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: OBJECTIVE To determine the association of different feeding patterns for infants ( exclusive breastfeeding , predominant breastfeeding , partial breastfeeding and no breastfeeding ) with  mortality and hospital admissions  during the first half of infancy . METHODS This paper is based on a secondary analysis of data from a multicentre r and omized controlled trial on immunization-linked vitamin A supplementation . Altogether , 9424 infants and their mothers ( 2919 in Ghana , 4000 in India and 2505 in Peru ) were enrolled when infants were 18 - 42 days old in two urban slums in New Delhi , India , a periurban shanty town in Lima , Peru , and 37 villages in the Kintampo district of Ghana . Mother-infant pairs were visited at home every 4 weeks from the time the infant received the first dose of oral polio vaccine and diphtheria-pertussis-tetanus at the age of 6 weeks in Ghana and India and at the age of 10 weeks in Peru . At each visit , mothers were queried about what they had offered their infant to eat or drink during the past week . Information was also collected on hospital admissions and deaths occurring between the ages of 6 weeks and 6 months . The main outcome measures were all-cause mortality , diarrhoea-specific mortality , mortality caused by acute lower respiratory infections , and hospital admissions . FINDINGS There was no significant difference in the risk of death between children who were exclusively breastfed and those who were predominantly breastfed ( adjusted hazard ratio ( HR ) = 1.46 ; 95 % confidence interval ( CI ) = 0.75 - 2.86 ) . Non-breastfed infants had a higher risk of dying when compared with those who had been predominantly breastfed ( HR = 10.5 ; 95 % CI = 5.0 - 22.0 ; P < 0.001 ) as did partially breastfed infants ( HR = 2.46 ; 95 % CI = 1.44 - 4.18 ; P = 0.001 ) . CONCLUSION There are two major implication s of these findings . First , the extremely high risks of infant mortality associated with not being breastfed need to be taken into account when informing HIV-infected mothers about options for feeding their infants . Second , our finding that the risks of death are similar for infants who are predominantly breastfed and those who are exclusively breastfed suggests that in setting s where rates of predominant breastfeeding are already high , promotion efforts should focus on sustaining these high rates rather than on attempting to achieve a shift from predominant breastfeeding to exclusive breastfeeding 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 BACKGROUND The aim of the study was to determine whether peer counselling in the antenatal and post-natal period would increase the prevalence and duration of breastfeeding among low-income women in Glasgow . METHODS The study was design ed as a quasi-experimental evaluation of a community-based breastfeeding promotion programme . The intervention comprised peer counselling of pregnant women , support of breastfeeding mothers and local awareness-raising activities .  The study subjects were all women attending the antenatal booking clinic resident in either the intervention or control area . Data were collected by means of four self-completion question naires , two administered antenatally and two post-natally . The proportions intending to breastfeed or breastfeeding in the intervention and control groups were compared at each assessment and over time . RESULTS Of the 995 women enrolled in the study , data were available for analysis on 919 ( 92 per cent ) to 6 weeks postnatally . At booking , 18 per cent of the intervention group and 21 per cent of the control group stated an intention to breastfeed . At delivery , the proportions initiating breastfeeding were 23 per cent of the intervention subjects and 20 per cent of the controls , and by 6 weeks post-natally , the proportion providing any breast milk had declined to 10 per cent of the intervention group and 8 per cent of the control group . Using multivariate analysis to adjust for factors ( such as socio-economic status ) known to influence breastfeeding , the breastfeeding prevalence was significantly higher in the intervention group relative to the controls at delivery [ odds ratio ( OR ) 2.0 ; 95 per cent confidence interval ( CI ) 1.2 - 3.1 , p = 0.006 ] . By 6 weeks post-natally the difference between the two groups was not statistically significant ( OR 1.8 ; 95 per cent CI 1.0 - 3.4 , p=0.07 ) . CONCLUSIONS As the impact of the intervention was not sustained even for the modest duration of 6 weeks postnatally , it would be premature to justify widespread use of peer support programmes to increase the prevalence of breastfeeding in socially disadvantaged communities Before carrying out a  breastfeeding promotion programme  in a periurban area of Mexico City , we conducted a rapid ethnographic study to determine the factors associated with absence of exclusive breastfeeding . The responses to pilot interviews were used to develop a st and ardized question naire regarding reasons for infant feeding choice , sources of advice , and barriers to breastfeeding . We interviewed a r and om sample of 150 mothers with a child < 5 years of age ; 136 ( 91 % ) of them had initiated breastfeeding ; but only 2 % exclusively breastfed up to 4 months . The mothers consistently stated that the child 's nutrition , health , growth , and hygiene were the main reasons for the type of feeding selected ; cost , comfort , and the husb and 's opinion were less important . Physicians were ranked as the most important source of advice . Reduction or cessation of breastfeeding occurred on the doctor 's advice ( 68 % ) ; or when the mothers encountered local folk illnesses such as " coraje " ( 52 % ) or " susto " ( 54 % ) , which are associated with anger or fright ; or had " not enough milk " ( 62 % ) or " bad milk " ( 56 % ) ; or because of illness of the mother ( 56 % ) or child ( 43 % ) . During childhood illnesses and conditions , breastfeeding was reduced and the use of supplementary foods was increased . This study emphasizes the importance of cultural values in infant feeding choices , defines specific barriers to breastfeeding , and provides a basis for interventions to promote exclusive breastfeeding in the study population As an intervention against diarrhoea , promotion of breastfeeding has been suggested by the World Health Organization ( WHO ) . In the present study from Guinea Bissau we tested the possibilities of promoting breastfeeding at a local health centre . A total of 1250 children were allocated r and omly into two groups . Mothers in the intervention group were given health education according to WHO 's recommendations ; about exclusive breastfeeding for at least the first 4 mo , prolonged breastfeeding and family planning methods . At 4 mo of age introduction of weaning food was delayed in the intervention group ( risk rate 1.18 ( 95 % CI 1.03‐1.38 ) and more mothers had an IUD inserted ( risk rate 2.45 ( 1.27‐4.70 ) . The median length of breastfeeding was 23 mo in both groups . There was no difference in the number of children weaned early . Although exclusive breastfeeding was promoted by the intervention , early weaning of children in special risk groups was not avoided . An evaluation of the impact of the WHO recommendations in different setting s is warranted . □ Breastfeeding promotion , intervention study , Guinea Bissau , epidemiology , WHO OBJECTIVES Assess the effectiveness of home visits for advising mothers about breast feeding and weaning on  early childhood caries ( ECC ) at the age of 12 months . METHODS A r and omized field trial was conducted in mothers who gave birth within the public health system in the Brazilian city of Sao Leopoldo ( intervention group = 200 ; controls = 300 ) . The intervention group received the advice 10 days after the child 's birth , monthly up to 6 months , at 8 , 10 and 12 months , based on the ' Ten Steps for Healthy Feeding ' , a Brazilian national health policy for primary care , based on WHO guidelines . Both groups had research assessment at 6 and 12 months , with dental caries investigated in this last assessment ; 122 children were lost in the 1-year follow-up ; 378 were assessed for caries : two predentulous children were excluded from the analysis .  Mann-Whitney U was used to test if the average number of decayed surfaces ( DS ; white spots and cavities ) differed between the intervention and control groups , and logistic regression to estimate the effects of the intervention on the odds of ECC . Chi-square test was used to test for differences between the intervention and control groups in the distribution of feeding behaviours tackled by the dietary intervention . RESULTS 10.2 % of the children in the intervention group and 18.3 % of the controls had caries . The odds of caries was 48 % lower for the intervention group , adjusted for number of teeth ( OR = 0.52 , 95 % CI = 0.27 - 0.97 ) . Mean DS were lower for the intervention group ( 0.37 ) when compared with the control group ( 0.63 ) , ( Mann-Whitney U , P = 0.03 ) . The intervention group had significantly longer duration of exclusive breast feeding ( P = 0.000 ) , later introduction of sugar ( P = 0.005 ) , and smaller probability of ever having eaten biscuits ( P = 0.000 ) , honey ( P = 0.003 ) , soft drinks ( P = 0.02 ) , fromage-frais ( P = 0.001 ) , chocolate and sweets ( P = 0.001 ) . CONCLUSIONS ECC is a public health problem in that population . The home visits for dietary advice appear to help reducing dental caries in infants . Greater efforts are needed to tackle cariogenic dietary behaviours even further , as a relevant proportion of children of the intervention group were shown to present with dental caries . Further studies should examine the effect of the intervention in the longer term BACKGROUND Exclusive breastfeeding ( EBF ) is reported to be a life-saving intervention in low-income setting s. The effect of breastfeeding counselling by peer counsellors was assessed in Africa . METHODS 24 communities in Burkina Faso , 24 in Ug and a , and 34 in South Africa were assigned in a 1:1 ratio , by use of a computer-generated r and omisation sequence , to the control or intervention clusters . In the intervention group , we scheduled one antenatal breastfeeding peer counselling visit and four post-delivery visits by trained peers . The data gathering team were masked to the intervention allocation . The primary outcomes were prevalance of EBF and diarrhoea reported by mothers for infants aged 12 weeks and 24 weeks .  Country-specific prevalence ratios were adjusted for cluster effects and sites . Analysis was by intention to treat . This study is registered with Clinical Trials.gov , number NCT00397150 . FINDINGS 2579 mother-infant pairs were assigned to the intervention or control clusters in Burkina Faso ( n=392 and n=402 , respectively ) , Ug and a ( n=396 and n=369 , respectively ) , and South Africa ( n=535 and 485 , respectively ) .  The EBF prevalences based on 24-h recall at 12 weeks in the intervention and control clusters were 310 ( 79 % ) of 392 and 139 ( 35 % ) of 402 , respectively , in Burkina Faso ( prevalence ratio 2·29 , 95 % CI 1·33 - 3·92 ) ; 323 ( 82 % ) of 396 and 161 ( 44 % ) of 369 , respectively , in Ug and a ( 1·89 , 1·70 - 2·11 ) ; and 56 ( 10 % ) of 535 and 30 ( 6 % ) of 485 , respectively , in South Africa ( 1·72 , 1·12 - 2·63 ) . The EBF prevalences based on 7-day recall in the intervention and control clusters were 300 ( 77 % ) and 94 ( 23 % ) , respectively , in Burkina Faso ( 3·27 , 2·13 - 5·03 ) ; 305 ( 77 % ) and 125 ( 34 % ) , respectively , in Ug and a (  
    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: OBJECTIVE To determine the association of different feeding patterns for infants ( exclusive breastfeeding , predominant breastfeeding , partial breastfeeding and no breastfeeding ) with  mortality and hospital admissions  during the first half of infancy . METHODS This paper is based on a secondary analysis of data from a multicentre r and omized controlled trial on immunization-linked vitamin A supplementation . Altogether , 9424 infants and their mothers ( 2919 in Ghana , 4000 in India and 2505 in Peru ) were enrolled when infants were 18 - 42 days old in two urban slums in New Delhi , India , a periurban shanty town in Lima , Peru , and 37 villages in the Kintampo district of Ghana . Mother-infant pairs were visited at home every 4 weeks from the time the infant received the first dose of oral polio vaccine and diphtheria-pertussis-tetanus at the age of 6 weeks in Ghana and India and at the age of 10 weeks in Peru . At each visit , mothers were queried about what they had offered their infant to eat or drink during the past week . Information was also collected on hospital admissions and deaths occurring between the ages of 6 weeks and 6 months . The main outcome measures were all-cause mortality , diarrhoea-specific mortality , mortality caused by acute lower respiratory infections , and hospital admissions . FINDINGS There was no significant difference in the risk of death between children who were exclusively breastfed and those who were predominantly breastfed ( adjusted hazard ratio ( HR ) = 1.46 ; 95 % confidence interval ( CI ) = 0.75 - 2.86 ) . Non-breastfed infants had a higher risk of dying when compared with those who had been predominantly breastfed ( HR = 10.5 ; 95 % CI = 5.0 - 22.0 ; P < 0.001 ) as did partially breastfed infants ( HR = 2.46 ; 95 % CI = 1.44 - 4.18 ; P = 0.001 ) . CONCLUSION There are two major implication s of these findings . First , the extremely high risks of infant mortality associated with not being breastfed need to be taken into account when informing HIV-infected mothers about options for feeding their infants . Second , our finding that the risks of death are similar for infants who are predominantly breastfed and those who are exclusively breastfed suggests that in setting s where rates of predominant breastfeeding are already high , promotion efforts should focus on sustaining these high rates rather than on attempting to achieve a shift from predominant breastfeeding to exclusive breastfeeding 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 BACKGROUND The aim of the study was to determine whether peer counselling in the antenatal and post-natal period would increase the prevalence and duration of breastfeeding among low-income women in Glasgow . METHODS The study was design ed as a quasi-experimental evaluation of a community-based breastfeeding promotion programme . The intervention comprised peer counselling of pregnant women , support of breastfeeding mothers and local awareness-raising activities .  The study subjects were all women attending the antenatal booking clinic resident in either the intervention or control area . Data were collected by means of four self-completion question naires , two administered antenatally and two post-natally . The proportions intending to breastfeed or breastfeeding in the intervention and control groups were compared at each assessment and over time . RESULTS Of the 995 women enrolled in the study , data were available for analysis on 919 ( 92 per cent ) to 6 weeks postnatally . At booking , 18 per cent of the intervention group and 21 per cent of the control group stated an intention to breastfeed . At delivery , the proportions initiating breastfeeding were 23 per cent of the intervention subjects and 20 per cent of the controls , and by 6 weeks post-natally , the proportion providing any breast milk had declined to 10 per cent of the intervention group and 8 per cent of the control group . Using multivariate analysis to adjust for factors ( such as socio-economic status ) known to influence breastfeeding , the breastfeeding prevalence was significantly higher in the intervention group relative to the controls at delivery [ odds ratio ( OR ) 2.0 ; 95 per cent confidence interval ( CI ) 1.2 - 3.1 , p = 0.006 ] . By 6 weeks post-natally the difference between the two groups was not statistically significant ( OR 1.8 ; 95 per cent CI 1.0 - 3.4 , p=0.07 ) . CONCLUSIONS As the impact of the intervention was not sustained even for the modest duration of 6 weeks postnatally , it would be premature to justify widespread use of peer support programmes to increase the prevalence of breastfeeding in socially disadvantaged communities Before carrying out a  breastfeeding promotion programme  in a periurban area of Mexico City , we conducted a rapid ethnographic study to determine the factors associated with absence of exclusive breastfeeding . The responses to pilot interviews were used to develop a st and ardized question naire regarding reasons for infant feeding choice , sources of advice , and barriers to breastfeeding . We interviewed a r and om sample of 150 mothers with a child < 5 years of age ; 136 ( 91 % ) of them had initiated breastfeeding ; but only 2 % exclusively breastfed up to 4 months . The mothers consistently stated that the child 's nutrition , health , growth , and hygiene were the main reasons for the type of feeding selected ; cost , comfort , and the husb and 's opinion were less important . Physicians were ranked as the most important source of advice . Reduction or cessation of breastfeeding occurred on the doctor 's advice ( 68 % ) ; or when the mothers encountered local folk illnesses such as " coraje " ( 52 % ) or " susto " ( 54 % ) , which are associated with anger or fright ; or had " not enough milk " ( 62 % ) or " bad milk " ( 56 % ) ; or because of illness of the mother ( 56 % ) or child ( 43 % ) . During childhood illnesses and conditions , breastfeeding was reduced and the use of supplementary foods was increased . This study emphasizes the importance of cultural values in infant feeding choices , defines specific barriers to breastfeeding , and provides a basis for interventions to promote exclusive breastfeeding in the study population As an intervention against diarrhoea , promotion of breastfeeding has been suggested by the World Health Organization ( WHO ) . In the present study from Guinea Bissau we tested the possibilities of promoting breastfeeding at a local health centre . A total of 1250 children were allocated r and omly into two groups . Mothers in the intervention group were given health education according to WHO 's recommendations ; about exclusive breastfeeding for at least the first 4 mo , prolonged breastfeeding and family planning methods . At 4 mo of age introduction of weaning food was delayed in the intervention group ( risk rate 1.18 ( 95 % CI 1.03‐1.38 ) and more mothers had an IUD inserted ( risk rate 2.45 ( 1.27‐4.70 ) . The median length of breastfeeding was 23 mo in both groups . There was no difference in the number of children weaned early . Although exclusive breastfeeding was promoted by the intervention , early weaning of children in special risk groups was not avoided . An evaluation of the impact of the WHO recommendations in different setting s is warranted . □ Breastfeeding promotion , intervention study , Guinea Bissau , epidemiology , WHO OBJECTIVES Assess the effectiveness of home visits for advising mothers about breast feeding and weaning on  early childhood caries ( ECC ) at the age of 12 months . METHODS A r and omized field trial was conducted in mothers who gave birth within the public health system in the Brazilian city of Sao Leopoldo ( intervention group = 200 ; controls = 300 ) . The intervention group received the advice 10 days after the child 's birth , monthly up to 6 months , at 8 , 10 and 12 months , based on the ' Ten Steps for Healthy Feeding ' , a Brazilian national health policy for primary care , based on WHO guidelines . Both groups had research assessment at 6 and 12 months , with dental caries investigated in this last assessment ; 122 children were lost in the 1-year follow-up ; 378 were assessed for caries : two predentulous children were excluded from the analysis .  Mann-Whitney U was used to test if the average number of decayed surfaces ( DS ; white spots and cavities ) differed between the intervention and control groups , and logistic regression to estimate the effects of the intervention on the odds of ECC . Chi-square test was used to test for differences between the intervention and control groups in the distribution of feeding behaviours tackled by the dietary intervention . RESULTS 10.2 % of the children in the intervention group and 18.3 % of the controls had caries . The odds of caries was 48 % lower for the intervention group , adjusted for number of teeth ( OR = 0.52 , 95 % CI = 0.27 - 0.97 ) . Mean DS were lower for the intervention group ( 0.37 ) when compared with the control group ( 0.63 ) , ( Mann-Whitney U , P = 0.03 ) . The intervention group had significantly longer duration of exclusive breast feeding ( P = 0.000 ) , later introduction of sugar ( P = 0.005 ) , and smaller probability of ever having eaten biscuits ( P = 0.000 ) , honey ( P = 0.003 ) , soft drinks ( P = 0.02 ) , fromage-frais ( P = 0.001 ) , chocolate and sweets ( P = 0.001 ) . CONCLUSIONS ECC is a public health problem in that population . The home visits for dietary advice appear to help reducing dental caries in infants . Greater efforts are needed to tackle cariogenic dietary behaviours even further , as a relevant proportion of children of the intervention group were shown to present with dental caries . Further studies should examine the effect of the intervention in the longer term BACKGROUND Exclusive breastfeeding ( EBF ) is reported to be a life-saving intervention in low-income setting s. The effect of breastfeeding counselling by peer counsellors was assessed in Africa . METHODS 24 communities in Burkina Faso , 24 in Ug and a , and 34 in South Africa were assigned in a 1:1 ratio , by use of a computer-generated r and omisation sequence , to the control or intervention clusters . In the intervention group , we scheduled one antenatal breastfeeding peer counselling visit and four post-delivery visits by trained peers . The data gathering team were masked to the intervention allocation . The primary outcomes were prevalance of EBF and diarrhoea reported by mothers for infants aged 12 weeks and 24 weeks .  Country-specific prevalence ratios were adjusted for cluster effects and sites . Analysis was by intention to treat . This study is registered with Clinical Trials.gov , number NCT00397150 . FINDINGS 2579 mother-infant pairs were assigned to the intervention or control clusters in Burkina Faso ( n=392 and n=402 , respectively ) , Ug and a ( n=396 and n=369 , respectively ) , and South Africa ( n=535 and 485 , respectively ) .  The EBF prevalences based on 24-h recall at 12 weeks in the intervention and control clusters were 310 ( 79 % ) of 392 and 139 ( 35 % ) of 402 , respectively , in Burkina Faso ( prevalence ratio 2·29 , 95 % CI 1·33 - 3·92 ) ; 323 ( 82 % ) of 396 and 161 ( 44 % ) of 369 , respectively , in Ug and a ( 1·89 , 1·70 - 2·11 ) ; and 56 ( 10 % ) of 535 and 30 ( 6 % ) of 485 , respectively , in South Africa ( 1·72 , 1·12 - 2·63 ) . The EBF prevalences based on 7-day recall in the intervention and control clusters were 300 ( 77 % ) and 94 ( 23 % ) , respectively , in Burkina Faso ( 3·27 , 2·13 - 5·03 ) ; 305 ( 77 % ) and 125 ( 34 % ) , respectively , in Ug and a (  
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