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 increase knowledge on iron status and growth during the first 6 months of life . We hypothesized that iron status would be better in infants who received complementary foods in addition to breast milk compared with those exclusively breastfed . METHODS : One hundred nineteen healthy term ( ≥37 weeks ) singleton infants were r and omly assigned to receive either complementary foods in addition to breast milk from age 4 months ( CF ) or to exclusive breastfeeding for 6 months ( EBF ) . Dietary data were collected by 3-day weighed food records , and data on iron status and growth were also collected . RESULTS : One hundred infants ( 84 % ) completed the trial . Infants in the CF group had higher mean serum ferritin levels at 6 months ( P = .02 ) , which remained significant when adjusted for baseline characteristics . No difference was seen between groups in iron deficiency anemia , iron deficiency , or iron depletion . The average daily energy intake from complementary foods of 5-month-olds in the CF group was 36.8 kJ per kg body weight . Infants in both groups grew at the same rate between 4 and 6 months of age . CONCLUSIONS : In a high-income country , adding a small amount of complementary food in addition to breast milk to infants ’ diets from 4 months of age does not affect growth rate between 4 and 6 months , but has a small and positive effect on iron status at 6 months . The biological importance of this finding remains to be determined Objective : Early supplementation of breastfed infants may have consequences both for the mother and the child . We hypothesised that it would result in decreased maternal weight loss and in shorter duration s of breastfeeding and birth intervals . Design : Controlled r and omised population -based trial . Setting : Six villages in the Sine area of Senegal , West Africa . Subjects : Healthy breastfed infants and their mothers , 68 controls and 66 supplemented infants at r and omization . Intervention : Supplementation with high-energy , nutrient dense food from 4 to 7 months of age , twice daily under supervision of field workers . Both controls and supplemented infants were free to eat other complementary foods .  Maternal weight was measured monthly . Date s of breastfeeding cessation and of subsequent births were collected prospect ively through weekly demographic surveillance , and were analysed using Cox 's regression models and ‘ intent-to-supplement ’ approach . Results : Mean maternal weight gain from 4 to 7 months postpartum tended to be greater in the supplemented group ( + 0.25 kg/months , 95 % confidence interval ( CI ) : −0.07 , + 0.57 ) . Supplemented infants were breastfed for significantly longer duration s than controls ( medians : 24.9 and 23.7 months , respectively , P : 0.034 ) . Their adjusted hazard ratio ( HR ) for breastfeeding cessation was 0.59 ( 95 % CI : 0.40 , 0.89 ) . Their mothers had a lower risk of a new birth than mothers of controls ( adjusted HR : 0.57 , 95 % CI : 0.36 , 0.92 ) . Conclusions : Early short-term infant supplementation tended to decrease maternal postpartum weight loss , but it increased , rather than shortened , the duration of breastfeeding and birth interval . Sponsorship : This study was supported by a grant from the French Ministry of Research ( Grant 92L0623 ) OBJECTIVE --To assess the relations between early introduction of solid food and infant weight , gastrointestinal illness , and allergic illnesses during the first two years of life . DESIGN -- Prospect i ve observational study of infants followed up for 24 months after birth . SETTING --Community setting in Dundee . PATIENTS --671 newborn infants , of whom 455 were still available for study at 2 years of age . MAIN OUTCOME MEASURES --Infants ' diet , weight , and incidence of gastrointestinal illness , respiratory illness , napkin dermatitis , and eczema at 2 weeks and 2 , 3 , 4 , 6 , 9 , 12 , 15 , 18 , 21 , and 24 months of age . RESULTS --The infants given solid food at an early age ( at < 8 weeks or 8 - 12 weeks ) were heavier than those introduced to solids later ( after 12 weeks ) at 4 , 8 , 13 , and 26 weeks of age ( p < 0.01 ) but not at 52 and 104 weeks . At their first solid feed those given solids early were heavier than infants of similar age who had not yet received solids . The incidence of gastrointestinal illness , wheeze , and nappy dermatitis was not related to early introduction of solids . There was a significant but less than twofold increase in respiratory illness at 14 - 26 weeks of age and persistent cough at 14 - 26 and 27 - 39 weeks of age among the infants given solids early . The incidence of eczema was increased in the infants who received solids at 8 - 12 weeks of age . CONCLUSION --Early introduction of solid food to infants is less harmful than was previously reported . Longer follow up is needed , but , meanwhile , a more relaxed approach to early feeding with solids should be considered BACKGROUND Koko , a fermented maize porridge used as the primary complementary food in Ghana , has been implicated in the high prevalence of child malnutrition . Weanimix , a cereal-legume blend developed by the United Nations Children 's Fund and the Ghanaian government , has been promoted as an alternative . OBJECTIVE We evaluated the effect of feeding Weanimix and 3 other locally formulated , central ly processed complementary foods on the nutritional status of 208 breast-fed infants . DESIGN Infants were r and omly assigned to receive 1 of 4 foods from 6 to 12 mo of age : Weanimix ( W ) , Weanimix plus vitamins and minerals ( WM ) , Weanimix plus fish powder ( WF ) , and koko plus fish powder ( KF ) . Dietary and anthropometric data were collected regularly . Blood was collected at 6 and 12 mo of age to assess iron , zinc , vitamin A , and riboflavin status . Before and after the intervention , cross-sectional data on the anthropometric status of infants not included in the intervention ( NI ; n = 464 ) were collected . RESULTS There were no significant differences between intervention groups in weight or length gain or in hemoglobin , hematocrit , transferrin saturation , plasma zinc , or erythrocyte riboflavin values between 6 and 12 mo of age . From 9 to 12 mo of age , z scores were lower in NI infants than in the combined intervention groups [ at 12 mo : -1.71 + /- 0.90 compared with -1.19 + /- 0.93 for weight and -1.27 + /- 1.02 compared with -0.63 + /- 0.84 for length ( P < 0.001 for both ) , respectively ] . The percentage of infants with low ferritin values increased significantly between 6 and 12 mo of age in groups W , WF , and KF but not in group WM . Change in plasma retinol between 6 and 12 mo of age was significantly greater in group WM than in the other 3 groups combined ( 0.14 + /- 0.3 compared with -0.04 + /- 0.3 micromol/L , P = 0 . 003 ) . CONCLUSIONS All 4 foods improved growth relative to the NI group . Infants fed WM had better iron stores and vitamin A status than those fed nonfortified foods BACKGROUND Women who are overweight or obese before pregnancy breastfeed for shorter duration s than do normal-weight women . These shorter duration s may place infants of overweight and obese women at risk of not receiving the benefits of breastfeeding , which may include a reduced risk of overweight later in life . OBJECTIVE We examined how maternal prepregnant body mass index ( BMI ; in kg/m2 ) and infant feeding pattern are associated with  infant weight gain .  DESIGN In this prospect i ve , observational study , we used multiple regression analyses adjusted for potential confounding factors to examine these associations among 3768 mother-infant dyads from the Danish National Birth Cohort . RESULTS In multiple regression analyses , increasing maternal prepregnant BMI , decreasing duration s of breastfeeding , and earlier complementary food introduction were associated with increased infant weight gain . An interaction was identified for short duration s of breastfeeding ( < 20 wk ) . Earlier complementary food introduction ( < 16 wk ) was associated with greater infant weight gain ; however , the timing of complementary food introduction did not increase infant weight gain at longer duration s of breastfeeding ( > or = 20 wk ) . In this sample , prepregnant obesity ( BMI > or = 30.0 ) , short duration s of breastfeeding , and earlier introduction of complementary food were associated with 0.7 kg of additional weight gain during infancy . CONCLUSIONS  Infant weight gain is associated with maternal prepregnant BMI and with an interaction between the duration of breastfeeding and the timing of complementary food introduction . Future investigations of the effects of breastfeeding on infant weight gain should account for all of these factors To evaluate the effect of introducing complementary foods before 6 mo of age , we r and omly assigned 164 infants who had been exclusively breast-fed for 4 mo to continue being exclusively breast-fed until 6 mo ( EBF group ) or to receive iron-fortified foods in addition to breast milk from 4 to 6 mo ( BF+SF group ) . At 6 mo , the BF+SF group had higher mean iron intake ( 4 mg/d compared with 0.2 mg/d in EBF infants ) and higher hemoglobin , hematocrit , and ferritin values than the EBF group ( P < 0.05 ) . The percentage with low hemoglobin ( < 103 g/L ) did not differ significantly between groups , but fewer infants in the BF+SF group had a low hematocrit ( < 0.33 ; 21.4 % compared with 32.0 % , respectively ; P < 0.05 ) . The percentage of infants with ferritin concentrations < 12 microg/L at 6 mo was lower than the percentage with low hemoglobin or hematocrit , raising questions about the validity of the cutoffs at this age . Infants at greatest risk for anemia and low ferritin were those with birth weights < 2500 g ; no infant with a birth weight > 3000 g had a low ferritin value at 6 mo . We conclude that the risk of iron deficiency is low among infants with birth weights > 3000 g who are exclusively breast-fed for 6 mo . Iron drops are recommended for low-birth-weight infants ; for breast-fed infants with birth weights between 2500 and 3000 g , further research is needed to determine whether iron drops are more effective than complementary foods for preventing iron deficiency before 6 mo The effect of supplementation on growth was tested by means of four similar controlled r and omized trials in the Congo ( n = 120 ) , Senegal ( n = 110 ) , Bolivia ( n = 127 ) , and New Caledonia ( n = 90 ) . Four-month-old infants were r and omly allocated to supplement or control groups . A cereal-based precooked porridge was offered twice daily for 3 mo and consumption was monitored . Both groups were free to eat local food . At 7 mo of age , all infants were still breast-fed in the Congo , Senegal , and Bolivia compared with 47 % in New Caledonia . Mean daily consumption of the supplement varied among countries ( 558 - 790 kJ/d ) . Mean length at 4 mo was lowest in Bolivia , higher in Senegal and the Congo , and near the National Center for Health Statistics reference in New Caledonia . The mean 4 - 7 mo length increment was 0.48 cm higher for supplemented than for control infants in Senegal ( P < 0.05 ) , whereas weight increments did not differ . No significant effect was found in the other countries Background Whether the design of an anti-vacuum infant feeding bottle influences infant milk intake , growth or behavior is unknown , and was the subject of this r and omized trial . Methods Subjects : 63 ( 36 male ) healthy , exclusively formula-fed term infants . Intervention : R and omisation to use Bottle A ( n = 31 ) , one-way air valve : Philips Avent ) versus Bottle B ( n = 32 ) , internal venting system : Dr Browns ) . 74 breast-fed reference infants were recruited , with r and omisation ( n = 24 ) to bottle A ( n = 11 ) or B ( n = 13 ) if bottle-feeding was subsequently introduced . R and omisationstratified by gender and parity ; computer-based telephone r and omisation by independent clinical trials unit . Setting Infant home . Primary outcome measureinfant weight gain to 4 weeks . Secondary outcomes ( i ) milk intake ( ii ) infant behaviour measured at 2 weeks ( vali date d 3-day diary ) ; ( iii ) risk of infection ; ( iv ) continuation of breastfeeding following introduction of mixed feeding . Results Number analysed for primary outcome Bottle A n = 29 , Bottle B n = 25 . Primary outcome There was no significant difference in weight gain between r and omised groups ( 0 - 4 weeks Bottle A 0.74 ( SD 1.2 ) SDS versus bottle B 0.51 ( 0.39 ) , mean difference 0.23 ( 95 % CI -0.31 to 0.77 ) . Secondary outcomes Infants using bottle 
    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 increase knowledge on iron status and growth during the first 6 months of life . We hypothesized that iron status would be better in infants who received complementary foods in addition to breast milk compared with those exclusively breastfed . METHODS : One hundred nineteen healthy term ( ≥37 weeks ) singleton infants were r and omly assigned to receive either complementary foods in addition to breast milk from age 4 months ( CF ) or to exclusive breastfeeding for 6 months ( EBF ) . Dietary data were collected by 3-day weighed food records , and data on iron status and growth were also collected . RESULTS : One hundred infants ( 84 % ) completed the trial . Infants in the CF group had higher mean serum ferritin levels at 6 months ( P = .02 ) , which remained significant when adjusted for baseline characteristics . No difference was seen between groups in iron deficiency anemia , iron deficiency , or iron depletion . The average daily energy intake from complementary foods of 5-month-olds in the CF group was 36.8 kJ per kg body weight . Infants in both groups grew at the same rate between 4 and 6 months of age . CONCLUSIONS : In a high-income country , adding a small amount of complementary food in addition to breast milk to infants ’ diets from 4 months of age does not affect growth rate between 4 and 6 months , but has a small and positive effect on iron status at 6 months . The biological importance of this finding remains to be determined Objective : Early supplementation of breastfed infants may have consequences both for the mother and the child . We hypothesised that it would result in decreased maternal weight loss and in shorter duration s of breastfeeding and birth intervals . Design : Controlled r and omised population -based trial . Setting : Six villages in the Sine area of Senegal , West Africa . Subjects : Healthy breastfed infants and their mothers , 68 controls and 66 supplemented infants at r and omization . Intervention : Supplementation with high-energy , nutrient dense food from 4 to 7 months of age , twice daily under supervision of field workers . Both controls and supplemented infants were free to eat other complementary foods .  Maternal weight was measured monthly . Date s of breastfeeding cessation and of subsequent births were collected prospect ively through weekly demographic surveillance , and were analysed using Cox 's regression models and ‘ intent-to-supplement ’ approach . Results : Mean maternal weight gain from 4 to 7 months postpartum tended to be greater in the supplemented group ( + 0.25 kg/months , 95 % confidence interval ( CI ) : −0.07 , + 0.57 ) . Supplemented infants were breastfed for significantly longer duration s than controls ( medians : 24.9 and 23.7 months , respectively , P : 0.034 ) . Their adjusted hazard ratio ( HR ) for breastfeeding cessation was 0.59 ( 95 % CI : 0.40 , 0.89 ) . Their mothers had a lower risk of a new birth than mothers of controls ( adjusted HR : 0.57 , 95 % CI : 0.36 , 0.92 ) . Conclusions : Early short-term infant supplementation tended to decrease maternal postpartum weight loss , but it increased , rather than shortened , the duration of breastfeeding and birth interval . Sponsorship : This study was supported by a grant from the French Ministry of Research ( Grant 92L0623 ) OBJECTIVE --To assess the relations between early introduction of solid food and infant weight , gastrointestinal illness , and allergic illnesses during the first two years of life . DESIGN -- Prospect i ve observational study of infants followed up for 24 months after birth . SETTING --Community setting in Dundee . PATIENTS --671 newborn infants , of whom 455 were still available for study at 2 years of age . MAIN OUTCOME MEASURES --Infants ' diet , weight , and incidence of gastrointestinal illness , respiratory illness , napkin dermatitis , and eczema at 2 weeks and 2 , 3 , 4 , 6 , 9 , 12 , 15 , 18 , 21 , and 24 months of age . RESULTS --The infants given solid food at an early age ( at < 8 weeks or 8 - 12 weeks ) were heavier than those introduced to solids later ( after 12 weeks ) at 4 , 8 , 13 , and 26 weeks of age ( p < 0.01 ) but not at 52 and 104 weeks . At their first solid feed those given solids early were heavier than infants of similar age who had not yet received solids . The incidence of gastrointestinal illness , wheeze , and nappy dermatitis was not related to early introduction of solids . There was a significant but less than twofold increase in respiratory illness at 14 - 26 weeks of age and persistent cough at 14 - 26 and 27 - 39 weeks of age among the infants given solids early . The incidence of eczema was increased in the infants who received solids at 8 - 12 weeks of age . CONCLUSION --Early introduction of solid food to infants is less harmful than was previously reported . Longer follow up is needed , but , meanwhile , a more relaxed approach to early feeding with solids should be considered BACKGROUND Koko , a fermented maize porridge used as the primary complementary food in Ghana , has been implicated in the high prevalence of child malnutrition . Weanimix , a cereal-legume blend developed by the United Nations Children 's Fund and the Ghanaian government , has been promoted as an alternative . OBJECTIVE We evaluated the effect of feeding Weanimix and 3 other locally formulated , central ly processed complementary foods on the nutritional status of 208 breast-fed infants . DESIGN Infants were r and omly assigned to receive 1 of 4 foods from 6 to 12 mo of age : Weanimix ( W ) , Weanimix plus vitamins and minerals ( WM ) , Weanimix plus fish powder ( WF ) , and koko plus fish powder ( KF ) . Dietary and anthropometric data were collected regularly . Blood was collected at 6 and 12 mo of age to assess iron , zinc , vitamin A , and riboflavin status . Before and after the intervention , cross-sectional data on the anthropometric status of infants not included in the intervention ( NI ; n = 464 ) were collected . RESULTS There were no significant differences between intervention groups in weight or length gain or in hemoglobin , hematocrit , transferrin saturation , plasma zinc , or erythrocyte riboflavin values between 6 and 12 mo of age . From 9 to 12 mo of age , z scores were lower in NI infants than in the combined intervention groups [ at 12 mo : -1.71 + /- 0.90 compared with -1.19 + /- 0.93 for weight and -1.27 + /- 1.02 compared with -0.63 + /- 0.84 for length ( P < 0.001 for both ) , respectively ] . The percentage of infants with low ferritin values increased significantly between 6 and 12 mo of age in groups W , WF , and KF but not in group WM . Change in plasma retinol between 6 and 12 mo of age was significantly greater in group WM than in the other 3 groups combined ( 0.14 + /- 0.3 compared with -0.04 + /- 0.3 micromol/L , P = 0 . 003 ) . CONCLUSIONS All 4 foods improved growth relative to the NI group . Infants fed WM had better iron stores and vitamin A status than those fed nonfortified foods BACKGROUND Women who are overweight or obese before pregnancy breastfeed for shorter duration s than do normal-weight women . These shorter duration s may place infants of overweight and obese women at risk of not receiving the benefits of breastfeeding , which may include a reduced risk of overweight later in life . OBJECTIVE We examined how maternal prepregnant body mass index ( BMI ; in kg/m2 ) and infant feeding pattern are associated with  infant weight gain .  DESIGN In this prospect i ve , observational study , we used multiple regression analyses adjusted for potential confounding factors to examine these associations among 3768 mother-infant dyads from the Danish National Birth Cohort . RESULTS In multiple regression analyses , increasing maternal prepregnant BMI , decreasing duration s of breastfeeding , and earlier complementary food introduction were associated with increased infant weight gain . An interaction was identified for short duration s of breastfeeding ( < 20 wk ) . Earlier complementary food introduction ( < 16 wk ) was associated with greater infant weight gain ; however , the timing of complementary food introduction did not increase infant weight gain at longer duration s of breastfeeding ( > or = 20 wk ) . In this sample , prepregnant obesity ( BMI > or = 30.0 ) , short duration s of breastfeeding , and earlier introduction of complementary food were associated with 0.7 kg of additional weight gain during infancy . CONCLUSIONS  Infant weight gain is associated with maternal prepregnant BMI and with an interaction between the duration of breastfeeding and the timing of complementary food introduction . Future investigations of the effects of breastfeeding on infant weight gain should account for all of these factors To evaluate the effect of introducing complementary foods before 6 mo of age , we r and omly assigned 164 infants who had been exclusively breast-fed for 4 mo to continue being exclusively breast-fed until 6 mo ( EBF group ) or to receive iron-fortified foods in addition to breast milk from 4 to 6 mo ( BF+SF group ) . At 6 mo , the BF+SF group had higher mean iron intake ( 4 mg/d compared with 0.2 mg/d in EBF infants ) and higher hemoglobin , hematocrit , and ferritin values than the EBF group ( P < 0.05 ) . The percentage with low hemoglobin ( < 103 g/L ) did not differ significantly between groups , but fewer infants in the BF+SF group had a low hematocrit ( < 0.33 ; 21.4 % compared with 32.0 % , respectively ; P < 0.05 ) . The percentage of infants with ferritin concentrations < 12 microg/L at 6 mo was lower than the percentage with low hemoglobin or hematocrit , raising questions about the validity of the cutoffs at this age . Infants at greatest risk for anemia and low ferritin were those with birth weights < 2500 g ; no infant with a birth weight > 3000 g had a low ferritin value at 6 mo . We conclude that the risk of iron deficiency is low among infants with birth weights > 3000 g who are exclusively breast-fed for 6 mo . Iron drops are recommended for low-birth-weight infants ; for breast-fed infants with birth weights between 2500 and 3000 g , further research is needed to determine whether iron drops are more effective than complementary foods for preventing iron deficiency before 6 mo The effect of supplementation on growth was tested by means of four similar controlled r and omized trials in the Congo ( n = 120 ) , Senegal ( n = 110 ) , Bolivia ( n = 127 ) , and New Caledonia ( n = 90 ) . Four-month-old infants were r and omly allocated to supplement or control groups . A cereal-based precooked porridge was offered twice daily for 3 mo and consumption was monitored . Both groups were free to eat local food . At 7 mo of age , all infants were still breast-fed in the Congo , Senegal , and Bolivia compared with 47 % in New Caledonia . Mean daily consumption of the supplement varied among countries ( 558 - 790 kJ/d ) . Mean length at 4 mo was lowest in Bolivia , higher in Senegal and the Congo , and near the National Center for Health Statistics reference in New Caledonia . The mean 4 - 7 mo length increment was 0.48 cm higher for supplemented than for control infants in Senegal ( P < 0.05 ) , whereas weight increments did not differ . No significant effect was found in the other countries Background Whether the design of an anti-vacuum infant feeding bottle influences infant milk intake , growth or behavior is unknown , and was the subject of this r and omized trial . Methods Subjects : 63 ( 36 male ) healthy , exclusively formula-fed term infants . Intervention : R and omisation to use Bottle A ( n = 31 ) , one-way air valve : Philips Avent ) versus Bottle B ( n = 32 ) , internal venting system : Dr Browns ) . 74 breast-fed reference infants were recruited , with r and omisation ( n = 24 ) to bottle A ( n = 11 ) or B ( n = 13 ) if bottle-feeding was subsequently introduced . R and omisationstratified by gender and parity ; computer-based telephone r and omisation by independent clinical trials unit . Setting Infant home . Primary outcome measureinfant weight gain to 4 weeks . Secondary outcomes ( i ) milk intake ( ii ) infant behaviour measured at 2 weeks ( vali date d 3-day diary ) ; ( iii ) risk of infection ; ( iv ) continuation of breastfeeding following introduction of mixed feeding . Results Number analysed for primary outcome Bottle A n = 29 , Bottle B n = 25 . Primary outcome There was no significant difference in weight gain between r and omised groups ( 0 - 4 weeks Bottle A 0.74 ( SD 1.2 ) SDS versus bottle B 0.51 ( 0.39 ) , mean difference 0.23 ( 95 % CI -0.31 to 0.77 ) . Secondary outcomes Infants using bottle 
    Output:
    