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December 19, 1986


JAMA. 1986;256(23):3215. doi:10.1001/jama.1986.03380230039012

To the Editor.—  It can be deduced from the critical review by Bauchner et al1 that breast milk per se probably has no in vivo anti-infective qualities. However, their review is unduly restrictive and leaves unanswered major issues, such as why breast-feeding in developing countries is lifesaving. It may also reduce the pressure to reinstate breast-feeding in these countries.Studies before 1970 were omitted, so that the secular trend in developed countries was ignored. Mortality in Chicago in the 1920s was ten times greater in artificially fed than in breast-fed infants,2 which cannot be explained by any of the authors' biases. One reason for this was unskilled artificial feeding by mothers who were immigrants; they came from societies with no tradition of artificial feeding.The authors state that results should be analyzed separately for different types of infections, but do not do so. A review3 of all available