Comment: The quality of evidence is downgraded by study limitations (lack of/unclear allocation concealment and blinding), and by imprecise results (few patients and outcome events).
A Cochrane review included 11 studies. 9 studies (n = 2226) provided data on outcomes of interest. In one study (n=170) comparing exclusively breastfeeding infants with infants who were allowed additional glucose water, the likelihood of breastfeeding was significantly greater in the exclusive breastfeeding group up to and including week 20 (RR 1.45, 95% CI 1.05 to 1.99). In one study (n=100) comparing exclusive breastfed infants with non-exclusive breastfed infants who were provided with artificial milk, did not affect breastfeeding at hospital discharge.
For infant morbidity, one newborn study (n=170) found higher serum glucose levels in glucose supplemented infants in the first 24 hours, though not at 48 hours (MD -0.24 mmol/L, 95% CI -0.51 to 0.03) (very low-quality evidence). In another trial with the water and glucose water arms combined (one trial, 47 infants), there was found no significant difference in weight loss between the additional fluid group and the exclusively breastfeeding group on either day three or day five (very low-quality evidence).
Three studies with four- to six-month-old infants provided no evidence to support any benefit from the addition of complementary foods at 4 months versus exclusive breastfeeding to 6 months nor any risks related either morbidity or weight change (or both).None of the trials reported on the remaining primary outcomes, infant mortality or physiological jaundice.
Date of latest search: 1 March 2016