Can water safety interventions reduce diarrhea during weaning?

September 2009

After implementing the Kisumu Breastfeeding Study (KiBS) for one and a half years, the study’s safety board noted that infants had high rates of diarrhea at age 6 months—the age at which their mothers were advised to rapidly stop breastfeeding. In a study published in the Journal of Infectious Diseases in September 2009, investigators hypothesized that a main cause of infant diarrhea was waterborne pathogens. The authors implemented a set of household interventions to improve water safety for KiBS study participants, including providing sodium hypochlorite solution to treat water, providing water storage vessels, and delivering behavior change messages to improve hand washing and other hygiene practices. They hypothesized that this combination of interventions, called the safe water system (SWS), would reduce incidence of diarrhea during weaning. In comparison to infants who enrolled in KiBS before implementing the SWS, the number of clinic visits for diarrhea during the weaning period was lower during the recommended exclusive breastfeeding period (0–5 months of age) and following breastfeeding cessation (7–11 months of age). However, during the weaning period (6 months of age), the frequency of diarrhea was the same in both groups (16%), leading the authors to conclude that diarrhea during the weaning period may be attributable to factors other than waterborne pathogens. The findings, they say, suggest that additional studies are needed to help clarify the definition of “safe” replacement feeding.   

Effect of a point-of-use water treatment and safe water storage intervention on diarrhea in infants of HIV-infected mothers