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June 26, 1987

Breast-feeding and Infectious Diarrhea-Reply

Author Affiliations



JAMA. 1987;257(24):3362. doi:10.1001/jama.1987.03390240067014

In Reply.—  In 1981, I concluded that infantile diarrhea was not due to contaminated food or water.1 Up to now, this conclusion has not been challenged. Dr Holland merely shows that most Third World infant food is contaminated. More relevant is the question of why most infants thrive despite this contamination. If his references are the best available to support his thesis— and I am unaware of any better2—then it is time the contamination/diarrhea link was critically tested, especially now that transmission of acquired immunodeficiency syndrome via breast milk has been proposed. Fear of breast-feeding may compound the acquired immunodeficiency syndrome tragedy in Africa.Turning to his sources, in Gambia there was no control group, and neither then nor later have Rowland et al correlated dirty food and diarrhea. No references for such a link were cited. In Chile, the dirty bottles belonged to rural children, not