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: BACKGROUND The Baby-Friendly Hospital Initiative was launched by the World Health Organization and UNICEF in 1989 to promote , protect , and support breastfeeding worldwide . The objective of this study was to report breastfeeding rates and adherence to the Baby Friendly Hospital Initiative of the World Health Organization and UNICEF in Canada , as reported by participants in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System . METHODS Eligible women ( n = 8,244 ) were identified from a r and omly selected sample of infants born 3 months before the May 2006 Canadian Census , and stratified by province or territory . Birth mothers living with their infants at the time of interview were invited to participate in a computer-assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada . Interviews took approximately 45 minutes and were completed when infants were between 5 and 10 months old ( between 9 and 14 months in the territories ) . Completed responses were obtained from 6,421 women ( 78 % response rate ) . Nineteen of 309 questions concerned early mother-infant contact and breastfeeding practice s. RESULTS Breastfeeding intention ( 90.0 % ) and initiation ( 90.3 % ) rates were high , although exclusive breastfeeding rates at 6 months after birth ( 14.4 % ) were lower than desirable . The findings suggested a low adherence to several best practice s advocated by the Baby-Friendly Hospital Initiative . CONCLUSION Although breastfeeding initiation rates were relatively high in Canada , exclusive breastfeeding duration fell short of globally recommended st and ards The study objective was to investigate whether exclusively breast-fed infants could be taught to sleep through the night ( defined from 12:00 AM to 5:00 AM ) during the first 8 weeks of life . The design was short-term longitudinal , from the last trimester of pregnancy until the eighth week after birth . Twenty-six first-time parents and their newborn were r and omly assigned to treatment and control groups ( 13 in each group ) . Treatment parents were instructed to offer a " focal feed " ( between 10 PM and 12 AM ) to their infants every night , to gradually lengthen intervals between middle-of-the-night feeds by carrying out alternative caretaking behaviors ( eg , reswaddling , diapering , walking ) , and to maximize environmental differences between day and nighttime . All parents kept 72-hour diaries of their infants ' feeding and sleeping patterns every week from birth to 8 weeks of age and rated their infants ' temperament at birth and at 8 weeks . By 3 weeks , treatment infants showed significantly longer sleep episodes at night . By 8 weeks 100 % of treatment infants were sleeping through the night compared to 23 % of control infants . Treatment infants were feeding less frequently at night but compensated for the relatively long nighttime interval without a feed by consuming more milk in the early morning . Milk intake for 24-hour periods did not differ between groups . Treatment infants were rated as more predictable on Bates ' Infant Characteristics Question naire . It is concluded that parents can have a powerful influence on the development of their infants ' sleep patterns . Frequent night waking in breast-fed infants often results in early termination of lactation . ( ABSTRACT TRUNCATED AT 250 WORDS AIM This study aim ed to investigate the prevalence of , and factors influencing , exclusive breastfeeding ( EBF )  at 6 months and continued breastfeeding ( CBF ) at 2 years . METHODS Between January and February 2007 , a cross-sectional study was conducted using a  semi-structured question  naire in 40 villages in the Vientiane capital and the Vientiane province of Lao PDR . A total of 400 mothers with children less than 2 years old were recruited by multistage r and om sampling . Based on the 1991 World Health Organization Breastfeeding Indicators , children were classified into three groups , 6 - 23-month-old children for assessing EBF at 6 months , 12 - 15-month-old children for CBF at 1 year and 20 - 23-month-old children for CBF at 2 years . RESULTS The prevalence of EBF at 6 months and CBF at 2 years were 19.4 % ( n= 283 ) and 18.6 % ( n= 43 ) , respectively . Some of the factors influencing EBF at 6 months in a univariate logistic regression model included : location of residence , ( OR : 19.19 , 95 % CI 6.96 - 57.01 ) , ethnicity ( OR : 3.15 , 95 % CI 1.63 - 6.08 ) , encouragement of the child 's father ( OR : 9.03 , 95%CI 1.21 - 67.57 ) and inter-spousal communication ( OR : 5.20 , 95 % CI 2.34 - 11.56 ) . A majority of the mothers ( 75.0 % ) had watched television advertisements for infant formula from Thail and , and 48.4 % reported that they wanted to buy formula milk after having watched them . CONCLUSION This study showed a low prevalence of EBF at 6 months in the studied area in Lao PDR . Some of the factors that had a strong impact on EBF at 6 months included : location of residence , ethnicity , father 's involvement , early breastfeeding plan , Mother 's Card in antenatal care and television advertisement . There may be opportunities for government to review a range of policies relating to paternal involvement , antenatal care and formula advertising that could help to improve EBF rate BACKGROUND Although the benefits of exclusive breastfeeding for child health and survival , particularly in the post-neonatal period , are established , the independent beneficial effect of early breastfeeding initiation remains unclear . We studied the association between timing of breastfeeding initiation and  post-enrolment neonatal and post-neonatal mortality up to 6 months of age , as well as the associations between breastfeeding pattern and mortality . METHODS We examined associations between timing of breastfeeding initiation , post-enrolment neonatal mortality ( enrolment 28 days ) , and post-neonatal mortality up to 6 months of age ( 29 - 180 days ) in a large cohort from three neonatal vitamin A trials in Ghana , India , and Tanzania . Newborn babies were eligible for these trials if their mother reported that they were likely to stay in the study area for the next 6 months , they could feed orally , were aged less than 3 days , and the primary caregiver gave informed consent . We excluded infants who initiated breastfeeding after 96 h , did not initiate , or had missing initiation status . We pooled the data from both r and omised groups of the three trials and then categorised time of breastfeeding initiation as : at ≤1 h , 2 - 23 h , and 24 - 96 h. We defined breastfeeding patterns as exclusive , predominant , or partial breastfeeding at 4 days , 1 month , and 3 months of age . We estimated relative risks using log binomial regression and Poisson regression with robust variances . Multivariate models controlled for site and potential confounders . FINDINGS Of 99 938 enrolled infants , 99 632 babies initiated breastfeeding by 96 h of age and were included in our prospect i ve cohort . 56 981 ( 57·2 % ) initiated breastfeeding at ≤1 h , 38 043 ( 38·2 % ) at 2 - 23 h , and 4608 ( 4·6 % ) at 24 - 96 h. Compared with infants initiating breastfeeding within the first hour of life , neonatal mortality between enrolment and 28 days was higher in infants initiating at 2 - 23 h ( adjusted relative risk 1·41 [ 95 % CI 1·24 - 1·62 ] , p<0·0001 ) , and in those initiating at 24 - 96 h ( 1·79 [ 1·39 - 2·30 ] , p<0·0001 ) . These associations were similar when deaths in the first 4 days of life were excluded ( 1·32 [ 1·10 - 1·58 ] , p=0·003 , for breastfeeding initiation at 2 - 23 h , and 1·90 [ 1·38 - 2·62 ] , p=0·0001 , for initiation at 24 - 96 h ) . When data were stratified by exclusive breastfeeding status at 4 days of age ( p value for interaction=0·690 ) , these associations were also similar in magnitude but with wider confidence intervals for initiation at 2 - 23 h ( 1·41 [ 1·12 - 1·77 ] , p=0·003 ) and for initiation at 24 - 96 h ( 1·51 [ 0·63 - 3·65 ] , p=0·357 ) . Exclusive breastfeeding was also associated with the lower mortality during the first 6 months of life ( 1 - 3 months mortality : exclusive vs partial breastfeeding at 1 month 1·83 [ 1·45 - 2·32 ] , p<0·0001 , and exclusive breastfeeding vs no breastfeeding at 1 month 10·88 [ 8·27 - 14·31 ] , p<0·0001 ) . INTERPRETATION Our findings suggest that early initiation of breastfeeding reduces neonatal and early infant mortality both through increasing rates of exclusive breastfeeding and by additional mechanisms . Both practice s should be promoted by public health programmes and should be used in models to estimate lives saved . FUNDING Bill & Melinda Gates Foundation through a grant to the WHO OBJECTIVE Our purpose was to evaluate the effect of breast-feeding frequency on serum bilirubin levels in the first 3 days after birth . STUDY DESIGN Two hundred seventy-five infants were r and omly assigned to a frequent or dem and breast-feeding schedule . RESULTS Infants in the frequent group ( n = 131 ) nursed nine ( 7.5 to 10.5 ) times per day ( median and inner 80 % ) , and the dem and group ( n = 143 ) fed 6.5 ( 5.5 to 8.0 ) times per day . The serum bilirubin level was measured in all infants between 48 and 80 hours ( median 53 hours , inner 80 % 48 to 68 hours ) and was 7.4 ( 1.8 to 10.7 ) mg/dl in the frequent group and 8.0 ( 2.9 to 11.2 ) mg/dl in the dem and group ( p = 0.103 ) . There was no correlation between the frequency of breast-feeding and the serum bilirubin level . CONCLUSION Within the range of the frequency of nursing observed in this study , we could not demonstrate a significant effect on serum bilirubin levels in the first 3 days after birth Background : Although exclusive breastfeeding is recommended for the first 6 months , the use of breast milk substitutes is widespread around the world . Objectives : To describe the patterns of infant formula supplementation among healthy breastfeeding newborns , to identify factors contributing to in-hospital formula supplementation , and to assess the dose-response relationship between the amount of in-hospital formula supplementation and the duration of any breastfeeding . Methods : A sample of 1246 breastfeeding mother – infant pairs was recruited from 4 public hospitals in Hong Kong and followed prospect ively for 12 months or until weaned . Multiple logistic regression analysis was used to examine factors associated with in-hospital supplementation . Cox regression analysis was used to explore the impact of in-hospital supplementation  on breastfeeding duration . Results : Of the total , 82.5 % of newborns were supplemented in the hospital ; one-half received formula within 5 hours of birth . Assisted vaginal delivery ( odds ratio [ OR ] = 2.06 , 95 % confidence interval [ CI ] 1.03 , 4.15 ) , cesarean section ( OR = 3.45 , 95 % CI 1.75 , 6.80 ) , and higher birth weight ( OR = 1.56 , 95 % CI 1.12 , 2.18 ) were positively associated with in-hospital formula supplementation , whereas initiating breastfeeding in the delivery room ( OR = 0.55 , 95 % CI 0.33 , 0.89 ) was associated with decreased likelihood of in-hospital supplementation . Any infant formula in the first 48 hours was associated with a shorter duration of breastfeeding ( hazard ratio [ HR ] = 1.51 , 95 % CI 1.27 , 1.80 ) , but there was no dose-response effect . Conclusion : In-hospital formula supplementation is common in Hong Kong hospitals and appears to be detrimental to breastfeeding duration . Continued efforts should be made to avoid the provision of infant formula to breastfeeding babies while in the hospital unless medically indicated BACKGROUND Breastfeeding conveys many benefits , but women often encounter difficulties in the first few weeks . The objective of this study was to examine women 's perspectives on the information , advice , and support they receive with breastfeeding . METHODS A qualitative analysis was conducted of women 's responses to open questions about their experiences of breastfeeding support . Participants were recruited as part of a r and omized controlled trial of additional support from volunteer breastfeeding counselors , and they completed question naires when their babies were 6 weeks old . RESULTS Of the 720 women recruited to the trial , 654 began breastfeeding and completed 
    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: BACKGROUND The Baby-Friendly Hospital Initiative was launched by the World Health Organization and UNICEF in 1989 to promote , protect , and support breastfeeding worldwide . The objective of this study was to report breastfeeding rates and adherence to the Baby Friendly Hospital Initiative of the World Health Organization and UNICEF in Canada , as reported by participants in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System . METHODS Eligible women ( n = 8,244 ) were identified from a r and omly selected sample of infants born 3 months before the May 2006 Canadian Census , and stratified by province or territory . Birth mothers living with their infants at the time of interview were invited to participate in a computer-assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada . Interviews took approximately 45 minutes and were completed when infants were between 5 and 10 months old ( between 9 and 14 months in the territories ) . Completed responses were obtained from 6,421 women ( 78 % response rate ) . Nineteen of 309 questions concerned early mother-infant contact and breastfeeding practice s. RESULTS Breastfeeding intention ( 90.0 % ) and initiation ( 90.3 % ) rates were high , although exclusive breastfeeding rates at 6 months after birth ( 14.4 % ) were lower than desirable . The findings suggested a low adherence to several best practice s advocated by the Baby-Friendly Hospital Initiative . CONCLUSION Although breastfeeding initiation rates were relatively high in Canada , exclusive breastfeeding duration fell short of globally recommended st and ards The study objective was to investigate whether exclusively breast-fed infants could be taught to sleep through the night ( defined from 12:00 AM to 5:00 AM ) during the first 8 weeks of life . The design was short-term longitudinal , from the last trimester of pregnancy until the eighth week after birth . Twenty-six first-time parents and their newborn were r and omly assigned to treatment and control groups ( 13 in each group ) . Treatment parents were instructed to offer a " focal feed " ( between 10 PM and 12 AM ) to their infants every night , to gradually lengthen intervals between middle-of-the-night feeds by carrying out alternative caretaking behaviors ( eg , reswaddling , diapering , walking ) , and to maximize environmental differences between day and nighttime . All parents kept 72-hour diaries of their infants ' feeding and sleeping patterns every week from birth to 8 weeks of age and rated their infants ' temperament at birth and at 8 weeks . By 3 weeks , treatment infants showed significantly longer sleep episodes at night . By 8 weeks 100 % of treatment infants were sleeping through the night compared to 23 % of control infants . Treatment infants were feeding less frequently at night but compensated for the relatively long nighttime interval without a feed by consuming more milk in the early morning . Milk intake for 24-hour periods did not differ between groups . Treatment infants were rated as more predictable on Bates ' Infant Characteristics Question naire . It is concluded that parents can have a powerful influence on the development of their infants ' sleep patterns . Frequent night waking in breast-fed infants often results in early termination of lactation . ( ABSTRACT TRUNCATED AT 250 WORDS AIM This study aim ed to investigate the prevalence of , and factors influencing , exclusive breastfeeding ( EBF )  at 6 months and continued breastfeeding ( CBF ) at 2 years . METHODS Between January and February 2007 , a cross-sectional study was conducted using a  semi-structured question  naire in 40 villages in the Vientiane capital and the Vientiane province of Lao PDR . A total of 400 mothers with children less than 2 years old were recruited by multistage r and om sampling . Based on the 1991 World Health Organization Breastfeeding Indicators , children were classified into three groups , 6 - 23-month-old children for assessing EBF at 6 months , 12 - 15-month-old children for CBF at 1 year and 20 - 23-month-old children for CBF at 2 years . RESULTS The prevalence of EBF at 6 months and CBF at 2 years were 19.4 % ( n= 283 ) and 18.6 % ( n= 43 ) , respectively . Some of the factors influencing EBF at 6 months in a univariate logistic regression model included : location of residence , ( OR : 19.19 , 95 % CI 6.96 - 57.01 ) , ethnicity ( OR : 3.15 , 95 % CI 1.63 - 6.08 ) , encouragement of the child 's father ( OR : 9.03 , 95%CI 1.21 - 67.57 ) and inter-spousal communication ( OR : 5.20 , 95 % CI 2.34 - 11.56 ) . A majority of the mothers ( 75.0 % ) had watched television advertisements for infant formula from Thail and , and 48.4 % reported that they wanted to buy formula milk after having watched them . CONCLUSION This study showed a low prevalence of EBF at 6 months in the studied area in Lao PDR . Some of the factors that had a strong impact on EBF at 6 months included : location of residence , ethnicity , father 's involvement , early breastfeeding plan , Mother 's Card in antenatal care and television advertisement . There may be opportunities for government to review a range of policies relating to paternal involvement , antenatal care and formula advertising that could help to improve EBF rate BACKGROUND Although the benefits of exclusive breastfeeding for child health and survival , particularly in the post-neonatal period , are established , the independent beneficial effect of early breastfeeding initiation remains unclear . We studied the association between timing of breastfeeding initiation and  post-enrolment neonatal and post-neonatal mortality up to 6 months of age , as well as the associations between breastfeeding pattern and mortality . METHODS We examined associations between timing of breastfeeding initiation , post-enrolment neonatal mortality ( enrolment 28 days ) , and post-neonatal mortality up to 6 months of age ( 29 - 180 days ) in a large cohort from three neonatal vitamin A trials in Ghana , India , and Tanzania . Newborn babies were eligible for these trials if their mother reported that they were likely to stay in the study area for the next 6 months , they could feed orally , were aged less than 3 days , and the primary caregiver gave informed consent . We excluded infants who initiated breastfeeding after 96 h , did not initiate , or had missing initiation status . We pooled the data from both r and omised groups of the three trials and then categorised time of breastfeeding initiation as : at ≤1 h , 2 - 23 h , and 24 - 96 h. We defined breastfeeding patterns as exclusive , predominant , or partial breastfeeding at 4 days , 1 month , and 3 months of age . We estimated relative risks using log binomial regression and Poisson regression with robust variances . Multivariate models controlled for site and potential confounders . FINDINGS Of 99 938 enrolled infants , 99 632 babies initiated breastfeeding by 96 h of age and were included in our prospect i ve cohort . 56 981 ( 57·2 % ) initiated breastfeeding at ≤1 h , 38 043 ( 38·2 % ) at 2 - 23 h , and 4608 ( 4·6 % ) at 24 - 96 h. Compared with infants initiating breastfeeding within the first hour of life , neonatal mortality between enrolment and 28 days was higher in infants initiating at 2 - 23 h ( adjusted relative risk 1·41 [ 95 % CI 1·24 - 1·62 ] , p<0·0001 ) , and in those initiating at 24 - 96 h ( 1·79 [ 1·39 - 2·30 ] , p<0·0001 ) . These associations were similar when deaths in the first 4 days of life were excluded ( 1·32 [ 1·10 - 1·58 ] , p=0·003 , for breastfeeding initiation at 2 - 23 h , and 1·90 [ 1·38 - 2·62 ] , p=0·0001 , for initiation at 24 - 96 h ) . When data were stratified by exclusive breastfeeding status at 4 days of age ( p value for interaction=0·690 ) , these associations were also similar in magnitude but with wider confidence intervals for initiation at 2 - 23 h ( 1·41 [ 1·12 - 1·77 ] , p=0·003 ) and for initiation at 24 - 96 h ( 1·51 [ 0·63 - 3·65 ] , p=0·357 ) . Exclusive breastfeeding was also associated with the lower mortality during the first 6 months of life ( 1 - 3 months mortality : exclusive vs partial breastfeeding at 1 month 1·83 [ 1·45 - 2·32 ] , p<0·0001 , and exclusive breastfeeding vs no breastfeeding at 1 month 10·88 [ 8·27 - 14·31 ] , p<0·0001 ) . INTERPRETATION Our findings suggest that early initiation of breastfeeding reduces neonatal and early infant mortality both through increasing rates of exclusive breastfeeding and by additional mechanisms . Both practice s should be promoted by public health programmes and should be used in models to estimate lives saved . FUNDING Bill & Melinda Gates Foundation through a grant to the WHO OBJECTIVE Our purpose was to evaluate the effect of breast-feeding frequency on serum bilirubin levels in the first 3 days after birth . STUDY DESIGN Two hundred seventy-five infants were r and omly assigned to a frequent or dem and breast-feeding schedule . RESULTS Infants in the frequent group ( n = 131 ) nursed nine ( 7.5 to 10.5 ) times per day ( median and inner 80 % ) , and the dem and group ( n = 143 ) fed 6.5 ( 5.5 to 8.0 ) times per day . The serum bilirubin level was measured in all infants between 48 and 80 hours ( median 53 hours , inner 80 % 48 to 68 hours ) and was 7.4 ( 1.8 to 10.7 ) mg/dl in the frequent group and 8.0 ( 2.9 to 11.2 ) mg/dl in the dem and group ( p = 0.103 ) . There was no correlation between the frequency of breast-feeding and the serum bilirubin level . CONCLUSION Within the range of the frequency of nursing observed in this study , we could not demonstrate a significant effect on serum bilirubin levels in the first 3 days after birth Background : Although exclusive breastfeeding is recommended for the first 6 months , the use of breast milk substitutes is widespread around the world . Objectives : To describe the patterns of infant formula supplementation among healthy breastfeeding newborns , to identify factors contributing to in-hospital formula supplementation , and to assess the dose-response relationship between the amount of in-hospital formula supplementation and the duration of any breastfeeding . Methods : A sample of 1246 breastfeeding mother – infant pairs was recruited from 4 public hospitals in Hong Kong and followed prospect ively for 12 months or until weaned . Multiple logistic regression analysis was used to examine factors associated with in-hospital supplementation . Cox regression analysis was used to explore the impact of in-hospital supplementation  on breastfeeding duration . Results : Of the total , 82.5 % of newborns were supplemented in the hospital ; one-half received formula within 5 hours of birth . Assisted vaginal delivery ( odds ratio [ OR ] = 2.06 , 95 % confidence interval [ CI ] 1.03 , 4.15 ) , cesarean section ( OR = 3.45 , 95 % CI 1.75 , 6.80 ) , and higher birth weight ( OR = 1.56 , 95 % CI 1.12 , 2.18 ) were positively associated with in-hospital formula supplementation , whereas initiating breastfeeding in the delivery room ( OR = 0.55 , 95 % CI 0.33 , 0.89 ) was associated with decreased likelihood of in-hospital supplementation . Any infant formula in the first 48 hours was associated with a shorter duration of breastfeeding ( hazard ratio [ HR ] = 1.51 , 95 % CI 1.27 , 1.80 ) , but there was no dose-response effect . Conclusion : In-hospital formula supplementation is common in Hong Kong hospitals and appears to be detrimental to breastfeeding duration . Continued efforts should be made to avoid the provision of infant formula to breastfeeding babies while in the hospital unless medically indicated BACKGROUND Breastfeeding conveys many benefits , but women often encounter difficulties in the first few weeks . The objective of this study was to examine women 's perspectives on the information , advice , and support they receive with breastfeeding . METHODS A qualitative analysis was conducted of women 's responses to open questions about their experiences of breastfeeding support . Participants were recruited as part of a r and omized controlled trial of additional support from volunteer breastfeeding counselors , and they completed question naires when their babies were 6 weeks old . RESULTS Of the 720 women recruited to the trial , 654 began breastfeeding and completed 
    Output:
    