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Relationship between infant feeding and infectious illness: a prospective study of infants during the first year of
D H Rubin1, J M Leventhal, P A Krasilnikoff
1Division of Pediatric, Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, New York.
Insights
This study found no significant link between infant feeding type and common infections like gastroenteritis or respiratory illness. Breast-feeding rates declined over the first year, but this did not correlate with illness incidence.
Area of Science:
- Pediatrics
- Epidemiology
- Public Health
Background:
- Conflicting data exists on breast-feeding's protective effect against infant infectious illnesses in developed nations.
- Methodological limitations in prior studies, including data collection and variable control, may explain discrepancies.
Purpose of the Study:
- To prospectively investigate the relationship between infant feeding practices and the incidence of common infectious illnesses.
- To address methodological challenges in previous research by employing rigorous data collection and analysis.
Main Methods:
- A prospective cohort study of 500 infants in Copenhagen, Denmark, over their first 12 months of life.
- Monthly mailed questionnaires collected data on infant feeding and illness occurrences (gastroenteritis, respiratory illness, otitis media).
- Statistical analysis adjusted for confounding variables like social class and household siblings.
Main Results:
- Breast-feeding prevalence decreased significantly from 88% at 1 month to 20% at 12 months.
- No statistically significant relationship was observed between infant feeding type and the incidence of gastroenteritis, upper respiratory illness, otitis media, or lower respiratory illness after covariate adjustment.
- Adjusted incidence density ratios for gastroenteritis and upper respiratory illnesses were non-significant.
Conclusions:
- Infant feeding type, including breast-feeding, did not demonstrate a statistically significant protective effect against common infectious illnesses in this cohort.
- The study highlights the importance of robust methodology in investigating infant feeding and health outcomes.
- Further research may be needed to explore other factors influencing infant susceptibility to infections.
Abstract:
Prior studies investigating the relationship between infant feeding and infectious illnesses in developed countries have provided conflicting data about whether breast-feeding protects against common infectious illnesses early in life. These conflicts may in part be due to the failure to consider the following methodologic issues: (1) collecting data prospectively at frequent intervals for active surveillance of the detection of infections and of feeding practices, (2) specifying what is meant by infectious illnesses and breast-feeding, (3) controlling for confounding variables such as social class or presence of siblings in the household, and (4) applying appropriate analytical strategies to a population in which both feeding and exposure to illness change over time. A total of 500 infants born consecutively in a university-affiliated community hospital in Copenhagen, Denmark, were studied prospectively for the first 12 months of life by means of a detailed, monthly, mailed questionnaire that focused on feeding practices and illnesses (overall response rate, 73%). The percentage of infants who were completely or mostly breast-fed decreased from 88% at 1 month to 20% at 12 months of age. After adjustment for major covariates, no statistically significant relationship was found between the type of infant feeding and the incidence of four categories of infectious illnesses: gastroenteritis, upper respiratory illness, otitis media, and lower respiratory illness. The adjusted incidence density ratio for gastroenteritis was 1.067 (95% confidence interval = 0.982, 1.226) and for upper respiratory illnesses 0.984 (95% confidence interval = 0.883, 1.096).(ABSTRACT TRUNCATED AT 250 WORDS)