Protective effect of exclusive breastfeeding and effectiveness of maternal vaccination in reducing pertussis-like illness
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Renata Medeiros do Nascimento1, Paulo Neves Baptista2, Katiuscia Araújo de Miranda Lopes1
1Universidade de Pernambuco, Pós-Graduação em Ciências da Saúde, Recife, PE, Brazil.
Insights
Exclusive breastfeeding significantly protects infants under six months from pertussis-like illness. This protection is enhanced when mothers are vaccinated against pertussis during pregnancy, offering robust infant health benefits.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Pertussis (whooping cough) poses a significant risk to infants under six months.
- Exclusive breastfeeding and maternal vaccination are potential strategies to protect vulnerable infants.
Purpose of the Study:
- To evaluate the protective effect of exclusive breastfeeding.
- To assess the effectiveness of maternal pertussis vaccination in reducing pertussis-like illness in infants.
Main Methods:
- A case-control study was conducted in Recife, Brazil, from July 2016 to July 2018.
- Cases were infants under six months with pertussis-like symptoms; controls were age-matched infants without the illness.
- Data on breastfeeding status and maternal vaccination history were collected.
Main Results:
- Exclusive breastfeeding showed a 74% protective effect against pertussis-like illness.
- Infants who were exclusively breastfed and whose mothers were vaccinated had a 79% reduced risk.
- Maternal vaccination alone had a low (27%) and non-significant effectiveness.
Conclusions:
- Exclusive breastfeeding is a key protective measure for infants under six months against pertussis-like illness.
- Combining exclusive breastfeeding with maternal pertussis vaccination offers enhanced protection.
- Promoting these combined strategies is recommended for infant health and disease prevention.
Objective:
To assess the protective effect of exclusive breastfeeding and the effectiveness of maternal vaccination in reducing pertussis-like illness.
Method:
This was a case-control study conducted in sentinel hospitals for pertussis in Recife between July 2016 and July 2018. Cases included children aged under six months with symptoms compatible with pertussis (pertussis-like illness). Controls included children aged under six months, living in the metropolitan region of Recife with no diagnosis of pertussis-like illness and matched by the same hospital and birth date.
Results:
Seventy-three cases and 194 controls were included. The diagnosis of pertussis-like illness was predominantly clinical (97,2%). Amongst the main symptoms, paroxysmal cough was observed in 95.89% of cases and vomiting in 53.4%. There were 29 hospitalized cases and no deaths. Out of the 73 cases, 47 were born to mothers vaccinated against pertussis during pregnancy, and the mothers of 144 of the 194 controls had been vaccinated. The protective effect of breastfeeding was of 74% (95% CI;38%, 89%). Children younger than six months, who were exclusively breastfed and with mothers vaccinated against pertussis during pregnancy were 5 times less likely to develop pertussis-like illness, corresponding to a protection of 79% (95% CI;31%, 94%). The effectiveness of maternal vaccination against pertussis-like illness in children under six months was low (27%) and not statistically significant (CI 95%; -34% a 60%).
Conclusions:
Exclusive breastfeeding protects children under six months from pertussis-like illness and may be enhanced when associated with maternal vaccination. These strategies should be encouraged because they also protect against pertussis-like illnesses.
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