGA ) babies , leptin , IGFBP-3 , insulin , and glucose concentrations were significantly higher in asymmetric LGA newborns than in symmetric LGA and AGA newborns . CONCLUSIONS We found relationships between metabolic factors , fetal growth , and anthropometry . Intrauterine growth restriction involved alteration in the fetal GH-IGF axis , with relatively low leptin and glucose concentrations and increased ghrelin concentrations . Leptin , insulin , and IGFBP-3 delineated subtypes of fetal overgrowth BACKGROUND Documented barriers to the implementation of Step 4 of the Baby Friendly Hospital Initiative , which relates to early initiation of breastfeeding , have not considered the impact of operative intervention in delivery on achievement of the goal . This study was design ed to test the hypothesis that hospital practice s in the immediate postpartum period that are associated with operative intervention in delivery can affect first mother-infant contact and initiation of breastfeeding . METHODS In a prospect i ve , longitudinal study , a sociodemographically representative sample of 203 primiparous women was recruited . Participants were interviewed at 2 days postpartum in metropolitan hospitals in Melbourne , Australia , and medical records were inspected . At 8 months postpartum 81 percent of participants completed a postal question naire . Three mode-of-delivery groups ( spontaneous vaginal delivery , instrumentally assisted vaginal delivery and cesarean section ) and 4 hospital-of-delivery groups ( including one accredited Baby Friendly Hospital ) were compared . RESULTS Two way ANOVA revealed that women who had a cesarean section experienced a significant delay in initiating breastfeeding compared with women giving birth vaginally , with or without instrumental assistance ( p < 0.001 ) . Significant differences in this aspect of care were also observed among hospitals , with the Baby-Friendly hospital performing significantly better than the other three hospitals ( p < 0.001 ) . An effect due to mode of delivery alone was demonstrated that could not be abolished by differences in hospital practice s ( p = 0.231 ) . Nevertheless , shorter elapsed time between birth and initiation of breastfeeding was not significantly associated with continuation of breastfeeding at 8 months postpartum ( p = 0.642 ) . CONCLUSIONS The findings confirmed that cesarean section was a significant barrier to the implementation of Baby Friendly Hospital Initiative Step 4 and that hospital practice s were amenable to changes that enabled its implementation regardless of the mode of delivery Background In Jordan , as in neighboring countries in the Middle East , higher education and higher employment rates in recent years among women have had an impact on traditionally based infant feeding . The objective of this study was to evaluate practice , knowledge and attitude to breastfeeding  and to assess factors associated with breastfeeding among women in the north of Jordan . Methods A cross sectional study was carried out between 15 July 2003 and 15 August 2003 . A total of 344 women with children aged between 6 months and 3 years from five different villages in the north of Jordan were r and omly selected and interviewed . Information regarding participants ' demographics , infant feeding in first six months of life , knowledge and attitude towards breastfeeding was collected . Results Full breastfeeding was reported by 58.3 % , mixed feeding was reported by 30.3 % and infant formula feeding was reported by 11.4 % . Almost one third of the full breastfeeding group did so for 6–12 months , and almost two thirds did continue breastfeeding for more than one year . Employed women were more likely not to practice full breastfeeding compared to unemployed women ( odds ratio 3.34 , 95 % CI 1.60 , 6.98 ) , and women who had caesarian delivery were more likely not to practice full breastfeeding compared to those who had vaginal delivery ( odds ratio 2.36 , 95 % CI 1.17 , 4.78 ) . Jordanian women had a positive attitude but work place and short maternity leaves had a negative impact on breastfeeding . Conclusion This study showed that a high proportion of Jordanian women did breastfeed for more than one year . However , working women and those who deliver by caesarean section were less likely to breastfeed . It is speculated that adopting facilitatory measures at hospitals and work place could increase the rate of full breastfeeding BACKGROUND There has been concern about rising rates of caesarean section worldwide . This Article reports the third phase of the WHO global survey , which aim ed to estimate the rate of different methods of delivery and to examine the relation between method of delivery and maternal and perinatal outcomes in selected facilities in Africa and Latin America in 2004 - 05 , and in Asia in 2007 - 08 . METHODS Nine countries participated in the Asia global survey : Cambodia , China , India , Japan , Nepal , Philippines , Sri Lanka , Thail and , and Vietnam . In each country , the capital city and two other regions or provinces were r and omly selected . We studied all women admitted for delivery during 3 months in institutions with 6000 or fewer expected deliveries per year and during 2 months in those with more than 6000 deliveries . We gathered data for institutions to obtain a detailed description of the health facility and its re sources for obstetric care . We obtained data from  women 's medical records to summarise obstetric and perinatal events . FINDINGS We obtained data for 109 101 of 112 152 deliveries reported in 122 recruited facilities ( 97 % coverage ) , and analysed 107 950 deliveries . The overall rate of caesarean section was 27.3 % ( n=29 428 ) and of operative vaginal delivery was 3.2 % ( n=3465 ) . Risk of maternal mortality and morbidity index ( at least one of : maternal mortality , admission to intensive care unit [ ICU ] , blood transfusion , hysterectomy , or internal iliac artery ligation ) was increased for operative vaginal delivery ( adjusted odds ratio 2.1 , 95 % CI 1.7 - 2.6 ) and all types of caesarean section ( antepartum without indication 2.7 , 1.4 - 5.5 ; antepartum with indication 10.6 , 9.3 - 12.0 ; intrapartum without indication 14.2 , 9.8 - 20.7 ; intrapartum with indication 14.5 , 13.2 - 16.0 ) . For breech presentation , caesarean section , either antepartum ( 0.2 , 0.1 - 0.3 ) or intrapartum ( 0.3 , 0.2 - 0.4 ) , was associated with improved perinatal outcomes , but also with increased risk of stay in neonatal ICU ( 2.0 , 1.1 - 3.6 ; and 2.1 , 1.2 - 3.7 , respectively ) . INTERPRETATION To improve maternal and perinatal outcomes , caesarean section should be done only when there is a medical indication . FUNDING US Agency for International Development ( USAID ) ; UNDP/UNFPA/WHO/World Bank Special Programme of Research , Development and Research Training in Human Reproduction ( HRP ) , WHO , Switzerl and ; Ministry of Health , Labour and Welfare of Japan ; Ministry of Public Health , China ; and Indian Council of Medical Research Breastfeeding is the recommended feeding for all healthy infants . The aim 
    Output:
    
There was a negative association between prelabor CD and early breastfeeding .
If breastfeeding is initiated , mode of delivery has no apparent effect on the number of mothers still breastfeeding at 6 mo .