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Is exclusive breastfeeding for six-months protective against pediatric tuberculosis?
Juan A Flores1,2, Julia Coit3, Milagros Mendoza4
1Escuela Profesional de Tecnología Médica, Universidad Privada San Juan Bautista , Lima, Peru.
Insights
Exclusive breastfeeding for six months did not show a link to decreased tuberculosis (TB) risk in children. However, breastfeeding by mothers with TB may increase infant TB risk, warranting further study.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Exclusive breastfeeding is recommended for infants up to six months for protection against childhood illnesses.
- Tuberculosis (TB) remains a significant global health concern, particularly in children.
- The potential impact of breastfeeding on pediatric TB risk requires further investigation.
Purpose of the Study:
- To investigate the association between exclusive breastfeeding and the risk of active tuberculosis (TB) in children.
- To explore whether exclusive breastfeeding protects children against TB, as hypothesized.
- To examine potential differences in this association based on the source of TB exposure.
Main Methods:
- Cross-sectional study analyzing data from 279 children (6-59 months) in Lima, Peru, with TB symptoms and a known adult TB contact.
- Mothers self-reported breastfeeding practices; children's TB status was assessed per national guidelines.
- Prevalence ratios were calculated using generalized linear models to quantify the association between exclusive breastfeeding and TB.
Main Results:
- Twenty-two percent of children were diagnosed with TB; 72% were exclusively breastfed for six months.
- No significant association was found between six months of exclusive breastfeeding and TB disease in bivariate or multivariable analyses.
- A weak positive association between breastfeeding and TB was observed in children whose mothers had TB, but not in those whose close contact was not the mother.
Conclusions:
- Exclusive breastfeeding for six months was not associated with a reduced risk of TB in this cohort.
- Breastfeeding by mothers with active TB may potentially increase the risk of TB transmission to their infants.
- Further longitudinal studies are needed to confirm these findings and inform interventions to minimize TB transmission from mothers to infants.
Abstract:
Experts recommend exclusive breastfeeding from birth to six months because it protects against deadly childhood illness, including respiratory tract infections and diarrhea. We hypothesized that exclusive breastfeeding would decrease the risk of active tuberculosis (TB) in children. We analyzed cross-sectional data from 279 children in Lima, Peru aged 6 to 59 months with TB symptoms and a close adult contact with TB. Mothers self-reported breastfeeding, and children were evaluated for TB per national guidelines. To quantify the association between exclusive breastfeeding and TB, we estimated prevalence ratios using a generalized linear model with a log link, binomial distribution, and robust variance. Twenty-two percent of children were diagnosed with TB and 72% were exclusively breastfed for six months. We found no evidence that six months of exclusive breastfeeding was associated with TB disease in either bivariate analyses (prevalence ratio [PR] = 1.5; 95%CI = 0.8-2.5) or multivariable analyses adjusting for sex and socioeconomic status (adjusted PR = 1.6; 95%[CI] = 0.9-2.7). In post hoc analyses among children whose close TB contact was their mother, we found evidence of a weak positive association between breastfeeding and TB (aPR = 2.1; 95%[CI] = 0.9-4.9). This association was not apparent among children whose close contact was not the mother (aPR = 1.2; 95%[CI] = 0.6-2.4). Our results raise the possibility that children who are breastfed by mothers with TB may be at increased risk for TB, given the close contact. Due to the cross-sectional study design, these results should be interpreted with caution. If these findings are confirmed in longitudinal analyses, future interventions could aim to minimize TB transmission from mothers with TB to breastfeeding infants.
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