human
***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: Abstract Objectives : To establish the relative cost effectiveness of postnatal support in the community in addition to the usual care provided by community midwives . Design : R and omised controlled trial with six month follow up . Setting : Recruitment in a university teaching hospital and care provided in women 's homes . Participants : 623 postnatal women allocated at r and om to intervention ( 311 ) or control ( 312 ) group . Intervention : Up to 10 home visits in the first postnatal month of up to three hours duration by a community postnatal support worker . Main outcome measure : General health status as measured by the SF-36 and risk of postnatal depression . Breast feeding rates , satisfaction with care , use of services , and personal costs . Results : At six weeks there was no significant improvement in health status among the women in the intervention group . At six weeks the mean total NHS costs were £ 635 for the intervention group and £ 456 for the control group ( P=0.001 ) . At six months figures were £ 815 and £ 639 ( P=0.001 ) . There were no differences between the groups in use of social services or personal costs . The women in the intervention group were very satisfied with the support worker visits . Conclusions : There was no health benefit of additional home visits by community postnatal support workers compared with traditional community midwifery visiting as measured by the SF-36 . There were no savings to the NHS over six months after the introduction of the community postnatal support worker service BACKGROUND Most mothers breastfeed in Bangladesh , but they rarely practise exclusive breastfeeding . Hospital-based strategies for breastfeeding promotion can not reach them because about 95 % have home deliveries . We postulated that with the intervention of trained peer counsellors , mothers could be enabled to breastfeed exclusively for the recommended duration of 5 months . METHODS 40 adjacent zones in Dhaka were r and omised to intervention or control groups . Women were enrolled during the last trimester of pregnancy between February and December , 1996 . In the intervention group , 15 home-based counselling visits were scheduled , with two visits in the last trimester , three early postpartum ( within 48 h , on day 5 , between days 10 and 14 ) , and fortnightly thereafter until the infant was 5 months old . Peer counsellors were local mothers who received 10 days ' training . FINDINGS 363 women were enrolled in each group .  Peer counselling significantly improved breastfeeding practice s. For the primary outcome , the prevalence of exclusive breastfeeding at 5 months was 202/228 ( 70 % ) for the intervention group and 17/285 ( 6 % ) for the control group ( difference=64 % ; 95 % CI 57%-71 % , p>0.0001 ) . For the secondary outcomes , mothers in the intervention group initiated breastfeeding earlier than control mothers and were less likely to give prelacteal and postlacteal foods . At day 4 , significantly more mothers in the intervention group breastfed exclusively than controls . INTERPRETATION Peer counsellors can effectively increase the initiation and duration of exclusive breastfeeding . We recommend incorporation of peer counsellors in mother and child health programmes in developing countries Lactation counsellors were trained to advise mothers of partially breast-fed infants who were admitted to hospital because of diarrhoea , so that they could start exclusive breast-feeding during their hospital stay . Infants ( n = 250 ) up to 12 weeks of age were r and omized to intervention and control groups . Mothers in the intervention group were individually advised by the counsellors while mothers in the control group received only routine group health education . During follow-up at home by the counsellors a week later , only the mothers in the intervention group were counselled . All the mothers were evaluated for infant feeding practice s at home two weeks after discharge . Among the 125 mother-infant pairs in each group , 60 % of mothers in the intervention group were breast-feeding exclusively at discharge compared with only 6 % in the control group ( P < 0.001 ) ; two weeks later , these rates rose to 75 % and 8 % in the intervention and control groups , respectively ( P < 0.001 ) . However , 49 % of mothers in the control group reverted back to bottle-feeding compared with 12 % in the intervention group ( P < 0.001 ) . Thus , individual counselling had a positive impact on mothers to start exclusive breast-feeding during hospitalization and to continue the practice at home . Maternal and child health facilities should include lactation counselling as an integral part of their programme to improve infant feeding practice Breast-feeding promotion is an important intervention for the control of infant diarrhoea .  This study assesses the impact of a breast-feeding counselling programme on the prevalence of exclusive breast feeding in rural communities in Nigeria . Mothers attending primary care facilities because their infants had acute diarrhoea were r and omised into two groups . The study group ( n = 82 ) received individual , focused breast-feeding counselling , while the controls ( n = 79 ) had routine advice for diarrhoea . Both groups were monitored and followed with home visits to determine infant-feeding practice s. The results showed marked increases in exclusive breast-feeding prevalence for the intervention group at day 7 ( 49 % vs. 6 % control ; p < 0.0001 ) and day 21 ( 46 % vs. 8 % ; p < 0.0001 ) . Moreover , diarrhoea re-occurrence at day 21 was less in the intervention group ( 12 % ) than controls ( 18 % ) . It is concluded that focused breast-feeding counselling can increase exclusive breast feeding and reduce the prevalence of diarrhoea in rural communities Abstract Objective : To investigate the relation of infant feeding practice to childhood respiratory illness , growth , body composition , and blood pressure . Design : Follow up study of a cohort of children ( mean age 7.3 years ) who had detailed infant feeding and demographic data collected prospect ively during the first two years of life . Setting : Dundee . Subjects : 674 infants , of whom 545 ( 81 % ) were available for study . Data on respiratory illness were available for 545 children ( mean age 7.3 ( range 6.1- 9.9 ) years ) ; height for 410 children ; weight and body mass index for 412 children ; body composition for 405 children ; blood pressure for 301 children ( mean age 7.2 ( range 6.9 - 10.0 ) years ) . Main outcome measures : Respiratory illness , weight , height , body mass index , percentage body fat , and blood pressure in relation to duration of breast feeding and timing of introduction of solids . Results : After adjustment for the significant confounding variables the estimated probability of ever having respiratory illness in children who received breast milk exclusively for at least 15 weeks was consistently lower ( 17.0 % ( 95 % confidence interval 15.9 % to 18.1 % ) for exclusive breast feeding , 31.0 % ( 26.8 % to 35.2 % ) for partial breast feeding , and 32.2 % ( 30.7 % to 33.7 % ) for bottle feeding . Solid feeding before 15 weeks was associated with an increased probability of wheeze during childhood ( 21.0 % ( 19.9 % to 22.1 % ) v 9.7 % ( 8.6 % to 10.8 % ) ) . It was also associated with increased percentage body fat and weight in childhood ( mean body fat 18.5 % ( 18.2 % to 18.8 % ) v 16.5 % ( 16.0 % to 17.0 % ) ; weight st and ard deviation score 0.02 ( −0.02 to 0.06 ) v −0.09 ( −0.16 to 0.02 ) . Systolic blood pressure was raised significantly in children who were exclusively bottle fed compared with children who received breast milk ( mean 94.2 ( 93.5 to 94.9 ) mm Hg v 90.7 ( 89.9 to 91.7 ) mm Hg ) . Conclusions : The probability of respiratory illness occurring at any time during childhood is significantly reduced if the child is fed exclusively breast milk for 15 weeks and no solid foods are introduced during this time . Breast feeding and the late introduction of solids may have a beneficial effect on childhood health and subsequent adult disease . Key messages Current guidelines in the United Kingdom recommend that babies are exclusively breast fed for the first 4 months of life , with solids being introduced thereafter This study found that exclusive breast feeding is associated with a significant reduction in childhood respiratory illness The early introduction of solids is associated with increased body fat and weight in childhood Exclusive bottle feeding is associated with higher systolic blood pressure in childhood Breast feeding and delaying the introduction of solids until after 15 weeks may have a beneficial effect on childhood health and subsequent adult An attempted controlled trial of exclusively breast fed neonates with atopic parents , to assess the effectiveness of breast feeding in preventing atopic allergy , was not successfully achieved . Analysis of the data as an observational study , however , provided evidence that breast feeding offers some protection against eczema in genetically vulnerable infants .  Feeds of soya preparations were associated with eczema as often as cows ' milk based feeds This quasi-experimental study was conducted in Shiraz , the Islamic Republic of Iran , on 120 pairs of mothers and infants in a maternity hospital that had a rooming-in programme . All 59 mothers in the study group received breastfeeding education , face-to-face , after delivery and during follow-up for 4 months in the mother and child health ( MCH ) centre or in their homes ; the remaining 61 mothers comprised the control group .  Exclusive breastfeeding rates were significantly higher in the study group ( 54 % ) than in the control group ( 6.5 % ) , but 5 % and 18 % of infants , respectively , in the study and control groups had stopped breastfeeding by the age of 4 months . The mean number of days of diarrhoea experienced by infants in the study group were significantly lower ( P < or = 0.004 ) than in the control group . At the end of 4 months , the mean weight and length of the infants were significantly higher ( both P < 0.05 ) in the study group than in the control group . The findings indicate that rooming-in is very important for promoting exclusive breastfeeding and that there is a need for continuous breastfeeding education of mothers We investigated the effectiveness of a program of intensive postpartum support for low-income , breast-feeding women and identified potential predictors of prolonged breast-feeding in this population . Ninety-seven low-income women were r and omized to receive intensive postpartum education and support for breast-feeding or to receive only the routine assistance provided by the obstetrical nurses .  Both groups were telephoned 6 weeks post partum to determine the method of infant feeding then , and those still breast-feeding were contacted monthly until complete weaning had occurred . No significant difference in breast-feeding duration between the two groups was noted . There was no association between duration of nursing and race , marital status , or the need to return to work or school . Earlier age at introduction of supplement , younger maternal age , and participation in prenatal classes predicted breast-feeding duration by logistic regression Abstract . A prospect i ve study of the course of breast feeding was carried out in 75 r and omly selected women . Weekly interviews were performed from the day after delivery until the termination of breast feeding , but in no case for longer than 6 months . In each case a detailed analysis was made of the factors leading to transient lactation crises or to complete cessation of breast feeding . A second group of 71 mothers , also r and omly selected , was interviewed in retrospect only , 6 months after delivery , and served as controls . Twenty‐four weeks after delivery 47 % of the mothers in the weekly interview group were still breast feeding . The corresponding figure in the control group was 38 % . In both groups only few mothers terminated lactation for medical reasons , while about one fourth stopped for some other reason and about one half because of a combination of factors . Brief case reports are presented to illustrate how varying the factors were that threatened breast feeding In a prospect i ve multicentre study on 926 preterm infants formally assigned to their early diet , necrotising enterocolitis developed in 51 ( 5.5 % ) .  Mortality was 26 % in stringently confirmed cases . In exclusively  formula-fed  babies confirmed disease was 6 - 10 times more common than in those fed breast milk alone and 3 times more common than in those who received formula plus breast milk . Pasteurised donor milk seemed to be as protective as raw maternal milk . Among babies born at more than 30 weeks ' gestation confirmed necrotising enterocolitis was rare in those whose diet included breast milk ; it was 20 times more common in those fed formula only . Other risk factors included very low  gestational age , respiratory disease , umbilical artery catheterisation , and polycythaemia . In formula-fed but not breast-milk-fed infants , delayed enteral feeding was associated with a lower frequency of necrotising enterocolitis . With the fall in the use of breast milk in British neonatal units , exclusive formula feeding could account for an estimated 500 extra cases of necrotising enterocolitis each year . About 100 of these infants would die BACKGROUND Exclusive breastfeeding is recommended worldwide but not commonly practised . We undertook a r and omised controlled study of the efficacy of home-based peer counselling to increase the proportion of exclusive breastfeeding among mothers and infants residing in periurban Mexico City . METHODS Two intervention groups with different counselling frequencies , six visits ( 44 ) and three visits ( 52 ) , were compared with a control group ( 34 
    Output:
    
agent
***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: Abstract Objectives : To establish the relative cost effectiveness of postnatal support in the community in addition to the usual care provided by community midwives . Design : R and omised controlled trial with six month follow up . Setting : Recruitment in a university teaching hospital and care provided in women 's homes . Participants : 623 postnatal women allocated at r and om to intervention ( 311 ) or control ( 312 ) group . Intervention : Up to 10 home visits in the first postnatal month of up to three hours duration by a community postnatal support worker . Main outcome measure : General health status as measured by the SF-36 and risk of postnatal depression . Breast feeding rates , satisfaction with care , use of services , and personal costs . Results : At six weeks there was no significant improvement in health status among the women in the intervention group . At six weeks the mean total NHS costs were £ 635 for the intervention group and £ 456 for the control group ( P=0.001 ) . At six months figures were £ 815 and £ 639 ( P=0.001 ) . There were no differences between the groups in use of social services or personal costs . The women in the intervention group were very satisfied with the support worker visits . Conclusions : There was no health benefit of additional home visits by community postnatal support workers compared with traditional community midwifery visiting as measured by the SF-36 . There were no savings to the NHS over six months after the introduction of the community postnatal support worker service BACKGROUND Most mothers breastfeed in Bangladesh , but they rarely practise exclusive breastfeeding . Hospital-based strategies for breastfeeding promotion can not reach them because about 95 % have home deliveries . We postulated that with the intervention of trained peer counsellors , mothers could be enabled to breastfeed exclusively for the recommended duration of 5 months . METHODS 40 adjacent zones in Dhaka were r and omised to intervention or control groups . Women were enrolled during the last trimester of pregnancy between February and December , 1996 . In the intervention group , 15 home-based counselling visits were scheduled , with two visits in the last trimester , three early postpartum ( within 48 h , on day 5 , between days 10 and 14 ) , and fortnightly thereafter until the infant was 5 months old . Peer counsellors were local mothers who received 10 days ' training . FINDINGS 363 women were enrolled in each group .  Peer counselling significantly improved breastfeeding practice s. For the primary outcome , the prevalence of exclusive breastfeeding at 5 months was 202/228 ( 70 % ) for the intervention group and 17/285 ( 6 % ) for the control group ( difference=64 % ; 95 % CI 57%-71 % , p>0.0001 ) . For the secondary outcomes , mothers in the intervention group initiated breastfeeding earlier than control mothers and were less likely to give prelacteal and postlacteal foods . At day 4 , significantly more mothers in the intervention group breastfed exclusively than controls . INTERPRETATION Peer counsellors can effectively increase the initiation and duration of exclusive breastfeeding . We recommend incorporation of peer counsellors in mother and child health programmes in developing countries Lactation counsellors were trained to advise mothers of partially breast-fed infants who were admitted to hospital because of diarrhoea , so that they could start exclusive breast-feeding during their hospital stay . Infants ( n = 250 ) up to 12 weeks of age were r and omized to intervention and control groups . Mothers in the intervention group were individually advised by the counsellors while mothers in the control group received only routine group health education . During follow-up at home by the counsellors a week later , only the mothers in the intervention group were counselled . All the mothers were evaluated for infant feeding practice s at home two weeks after discharge . Among the 125 mother-infant pairs in each group , 60 % of mothers in the intervention group were breast-feeding exclusively at discharge compared with only 6 % in the control group ( P < 0.001 ) ; two weeks later , these rates rose to 75 % and 8 % in the intervention and control groups , respectively ( P < 0.001 ) . However , 49 % of mothers in the control group reverted back to bottle-feeding compared with 12 % in the intervention group ( P < 0.001 ) . Thus , individual counselling had a positive impact on mothers to start exclusive breast-feeding during hospitalization and to continue the practice at home . Maternal and child health facilities should include lactation counselling as an integral part of their programme to improve infant feeding practice Breast-feeding promotion is an important intervention for the control of infant diarrhoea .  This study assesses the impact of a breast-feeding counselling programme on the prevalence of exclusive breast feeding in rural communities in Nigeria . Mothers attending primary care facilities because their infants had acute diarrhoea were r and omised into two groups . The study group ( n = 82 ) received individual , focused breast-feeding counselling , while the controls ( n = 79 ) had routine advice for diarrhoea . Both groups were monitored and followed with home visits to determine infant-feeding practice s. The results showed marked increases in exclusive breast-feeding prevalence for the intervention group at day 7 ( 49 % vs. 6 % control ; p < 0.0001 ) and day 21 ( 46 % vs. 8 % ; p < 0.0001 ) . Moreover , diarrhoea re-occurrence at day 21 was less in the intervention group ( 12 % ) than controls ( 18 % ) . It is concluded that focused breast-feeding counselling can increase exclusive breast feeding and reduce the prevalence of diarrhoea in rural communities Abstract Objective : To investigate the relation of infant feeding practice to childhood respiratory illness , growth , body composition , and blood pressure . Design : Follow up study of a cohort of children ( mean age 7.3 years ) who had detailed infant feeding and demographic data collected prospect ively during the first two years of life . Setting : Dundee . Subjects : 674 infants , of whom 545 ( 81 % ) were available for study . Data on respiratory illness were available for 545 children ( mean age 7.3 ( range 6.1- 9.9 ) years ) ; height for 410 children ; weight and body mass index for 412 children ; body composition for 405 children ; blood pressure for 301 children ( mean age 7.2 ( range 6.9 - 10.0 ) years ) . Main outcome measures : Respiratory illness , weight , height , body mass index , percentage body fat , and blood pressure in relation to duration of breast feeding and timing of introduction of solids . Results : After adjustment for the significant confounding variables the estimated probability of ever having respiratory illness in children who received breast milk exclusively for at least 15 weeks was consistently lower ( 17.0 % ( 95 % confidence interval 15.9 % to 18.1 % ) for exclusive breast feeding , 31.0 % ( 26.8 % to 35.2 % ) for partial breast feeding , and 32.2 % ( 30.7 % to 33.7 % ) for bottle feeding . Solid feeding before 15 weeks was associated with an increased probability of wheeze during childhood ( 21.0 % ( 19.9 % to 22.1 % ) v 9.7 % ( 8.6 % to 10.8 % ) ) . It was also associated with increased percentage body fat and weight in childhood ( mean body fat 18.5 % ( 18.2 % to 18.8 % ) v 16.5 % ( 16.0 % to 17.0 % ) ; weight st and ard deviation score 0.02 ( −0.02 to 0.06 ) v −0.09 ( −0.16 to 0.02 ) . Systolic blood pressure was raised significantly in children who were exclusively bottle fed compared with children who received breast milk ( mean 94.2 ( 93.5 to 94.9 ) mm Hg v 90.7 ( 89.9 to 91.7 ) mm Hg ) . Conclusions : The probability of respiratory illness occurring at any time during childhood is significantly reduced if the child is fed exclusively breast milk for 15 weeks and no solid foods are introduced during this time . Breast feeding and the late introduction of solids may have a beneficial effect on childhood health and subsequent adult disease . Key messages Current guidelines in the United Kingdom recommend that babies are exclusively breast fed for the first 4 months of life , with solids being introduced thereafter This study found that exclusive breast feeding is associated with a significant reduction in childhood respiratory illness The early introduction of solids is associated with increased body fat and weight in childhood Exclusive bottle feeding is associated with higher systolic blood pressure in childhood Breast feeding and delaying the introduction of solids until after 15 weeks may have a beneficial effect on childhood health and subsequent adult An attempted controlled trial of exclusively breast fed neonates with atopic parents , to assess the effectiveness of breast feeding in preventing atopic allergy , was not successfully achieved . Analysis of the data as an observational study , however , provided evidence that breast feeding offers some protection against eczema in genetically vulnerable infants .  Feeds of soya preparations were associated with eczema as often as cows ' milk based feeds This quasi-experimental study was conducted in Shiraz , the Islamic Republic of Iran , on 120 pairs of mothers and infants in a maternity hospital that had a rooming-in programme . All 59 mothers in the study group received breastfeeding education , face-to-face , after delivery and during follow-up for 4 months in the mother and child health ( MCH ) centre or in their homes ; the remaining 61 mothers comprised the control group .  Exclusive breastfeeding rates were significantly higher in the study group ( 54 % ) than in the control group ( 6.5 % ) , but 5 % and 18 % of infants , respectively , in the study and control groups had stopped breastfeeding by the age of 4 months . The mean number of days of diarrhoea experienced by infants in the study group were significantly lower ( P < or = 0.004 ) than in the control group . At the end of 4 months , the mean weight and length of the infants were significantly higher ( both P < 0.05 ) in the study group than in the control group . The findings indicate that rooming-in is very important for promoting exclusive breastfeeding and that there is a need for continuous breastfeeding education of mothers We investigated the effectiveness of a program of intensive postpartum support for low-income , breast-feeding women and identified potential predictors of prolonged breast-feeding in this population . Ninety-seven low-income women were r and omized to receive intensive postpartum education and support for breast-feeding or to receive only the routine assistance provided by the obstetrical nurses .  Both groups were telephoned 6 weeks post partum to determine the method of infant feeding then , and those still breast-feeding were contacted monthly until complete weaning had occurred . No significant difference in breast-feeding duration between the two groups was noted . There was no association between duration of nursing and race , marital status , or the need to return to work or school . Earlier age at introduction of supplement , younger maternal age , and participation in prenatal classes predicted breast-feeding duration by logistic regression Abstract . A prospect i ve study of the course of breast feeding was carried out in 75 r and omly selected women . Weekly interviews were performed from the day after delivery until the termination of breast feeding , but in no case for longer than 6 months . In each case a detailed analysis was made of the factors leading to transient lactation crises or to complete cessation of breast feeding . A second group of 71 mothers , also r and omly selected , was interviewed in retrospect only , 6 months after delivery , and served as controls . Twenty‐four weeks after delivery 47 % of the mothers in the weekly interview group were still breast feeding . The corresponding figure in the control group was 38 % . In both groups only few mothers terminated lactation for medical reasons , while about one fourth stopped for some other reason and about one half because of a combination of factors . Brief case reports are presented to illustrate how varying the factors were that threatened breast feeding In a prospect i ve multicentre study on 926 preterm infants formally assigned to their early diet , necrotising enterocolitis developed in 51 ( 5.5 % ) .  Mortality was 26 % in stringently confirmed cases . In exclusively  formula-fed  babies confirmed disease was 6 - 10 times more common than in those fed breast milk alone and 3 times more common than in those who received formula plus breast milk . Pasteurised donor milk seemed to be as protective as raw maternal milk . Among babies born at more than 30 weeks ' gestation confirmed necrotising enterocolitis was rare in those whose diet included breast milk ; it was 20 times more common in those fed formula only . Other risk factors included very low  gestational age , respiratory disease , umbilical artery catheterisation , and polycythaemia . In formula-fed but not breast-milk-fed infants , delayed enteral feeding was associated with a lower frequency of necrotising enterocolitis . With the fall in the use of breast milk in British neonatal units , exclusive formula feeding could account for an estimated 500 extra cases of necrotising enterocolitis each year . About 100 of these infants would die BACKGROUND Exclusive breastfeeding is recommended worldwide but not commonly practised . We undertook a r and omised controlled study of the efficacy of home-based peer counselling to increase the proportion of exclusive breastfeeding among mothers and infants residing in periurban Mexico City . METHODS Two intervention groups with different counselling frequencies , six visits ( 44 ) and three visits ( 52 ) , were compared with a control group ( 34 
    Output:
    