Full breastfeeding and associated decrease in respiratory tract infection in US children

Department of Pediatrics, University of Rochester, Rochester, New York, United States
PEDIATRICS (Impact Factor: 5.3). 02/2006; 117(2):425-32. DOI: 10.1542/peds.2004-2283
Source: PubMed

ABSTRACT The American Academy of Pediatrics recommends exclusive breastfeeding for an infant's first 6 months of life. When compared with exclusive breastfeeding for 4 months, greater protection against gastrointestinal infection, but not respiratory tract infection, has been demonstrated for the 6-month duration. The objective of this study was to ascertain if full breastfeeding of > or = 6 months compared with 4 to < 6 months in the United States provides greater protection against respiratory tract infection.
Secondary analysis of data from the National Health and Nutrition Examination Survey III, a nationally representative cross-sectional home survey conducted from 1988 to 1994, was performed. Data from 2277 children aged 6 to < 24 months, who were divided into 5 groups according to breastfeeding status, were compared. Children who required neonatal intensive care were excluded. SUDAAN software was used to account for the complex sampling design. Logistic regression adjusted for confounding factors. Outcome measures included adjusted odds of acquiring pneumonia, > or = 3 episodes of cold/influenza, > or = 3 episodes of otitis media (OM), or wheezing in the past year or acquiring first OM at < 12 months of age.
In unadjusted analyses, infants who were fully breastfed for 4 to < 6 months (n = 223) were at greater risk for pneumonia than those who were fully breastfed for > or = 6 months (n = 136) (6.5% vs 1.6%). There were not statistically significant differences in > or = 3 episodes of cold/influenza (45% vs 41%), wheezing (23% vs 24%), > or = 3 episodes of OM (27% vs 20%), or first OM at < 12 months of age (49% vs 47%). Adjusting for demographic variables, childcare, and smoke exposure revealed statistically significant increased risk for both pneumonia (odds ratio [OR]: 4.27; 95% confidence interval [CI]: 1.27-14.35) and > or = 3 episodes of OM (OR: 1.95; 95% CI: 1.06-3.59) in those who were fully breastfed for 4 to < 6 months compared with > or = 6 months.
This nationally representative study documents increased risk of respiratory tract infection including pneumonia and recurrent OM in children who were fully breastfed for 4 vs 6 months. These findings support current recommendations that infants receive only breast milk for the first 6 months of life.

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    • "79 Breastfeeding confers protection against respiratory infections in both developed [5] [6] and 80 developing countries [7], with infants who were exclusively breastfed for 4 to <6 months being 81 4.27 (95% confidence interval: 1.27-14.35) more likely to develop pneumonia than infants 82 exclusively breastfed for ≥6 months [5]. However, recent statistics show that the current rates of 83 exclusive or any breastfeeding fall below recommendations [8]. "
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    ABSTRACT: Identification and characterization of compounds that enhance the growth, development, and health of infants who are not breastfed continues to be a goal for nutritional science. This study explored the effects of one dietary component, (1,3/1,6)-β-d-glucan (Wellmune WGP), on lung immune development in the neonatal piglet. The hypothesis was that supplementation with WGP, a pathogen-associated molecular pattern, would enhance pathogen-responsive elements of the immune system, for instance, by increasing the size of the cytotoxic T-cell population or the expression of inflammatory cytokines. Piglets were fed a control formula or formula plus WGP at 1.8, 18, or 90 mg/kg body weight per day. Serum, thoracic lymph nodes (TLNs), mediastinal lymph nodes, and lung were collected at days 7 or 21. Immune parameters including tissue messenger RNA (mRNA) expression and T-cell phenotypes were analyzed. Normal developmental changes were observed, with a decrease in T-helper cells and an increase in cytotoxic T cells in both TLN and mediastinal lymph node, but there was no effect of WGP. Dietary WGP reduced the mRNA expression of transforming growth factor (TGF) β2 and tended to reduce the mRNA expression of TGF-β1 in lung tissue. With the exception of reducing TGF-β mRNA in the lung and tending to decrease the ratio of T helper to cytotoxic T cell in the TLN, dietary WGP did not affect lung-associated adaptive immunity in piglets.
    Nutrition research 04/2013; 33(4):322-31. DOI:10.1016/j.nutres.2013.02.006 · 2.59 Impact Factor
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    • "Babies who are not breastfed have an increased risk or morbidity and mortality from respiratory tract infections, atopic dermatitis, childhood asthma, type II diabetes, obesity and sudden infant death syndrome (Horta et al., 2007; Ip et al., 2007). Research suggests the health benefits of breastfeeding in general are enhanced with a longer duration and intensity of breastfeeding (Chantry et al., 2006) and it is now recognised that exclusive breastfeeding (the consumption of breast milk only) from birth to 6 months of age is associated with the best outcomes for both infant and mother (Kramer and Kakuma, 2002; WHO, 2011). The World Health Organization (WHO, 2011) currently recommends that all infants worldwide are exclusively breastfed for the first 6 months of life, with continued breastfeeding up to 2 years of age. "
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    ABSTRACT: BACKGROUND: the World Health Organization recommends that all infants worldwide are exclusively breastfed for the first 6 months of life for optimal health and development. However, very few women worldwide are meeting this recommendation. Psychosocial factors have been identified as potentially modifiable factors implicated in a woman's ability to successfully exclusively breastfeed, however there is very limited research examining these factors specifically for exclusive breastfeeding to 6 months duration. METHODS: a search of psychological, nursing and medical databases was conducted in June 2011 for studies published from 2000 to 2011 examining psychological correlates of exclusive breastfeeding to four to 6 months duration. RESULTS: nine papers from eight studies were found to be eligible for the review. Psychological factors have been reported to be highly predictive of exclusive breastfeeding outcomes. Research to date shows that psychosocial factors are not only importantly implicated in exclusive breastfeeding duration but they can also be changed through intervention and experiences. CONCLUSIONS: while there is a wealth of literature on the role of psychosocial factors in breastfeeding, there is very limited research specifically examining the role of psychosocial factors of exclusive breastfeeding to 6 months duration. Interpreting the results of the available literature is difficult due to the various methodologies and definitions of exclusive breastfeeding and small sample sizes. Further research, specifically, longitudinal cohort studies are needed which examine psychological determinants of exclusive breastfeeding and infant feeding methods from pregnancy through to 6 months postpartum.
    Midwifery 10/2012; 29(5). DOI:10.1016/j.midw.2012.04.009 · 1.71 Impact Factor
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    • "Very few were aware that breastmilk reduces the risk of pneumonia beyond six months of age. Recent research has recognised that breastfeeding reduces the risk of pneumonia and lower respiratory tract infection (Chantry, Howard & Auinger 2006), while length of hospitalisation for infants with these health issues is reduced for breastfed infants (Quigley, Kelly, & Sacker 2009; Tiewsoh, et al 2009). "
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    ABSTRACT: Breastfeeding and breastmilk are essential to hospitalised infants and young children and paediatric nurses are required to have breastfeeding knowledge. However, few studies have investigated paediatric nurses' knowledge and attitudes towards breastfeeding. A descriptive, cross-sectional survey design was used to investigate breastfeeding knowledge, knowledge related to breastfeeding the hospitalised infant, policy and guideline awareness, and attitudes to breastfeeding. Participants demonstrated excellent breastfeeding attitudes and general knowledge but deficits in breastfeeding knowledge related to specific outcomes were identified.
    Breastfeeding review: professional publication of the Australian Breastfeeding Association 11/2011; 19(3):13-24.
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