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Breastfeeding and the risk of respiratory tract infections after infancy: The Generation R Study
Ilse Tromp1,2, Jessica Kiefte-de Jong2,3,4, Hein Raat5
1The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Insights
Breastfeeding for six months or longer significantly reduces the risk of lower respiratory tract infections (LRTI) in children up to four years old. This supports recommendations for extended breastfeeding duration for continued protection against respiratory illnesses.
Area of Science:
- Pediatric Health
- Epidemiology
- Public Health Nutrition
Background:
- Breastfeeding is widely recognized for protecting infants against respiratory infections.
- However, limited research has explored the impact of breastfeeding on respiratory tract infections beyond infancy.
Purpose of the Study:
- To investigate the association between breastfeeding duration and dose with lower respiratory tract infections (LRTI) and upper respiratory tract infections (URTI).
- The study focused on children up to four years of age.
Main Methods:
- A prospective cohort study (The Generation R study) involving 5322 participants.
- Breastfeeding data (duration and dose) collected via questionnaires at 2, 6, and 12 months.
- LRTI and URTI data collected via doctor attendance reports at 2, 3, and 4 years.
Main Results:
- Breastfeeding for ≥6 months was significantly associated with a reduced risk of LRTI up to age 4 (aOR: 0.71).
- Similar protective effects for LRTI were observed for shorter breastfeeding durations (<3 months and 3-6 months).
- Weaker associations were found for URTI, and a similar trend was observed for partial and predominant breastfeeding doses.
Conclusions:
- Extended breastfeeding duration (≥6 months) is linked to a lower risk of LRTI in preschool-aged children.
- These findings suggest that the protective benefits of breastfeeding against respiratory infections extend beyond infancy.
- The results support current public health recommendations for breastfeeding for at least six months.
Background:
The protection of breastfeeding against respiratory tract infections in the first year of life has often been suggested. Few studies examined the effect of breastfeeding on respiratory tract infections after infancy.
Objective:
To examine the association between breastfeeding with lower respiratory tract infections (LRTI) and upper respiratory tract infections (URTI) after infancy up to 4 years of age (n = 5322).
Methods:
This study was embedded in The Generation R study, a Dutch population-based prospective cohort study from fetal life until young adulthood. Information on breastfeeding duration (never; <3 months; 3-6 months; ≥6 months) and dose (never; partially until 4 months; predominantly until 4 months) were collected by questionnaire at 2, 6, and 12 months of age. Information on doctor attendance for LRTI and URTI were obtained by questionnaire at 2, 3, and 4 years of age.
Results:
Breastfeeding for 6 months or longer was significantly associated with a reduced risk of LRTI up to 4 years of age (aOR: 0.71; 95% CI: 0.51-0.98). Similar ORs for LRTI were found with breastfeeding for less than 3 months and 3-6 months. Although in the same direction, weaker ORs were found for URTI and breastfeeding duration. The same trend was found for partial and predominant breastfeeding until 4 months and LRTI and URTI.
Conclusion:
Breastfeeding duration for 6 months or longer is associated with a reduced risk of LRTI in pre-school children. These findings are compatible with the hypothesis that the protective effect of breastfeeding for respiratory tract infections persist after infancy therefore supporting current recommendations for breastfeeding for at least 6 months.
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