Full breastfeeding duration and associated decrease in respiratory tract infection in US Children

Department of Pediatrics, University of Rochester, Rochester, New York, United States
PEDIATRICS (Impact Factor: 5.47). 02/2006; 117(2):425-32. DOI: 10.1542/peds.2004-2283
Source: PubMed


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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    • "The contribution of exclusive breastfeeding (EBF) to the decrease in infant morbidity and mortality has already been well documented. EBF in the first 6 months of life, as recommended by the World Health Organization (WHO) [1], protects against gastrointestinal infections [2-4], respiratory infections [5,6], allergies [7], and non-communicable chronic diseases [8]. Despite these benefits, EBF rates are still very low [8]. "
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    ABSTRACT: Considering that adolescent mothers may be more vulnerable to discontinuing exclusive breastfeeding (EBF) before 6 months and that their mothers may exert a negative influence on this practice, this study was conducted with the objective of evaluating the efficacy of breastfeeding counselling for adolescent mothers and their mothers in increasing EBF duration. A clinical trial was performed in 323 adolescent mothers with newborns and their mothers randomized in four groups: (1) not living with mother, without intervention; (2) not living with mother, with intervention; (3) living with mother, without intervention, (4) living with mother, with intervention. The intervention consisted of five counselling sessions directed to mother and grandmother, in the maternity hospital and on follow-up. Information about feeding practices during the newborn’s first six months of life was collected monthly by telephone. Intervention’s efficacy was measured through Cox regression and comparison of exclusive breastfeeding medians and survival curves for the different groups. The intervention increased the duration of EBF by67 days for the group which included grandmothers (HR = 0.64; CI 95% = 0.46-0.90) and 46 days for the group which did not include grandmothers (HR = 0.52; CI 95% = 0.36-0.76). Counselling sessions in the first four months of children’s lives proved to be effective in increasing EBF duration among adolescent mothers. Trial registration NCT00910377.
    Full-text · Article · Jul 2014 · Nutrition Journal
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    • "An increased risk or morbidity and mortality from respiratory tract infections, atopic dermatitis, childhood asthma, type II diabetes, obesity, and sudden infant death syndrome endanger babies who are not breastfed (4, 5). A longer duration and intensity of breastfeeding maximizes the health benefits of breast milk (6). It is also well known that exclusive breastfeeding for the first six months of life ensures the best outcomes for both infant and mother (1, 2). "
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    ABSTRACT: Maternal health status might have an important effect on breastfeeding, growth, and general health of the infants. This study was conducted to assess the association between maternal mental health and breastfeeding status of mothers in Kashan province. This case-control study was conducted on 458 mothers in two groups of unsuccessful breastfeeding (case) and successful breastfeeding (control) attending Kashan province health clinics. In this study, the GHQ questionnaire and clinical interview were employed to collect data. The data were statistically analyzed using Chi-square and Fisher's exact tests. It was found that mothers of the case group had a greater susceptibility to depression than those of the control group, that is, breastfeeding status was directly associated with susceptibility to depression (P = 0.001, OR = 5.48). Furthermore, there was a significant association between basic characteristics such as maternal occupational status (P = 0.04) or their educations (P = 0.006) with breastfeeding. Besides, clinical interview revealed that mixed depression and anxiety disorder was the most prevalent type of psychological disorder in the case group. Screening depression during pregnancy and postpartum period appeared to be necessary and it should be incorporated into prenatal and postnatal care due to its influence on mothers' successful breastfeeding.
    Full-text · Article · Mar 2014
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    • "Breastfeeding creates an inimitable psychosocial bond between the mother and baby [4,5], enhances modest cognitive deve lopment [6] and it is the underpinning of the infant’s wellbeing in the first year of life [5,7] even into the second year of life with appropriate complementary foods from 6 months [8]. Furthermore, breastfeeding reduces the risk of neonatal complications [9], respiratory and other varieties of illnesses [10-13]. "
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    ABSTRACT: Mothers' poor knowledge and negative attitude towards breastfeeding may influence practices and constitute barriers to optimizing the benefits of the baby-friendly initiative. This study assessed breastfeeding knowledge, attitude and techniques of postures, positioning, hold practice and latch-on among Nigerian mothers from a Semi-Urban community. Three hundred and eighty three consenting lactating mothers who have breastfed for 6 months and up to two years volunteered for this cross-sectional survey, yielding a response rate of 95.7%. A self-administered questionnaire that sought information on maternal socio-demographic variables, knowledge, attitudes and breastfeeding techniques of mothers was employed. Based on cumulative breastfeeding knowledge and attitude scores, 71.3% of the respondents had good knowledge while 54.0% had positive attitude. Seventy one point three percent practiced advisable breastfeeding posture. Sitting on a chair to breastfeed was common (62.4%); and comfort of mother/baby (60.8%) and convenience (29.5%) were the main reasons for adopting breastfeeding positions. Cross-cradle hold (80.4%), football hold technique (13.3%), breast-to-baby (18.0%) and baby-to-breast latch-on (41.3%) were the common breastfeeding techniques. A majority of the respondents (75.7%) agreed that neck flexion, slight back flexion, arm support with pillow and foot rest was essential during breastfeeding. There was no significant association between breastfeeding posture practice and each of cumulative breastfeeding knowledge score levels (X2 = 0.044; p = 0.834) and attitude score levels (X2 = 0.700; p = 0.403). Nigerian mothers demonstrated good knowledge and positive attitude towards breastfeeding. Most of the mothers practiced advisable breastfeeding postures, preferred sitting on a chair to breastfeed and utilized cross-cradle hold and baby-to-breast latch-on.
    Full-text · Article · Dec 2013 · BMC Research Notes
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