Effect of water supplementation of full-term newborns on arrival of milk in the nursing mother. Age of introduction of complementary foods and growth of term, low-birth-weight, breast-fed infants: a randomized intervention study in Honduras. The effect of feeding glucose water to breastfeeding newborns on weight, body temperature, blood glucose, and breastfeeding duration. Supplementary feeding and jaundice in newborns. The effect of early initiation of colostrum feeding on proliferation of intestinal bacteria in neonates.
It has been suggested that water supplementation of breast-fed newborns may delay the arrival of true milk. A total of 136 healthy term neonates were divided into two groups. Seventy-eight nursed exclusively on demand, and 58 received in addition supplemental water ad lib. Mean time for arrival of milk in the unsupplemented group was 54.9 hours and in the supplemented group 56.6 hours. This difference was not significant, indicating that water supplementation to the normal term newborn does not affect or disrupt the establishment of lactation. The optimal age at which to introduce complementary foods is a topic of considerable debate.
                This study was designed to evaluate this issue in a nutritionally vulnerable population in Honduras.
                Mothers of low-birth-weight (1500-2500 g) term (ie, small-for-gestational-age) infants were recruited in the hospital and assisted with exclusive breast-feeding during the first 4 mo. At 4 mo, mothers were randomly assigned to either continue exclusive breast-feeding to 6 mo (EBF; n = 59) or to feed complementary solid foods (jarred rice cereal, chicken, and fruit and vegetables) twice daily from 4 to 6 mo while continuing to breast-feed at their initial frequency (SF; n = 60). At 4 and 6 mo, breast milk and total energy intake were measured for a nonrandom subsample (those who could stay overnight in a central unit: 32 EBF and 31 SF).
                At 4 mo, breast milk intake in the subsample was not significantly different between groups (EBF: 729 +/- 135 g/d; SF: 683 +/- 151 g/d: P >0.2); from 4 to 6 mo it increased (by 28 g/d) in the EBF group but decreased (by 39 g/d) in the SF group (P < 0.005). Nonetheless, total energy intake (including solid foods) increased more from 4 to 6 mo in the SF than in the EBF group. However, there were no significant differences between groups in weight or length gain during the intervention or subsequently (6-12 mo).
                There was no growth advantage of complementary feeding of small-for-gestational-age, breast-fed infants between 4 and 6 mo of age. In order to determine the effect of feeding glucose water on breastfeeding newborns, we randomly distributed 180 normal newborns into two groups: a glucose water group (GW), fed 5% glucose solution during the first 3 days of life in addition to being breastfed; and an exclusively breastfed nonglucose water group (NGW). The following data were evaluated: weight at 6, 12, 24, 48, and 72 hours of life; temperature during the first 72 hours of life; serum glucose level at 6, 12, 24, and 48 hours; total duration of breastfeeding and age at introduction of infant formulas. In the NGW, there was a greater weight loss at 48 hours but not at 72 hours, temperatures higher than 37.5 degrees C were more frequent, and the mean serum glucose levels at 6, 12, and 24 hours were lower. This group also had more serum glucose level determinations under 2.2 mmol/l (40 mg/dL). However, no infants exhibited hypoglycemic symptoms. Infants in the GW received twice as many formulas during the first month and had a shorter duration of any breastfeeding. Our results suggest that the suppression of feedings with glucose water in the first days of life increases the probability of successful breastfeeding. However, infants who do not receive glucose water in the first few days of life may require greater supervision and close monitoring of blood glucose and body temperature, particularly in the first 24 hours of life. In a survey it was found that the majority of full-term breast fed infants receive supplementary feeds of water, dextrose solution or infant formula during the first few days of life. Breast fed babies receiving water or dextrose supplements had higher plasma bilirubins on the sixth day of life than bottle fed infants. Supplementation with water or dextrose did not reduce the hyperbilirubinaemia of term, breast fed infants. Since it may prejudice the establishment of breast feeding, we suggest that the practice is abandoned. One hundred eighty normal neonates with an average weight above 2.50 kg and having no feeding difficulties were divided into two groups and randomly assigned to either colostrum or to glucose water feeding regimens during the 3-day stay at the maternity ward. The effects of the feeding regimens on intestinal colonization were studied by examining the stools of the neonates. All bacteria recovered were identified quantitatively and biochemically. Of the 180 mothers, 105 complied with the instructions on feeding regimens. The majority of the neonates receiving colostrum had significantly lower bacterial counts than those on glucose water (p less than 0.001). The results of the preliminary study indicated that early initiation of colostrum feeding to neonates where potable water is not readily available will suppress the proliferation of bacteria in the neonates.
We were unable to fully assess the benefits or harms of supplementation or to determine the impact from timing and type of supplementation . 

We found no benefit to newborn infants and possible negative effects on the duration of breastfeeding from the brief use of additional water or glucose water. For infants at four to six months, we found no benefit from additional foods nor any risks related to morbidity or weight change. Future studies should examine the longer term effects on infants and mothers, though randomising infants to receive supplements without medical need may be considered unethical.
We found no evidence for disagreement with the recommendation of international health associations that exclusive breastfeeding should be recommended for healthy infants for the first six months.