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Impact of breast feeding on admission for pneumonia during postneonatal period in Brazil: nested case-control study
J A César1, C G Victora, F C Barros
1Departamento Materno Infantil, Fundação Universidade do Rio Grande, Rio Grande do Sol, Brazil.
Insights
Breastfeeding significantly protects infants from pneumonia, especially during the first three months of life. Not breastfeeding increases pneumonia hospitalization risk by 17 times.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health Nutrition
Background:
- Pneumonia is a leading cause of infant mortality globally.
- Understanding protective factors is crucial for public health interventions.
Purpose of the Study:
- To investigate the protective effect of breastfeeding against infant pneumonia.
- To determine if this protective effect varies with infant age.
Main Methods:
- A nested case-control study was conducted in Pelotas, southern Brazil.
- Infants hospitalized for pneumonia (cases) were compared to a population-based control group.
- Milk consumption (breast milk, formula, supplements) and feeding practices were assessed.
Main Results:
- Infants not breastfed had a 17-fold increased risk of pneumonia hospitalization compared to exclusively breastfed infants.
- The protective effect was strongest in infants under 3 months (RR=61), decreasing with age (RR=10).
- Early introduction of solid supplements significantly increased pneumonia risk, particularly in infants under 3 months (RR=175).
Conclusions:
- Breastfeeding provides substantial protection against infant pneumonia, particularly in early infancy.
- Targeted interventions focusing on breastfeeding promotion in the first months of life are recommended.
- Supplementation with solids should be carefully timed to minimize pneumonia risk.
Objective:
To determine whether breast feeding protects infants against pneumonia and whether the protection varies with age.
Design:
Nested case-control study.
Setting:
Pelotas, southern Brazil.
Subjects:
Cases were 152 infants aged 28-364 days who had been admitted to hospital for pneumonia. Controls were 2391 cases in a population based case-control study.
Main Outcome Measure:
Odds ratio of admission for pneumonia according to type of milk consumed (breast milk alone, breast and formula milk, or formula milk and other fluids only), use of fluid supplements apart from formula milk, and use of solid supplements.
Results:
Infants who were not being breast fed were 17 times more likely than those being breast fed without formula milk to be admitted to hospital for pneumonia (95% confidence interval 7.7 to 36.0). This relative risk was 61 (19.0 to 195.5) for children under 3 months old, decreasing to 10 (2.8 to 36. 2) thereafter. Supplementation with solids was associated with a relative risk of 13.4 (7.6 to 23.5) for all infants and 175 (21.8 to 1405.1) for those under 3 months old.
Conclusion:
Breast feeding protects young children against pneumonia, especially in the first months of life. These results may be used for targeting intervention campaigns at the most vulnerable age groups.