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Breastfeeding and Infections in Early Childhood: A Cohort Study
Nikolas Christensen1,2, Signe Bruun1,2,3, Jens Søndergaard4
1Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Insights
Longer breastfeeding, particularly exclusive breastfeeding, reduces hospitalizations for infections in infants under one year. However, breastfeeding does not appear to protect against infection symptoms or hospitalizations after the first year of life.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Conflicting evidence exists regarding breastfeeding's impact on childhood infections beyond infancy.
- A population-based birth cohort study was conducted to investigate this association.
Purpose of the Study:
- To determine if breastfeeding duration is associated with infection-related hospitalizations and home-reported infection symptoms in children up to 36 months of age.
- To differentiate the effects of any breastfeeding versus exclusive breastfeeding.
Main Methods:
- The Odense Child Cohort utilized weekly text message questionnaires for breastfeeding data and biweekly questionnaires for infection symptoms (12-36 months).
- Hospitalization data were sourced from the Danish National Patient Registry.
- 815 mother-infant pairs were included in the analysis.
Main Results:
- A longer duration of any breastfeeding was associated with a reduced incidence rate ratio (IRR) for infection-related hospitalizations (adjusted IRR: 0.96).
- Exclusive breastfeeding showed a stronger protective effect (adjusted IRR: 0.88).
- These protective effects were most pronounced for hospitalizations within the first year of life, particularly for lower respiratory tract infections.
Conclusions:
- Increased breastfeeding duration, especially exclusive breastfeeding, offers protection against infections requiring hospitalization during the first year of life.
- Breastfeeding did not demonstrate a protective association with infection symptoms or hospitalizations occurring after the first year of life.
Background:
Studies on the association between breastfeeding and infections in children beyond the first year of life reveal conflicting results. In a population-based birth cohort, we investigated whether the duration of breastfeeding was associated with the number of hospitalizations due to infection and symptoms of infection at home.
Methods:
In the Odense Child Cohort, text message questionnaires were used to register information on breastfeeding (weekly until end of weaning) and symptoms of infection (biweekly; 12-36 months of age). Hospitalization data were obtained from the Danish National Patient Registry.
Results:
Of the 1087 invited, 815 mother-infant pairs were included. The median duration of any breastfeeding was 7.6 (interquartile range: 3.5-10.4) months and of exclusive breastfeeding was 2.1 (interquartile range: 0.7-4.4) months. Hospitalization due to infection was seen in 207 (25.4%) infants during the first 3 years of life. The adjusted incidence rate ratio (IRR) for hospitalization due to any infection decreased with a longer duration of any breastfeeding (adjusted IRR: 0.96; 95% confidence interval 0.93-0.99; P < .001). The strongest associations between the duration of any breastfeeding and hospitalizations due to infection were found within the first year of life, for lower respiratory tract infections, and other infections (P ≤ .05). For infants exclusively breastfed, the adjusted IRR for hospitalization was 0.88 (95% confidence interval: 0.80-0.96; P = .006). No protective associations were present between breastfeeding and infection symptoms registered at home from ages 12 to 36 months.
Conclusions:
The results suggest that increased duration of breastfeeding, especially exclusive breastfeeding, protects against infections requiring hospitalization in the first year of life but not hospitalizations or symptoms of infection at home beyond the first year.
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