Preface

Abstract

In November 1981, Dr Edward N. Brandt, Assistant Secretary of Health, Department of Health and Human Services, commissioned the Task Force to examine the scientific evidence regarding infant feeding and infant health in both the United States and developing countries. In addition, the report was to include recent information on trends, infant-feeding practices, and factors associated with infant-feeding decisions. The purpose of the Task Force was to determine those areas that were reasonably well studied and well proven and also to indicate where important deficiencies in knowledge existed. Because of the enormous volume of scientific literature dealing with infant feeding, the Task Force elected to concentrate on the most recent studies. In addition, studies of health effects were reviewed if they primarily addressed clinical outcomes in infants or children as end points. This approach necessarily excluded many of the laboratory studies that provide the theoretical framework under which breast-feeding would be expected to have important positive health effects relative to other forms of infant feeding. The Task Force also realized that because of the nature of clinical and epidemiologic research in this area, few of their conclusions could be based on the gold standard of causal research, namely, the randomized clinical trial. Nevertheless, to avoid arriving at conclusions and to say merely that more research was needed, would not live up to responsibility the Task Force was given. Accordingly, the authors of this report have tried to indicate which observational studies were of sufficient quality and consistency that reasonably firm conclusions could be reached, while indicating methodologic difficulties as they were found.