There is very little evidence that any nutritional
impact is caused by infections among exclusively
breast-fed infants (26, 27, 30). This underlines again
the importance of exclusive breast-feeding for the
prevention of malnutrition, particularly during the
first 4-6 months of life. Breast milk compensates for
the loss of water and nutrients that occurs during
diarrhoea. In view of the protective effects of breast
milk against diarrhoea and malnutrition, continued
breast-feeding for at least 2 years is recommended
(5, 6).
Many studies have demonstrated that infections
may induce growth faltering during the weaning period.
In one study, for example, the relationship between
morbidity and growth in the first 2 years of
life among a cohort of 126 neonates was studied in a
Gambian township (27); the mean weight-for-age
exceeded the National Center for Health Statistics
(NCHS) standards in the first half of infancy, but
there was a mean deficit of 1.2 kg by 1 year of age.
It was estimated that diarrhoeal diseases were responsible
for half this deficit-and respiratory illnesses
for a quarter-and the effect of diarrhoeal
diseases on growth after the onset of weaning was
four times that in exclusively breast-fed infants.
Enterotoxigenic E. coli was the commonest organism
isolated in infants aged 6-12 months who had diarrhoea.
E. coli from contaminated weaning foods was