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Breast-feeding and diarrheal morbidity
B M Popkin1, L Adair, J S Akin
1Department of Nutrition, University of North Carolina, Chapel Hill 27516.
Insights
Supplementing breast milk with any liquids, including water or nutritive foods, significantly increases infant diarrhea risk. These risks diminish the benefits of breastfeeding later in infancy.
Area of Science:
- Pediatrics
- Public Health
- Nutrition
Background:
- Diarrheal diseases remain a significant cause of infant morbidity and mortality globally.
- Breastfeeding is recognized as a crucial protective factor against infant infections.
- Understanding the specific impact of different feeding patterns on diarrhea risk is essential for public health interventions.
Purpose of the Study:
- To examine the age-specific effects of various breastfeeding patterns on diarrheal morbidity.
- To quantify the risk associated with supplementing breast milk with other liquids or foods.
- To assess the generalizability of findings on infant feeding and diarrhea.
Main Methods:
- Longitudinal survey of over 3000 mother-infant pairs in the Cebu region, Philippines.
- Detailed examination of the sequence of breastfeeding and diarrheal morbidity events.
- Statistical analysis controlling for a wide range of environmental factors contributing to diarrhea.
Main Results:
- Introducing non-nutritive liquids (water, teas) alongside breast milk doubled or tripled diarrhea likelihood.
- Supplementation with nutritive foods or liquids significantly increased diarrhea risk.
- The protective benefits of breastfeeding diminished substantially in the second half of infancy, regardless of supplementation.
- Breastfeeding benefits were marginally greater in urban settings.
Conclusions:
- Exclusive breastfeeding is critical for reducing infant diarrhea, especially in the first year of life.
- Supplementation with any additional liquids or foods increases diarrhea risk and negates breastfeeding benefits.
- Findings underscore the importance of promoting exclusive breastfeeding for infant health in diverse populations.
Abstract:
This study used a unique longitudinal survey of more than 3000 mother-infant pairs observed from pregnancy through infancy. The sample is representative of infants from the Cebu region of the Philippines. The sequencing of breast-feeding and diarrheal morbidity events was carefully examined in a longitudinal analysis which allowed for the examination of age-specific effects of feeding patterns. Because the work controlled for a wide range of environmental causes of diarrhea, the results can be generalized to other populations with some confidence. The addition to the breast-milk diet of even water, teas, and other nonnutritive liquids doubled or tripled the likelihood of diarrhea. Supplementation of breast-feeding with additional nutritive foods or liquids further increased significantly the risk of diarrhea; most benefits of breast-feeding alone or in combination with nutritive foods/liquids became small during the second half of infancy. Benefits of breast-feeding were slightly greater in urban environments.