Infant feeding and infant health in American Samoa

This study examines the association between infant feeding patterns and health for 6,267 Samoan children born between 1976 and 1982, and represented in the Well Baby Clinic records at the LBJ Tropical Medical Center, American Samoa. The visits to the clinic were aggregated by trimester of age during the first year of life. For each trimester, the principal source of milk was determined, and the children were categorized as breast-fed if they were taking only breast milk, bottle-fed if they were getting no breast milk, or mixed-fed if they were getting both breast milk and milk from other sources. Symptoms and complaints noted in the records were assigned to ICD categories. Associations between source of milk and disease category were analyzed. The Samoan infants were found to be quite healthy for a tropical developing population, as evidenced by both growth in weight and length, as well as by frequency of illnesses. The most common specific disease category, aside from miscellaneous symptoms, was ICD 8, respiratory problems. Gastrointestinal diseases were rare for a developing area. There was an association between source of milk and illness (yes/no) for both the second and third trimesters. In both cases breast-fed infants were healthier than the mixed-fed infants, and during the second trimester the contrast was significant with bottle-fed infants also. When examined by ICD category, breast-fed infants tended to be less likely to have problems in any of the categories, but the only significant differences were between mixed-fed (lower prevalence) and bottle-fed infants during the first trimester for ICD 3, primarily nutritional problems; and for breast-fed (lower prevalence) and mixed-fed infants for ICD 9, digestive problems. These findings highlight the need for additional household work to delineate associations with the growth and health of Samoan infants.