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Differences in morbidity between breast-fed and formula-fed infants
K G Dewey1, M J Heinig, L A Nommsen-Rivers
1Department of Nutrition, University of California, Davis 95616-8669, USA.
Insights
Breast-feeding significantly reduces infant illness, including diarrhea and ear infections, in the first year of life. These findings highlight the public health importance of promoting breastfeeding for infant health.
Area of Science:
- Pediatrics
- Public Health
- Infectious Disease Epidemiology
Background:
- Investigating the protective effects of breastfeeding against infections in developed populations.
- Understanding the impact of infant feeding practices on morbidity during early childhood.
Purpose of the Study:
- To evaluate the protective role of breastfeeding against common infections in affluent infants.
- To quantify differences in illness incidence and duration between breastfed and formula-fed infants.
Main Methods:
- Matched cohort study design comparing breastfed (BF) and formula-fed (FF) infants up to 2 years of age.
- Weekly morbidity monitoring, controlling for birth weight, socioeconomic status, and daycare use.
- Analysis of diarrheal illness, otitis media, and respiratory infections.
Main Results:
- BF infants had half the incidence of diarrheal illness compared to FF infants in the first year.
- BF infants showed a 19% lower incidence of otitis media and an 80% reduction in prolonged episodes.
- While respiratory illness rates were similar, FF infants experienced longer durations of otitis media in the second year.
Conclusions:
- Breastfeeding offers significant protection against common infections like diarrhea and otitis media in the first year of life.
- The reduction in illness associated with breastfeeding is substantial enough to warrant public health attention.
- Breastfeeding contributes to shorter illness durations, particularly for otitis media, even into the second year of life.
Abstract:
To determine whether breast-feeding is protective against infection in relatively affluent populations, morbidity data were collected by weekly monitoring during the first 2 years of life from matched cohorts of infants who were either breast fed (BF) (N = 46) or formula fed (FF) (N = 41) until at least 12 months of age. Cohorts were matched for characteristics such as birth weight and parental socioeconomic status, and we controlled for use of day care in data analysis. Mean maternal educational level was high (16 years) in both groups. In the first year of life the incidence of diarrheal illness among BF infants was half that of FF infants; the percentage with any otitis media was 19% lower and with prolonged episodes (> 10 days) was 80% lower in BF compared with FF infants. There were no significant differences in rates of respiratory illness; nearly all cases were mild upper respiratory infections. Morbidity rates did not differ significantly between groups in the second year of life, but the mean duration of episodes of otitis media was longer in FF than BF infants (8.8 +/- 5.3 vs 5.9 +/- 3.5 days, respectively; p = 0.01). These results indicate that the reduction in morbidity associated with breast-feeding is of sufficient magnitude to be of public health significance.