Rifat N Ashraf, Fehmida Jalil, Lars A Hanson, Johan Karlberg.
Giving water during Breastfeeding increases diarrhoeal incidence and impairs early short term growth in a Poor Country.
Pak Paed J Jan ;27(2):47-55.

Diarrhoeal morbidity and early short term growth were related to breastfeeding with or without the addition of water. From an ongoing prospective study of 2364 infants in Lahore, Pakistan, 136 infants qualified for inclusion in this study. The inclusion criteria were: infants exclusively breastfed for at least a month; the addition of water to a pattern of breastfeeding during the first six months; infants remaining in the study at 3 months of age with at least 3 consecutive monthly examinations around the change in feeding pattern. Feeding pattern, diarrhoea morbidity and growth were recorded monthly. Diarrhoea incidence (%) and the differences in standard deviation scores (delta SIDS) for the body measurements were computed for all monthly intervals. The monthly diarrhoeal incidence (%) increased from 16.8% to 27.9% when water was given to the exclusively breastfed infants. There was a significant negative effect on short term linear growth (p<0.001) and head circumference (p<0.01) when the change in feeding pattern occurred between birth and four months of age. Length SIDS decreased on an average with 0.2 standard deviation scores per month, corresponding to 0.5 cm. Offering water to young breastfed infants should be discouraged, since it is not required and it increases the risk for diarrhoeal diseases and impairs short-term growth.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com