Continued breastfeeding and child growth in the second year of life: a prospective cohort study in western Kenya

Background The value of postinfancy breastfeeding for growth and nutritional status is debated. We have investigated this issue in a longitudinal study. Methods We prospectively followed up a cohort of 264 children in western Kenya for 6 months (mean age 14 months [range 9–18] at baseline) to investigate the nature of the association between breastfeeding and growth. Only 14 (5•3%) children had been weaned at baseline, and 173 (65•5%) were still breastfed at follow-up. For analysis, children were classified into three groups of breastfeeding duration as a proportion of the total follow-up period (0–49%, n=42; 50–99%, n=49; and 100%, n=173). Findings In general linear models multivariate analysis, children in the longest-duration breastfeeding group gained 3•4 cm (p=0•0001) and 370 g (p=0•005) more than those in the shortest duration group, and 0•6 cm (p=0•0015) and 230 g (p=0•038) more than children in the intermediate group. The strongest association between breastfeeding and linear growth was observed in households that had no latrine and daily water use of less than 10 L perperson. Interpretation Our findings support WHOʹs recommendation to continue breastfeeding for at least 2 years, especially in settings with poor sanitation and inadequate water supply.