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Bart Holland, PhD, MPH
University of Medicine and Dentistry of New Jersey— New Jersey Medical School Newark

JAMA. 1987;257(24):3361.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Gordon¹ raises the question of why breast-feeding is lifesaving in developing countries, and he terms it an "unanswered major issue." He implies that supine feeding is the problem, but neglects to mention the difficulties of maintaining a sanitary food supply in developing countries.

Where sanitation is poor, non—breastfed infants are more frequently exposed to sources of infection than are breastfed infants. For example, a study in Gambia² showed that supplementary foods provided to infants, whether traditional gruels or commercial infant formulas, "were heavily contaminated with potentially pathogenic microorganisms," because the foods were not freshly prepared. In Chile,³ 80% of feeding bottles were found to harbor dangerously large numbers of bacteria. In a study in Uganda,⁴ bacterial counts were elevated in infant foods and on the surface of utensils used in preparation and feeding. In that study, 49% of infants whose mothers had attempted . . . [Full Text PDF of this Article]

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