THE EFFECT OF BRIEF EXPOSURE TO WATER, BREAST-MILK SUBSTITUTES, OR OTHER LIQUIDS ON THE SUCCESS AND DURATION OF BREASTFEEDING: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS

Abstract

Objective: To systematically evaluate the effect of supplemental fluids or feedings during the first days of life on the overall breastfeeding duration and rate of exclusive breastfeeding among healthy infants. Design/search Strategy: Medical subject headings and free-language terms were used to search the following electronic databases for studies relevant to breastfeeding: MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health (CINAHL), The Cochrane Library, and La Leche League; additional sources were obtained from reference lists of review articles. Only randomized controlled trials (RCT) were considered for study inclusion. Main Results: Of 56 potentially relevant clinical trials identified, only one RCT (170 infants) met the inclusion criteria for this systematic review. In this study, formula feeding was significantly more frequent at 4 weeks in the experimental group in which breastfeeding had been supplemented with 5% glucose ad libitum during the first 3 days of life (n = 83) than in the exclusively breastfed control group (n = 87) (p < 0.05). At 16 weeks (5 months postpartum), the percentage of mothers who continued breastfeeding, either exclusively or partially, was significantly lower in the experimental group than in the control group (p < 0.01). Conclusions: On the basis of this systematic review, there remains considerable uncertainty about the effect of brief exposure to water, breast-milk substitutes, or other liquids on the success and duration of breastfeeding. Future trials are needed.