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Protective effect of exclusive breastfeeding against infections during infancy: a prospective study

Ladomenou F, Moschandreas J, Kafatos A, Tselentis Y, Galanakis E.

Arch Dis Child. 2010 Sep 27. [Epub ahead of print]

Abstract

Objective To prospectively investigate the effects of breastfeeding on the frequency and severity of infections in a well-defined infant population with adequate vaccination coverage and healthcare standards.

Study design In a representative sample of 926 infants, successfully followed up for 12 months, feeding mode and all infectious episodes, including acute otitis media (AOM), acute respiratory infection (ARI), gastroenteritis, urinary tract infection, conjunctivitis and thrush, were recorded at 1, 3, 6, 9 and 12 months of life.

Results Infants exclusively breastfed for 6 months, as per WHO recommendations, presented with fewer infectious episodes than their partially breastfed or non-breastfed peers and this protective effect persisted after adjustment for potential confounders for ARI (OR 0.58, 95% CI 0.36 to 0.92), AOM (OR 0.37, 95% CI 0.13 to 1.05) and thrush (OR 0.14, 95% CI 0.02 to 1.02).
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Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy

Duijts L, Jaddoe VW, Hofman A, Moll HA.
Pediatrics. 2010 Jun 21. [Epub ahead of print]

Abstract

Objective: To examine the associations of duration of exclusive breastfeeding with infections in the upper respiratory (URTI), lower respiratory (LRTI), and gastrointestinal tracts (GI) in infancy.

Methods: This study was embedded in the Generation R Study, a population-based prospective cohort study from fetal life onward in the Netherlands. Rates of breastfeeding during the first 6 months (never; partial for <4 months, not thereafter; partial for 4-6 months; exclusive for 4 months, not thereafter; exclusive for 4 months, partial thereafter; and exclusive for 6 months) and doctor-attended infections in the URTI, LRTI, and GI until the age of 12 months were assessed by questionnaires and available for 4164 subjects.
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International study of wheezing in infants: risk factors in affluent and non-affluent countries during the first year of life

Garcia-Marcos L, Mallol J, Solé D, Brand PL; the EISL Study Group.
Pediatr Allergy Immunol. 2010 Apr 27. [Epub ahead of print]

Abstract

Risk factors for wheezing during the first year of life (a major cause of respiratory morbidity worldwide) are poorly known in non-affluent countries. We studied and compared risk factors in infants living in affluent and non-affluent areas of the world. A population-based study was carried out in random samples of infants from centres in Latin America (LA) and Europe (EU).

Parents answered validated questionnaires referring to the first year of their infant’s life during routine health visits. Wheezing was stratified into occasional (1–2 episodes, OW) and recurrent (3 + episodes, RW).
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Breast-feeding is associated with a reduced frequency of acute otitis media and high serum antibody levels against NTHi and outer membrane protein vaccine antigen candidate P6.

Sabirov A, Casey JR, Murphy TF, Pichichero ME.
Pediatr Res. 2009 Nov;66(5):565-70.

Abstract

Nontypeable Haemophilus influenzae (NTHi) causes acute otitis media (AOM) in infants. Breast-feeding protects against AOM and/or nasopharyngeal (NP) colonization; however, the mechanism of protection is incompletely understood. Children with AOM and healthy children were studied according to feeding status: breastfed,breast/formula fed, or formula fed.

Cumulative episodes of AOM, ELISA titers of serum IgG antibodies to whole-cell NTHi and vaccine candidate outer membrane protein P6, bactericidal titers of serum and NP colonization by NTHi were assessed. A lower incidence of AOM was found in breast- versus formula-fed children. Levels of specific serum IgG antibody to NTHi and P6 were highest in breast-fed, intermediate in breast/formula fed, and lowest in formula-fed infants.
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Breastfeeding protects against infectious diseases during infancy in industrialized countries. A systematic review

Liesbeth Duijts, Made K. Ramadhani and Henriëtte A. Moll
Maternal & Child Nutrition Volume 5 Issue 3, Pages 199 – 210; 2009

Abstract

Firstly, this review was performed to assess the effect of breastfeeding on infections during infancy in industrialized countries. Secondly, the effect of duration and exclusiveness of breastfeeding were explored.

Studies were identified using Medline, Cochrane Library, Science Citation Index and by a manual search from bibliographies of articles from August 1986 to January 2008. Follow-up, case–control and randomized controlled trial (RCT) studies performed in an industrialized country, published in English, with breastfeeding as a determinant, with overall infections, gastrointestinal or respiratory tract infections as a major outcome, and at least 40 participants in the study were included.
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Differential Gender Response to Respiratory Infections and to the Protective Effect of Breast Milk in Preterm Infants

M. Inés Klein, MD, Eduardo Bergel, PhD, Luz Gibbons, PhD, Silvina Coviello, MS, Gabriela Bauer, MD, Alicia Benitez, MD, M. Elina Serra, MD, M. Florencia Delgado, MS, Guillermina A. Melendi, MD, Susana Rodríguez, MD, Steven R. Kleeberger, PhD and Fernando P. Polack, MD

PEDIATRICS Vol. 121 No. 6 June 2008, pp. e1510-e1516

Abstract

OBJECTIVE. The protective role of breastfeeding against severe acute lung disease in infants is well established, but its mechanism is unclear. Most hypotheses assume that breastfeeding confers similar passive protection to every infant; however, a few observations have suggested that the benefits of breast milk against severe lung disease may differ according to gender.
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Immunomodulatory constituents of human milk change in response to infant bronchiolitis

Dani-Louise Bryan, Prue H. Hart, Kevin D. Forsyth, Robert A. Gibson (2007)
Pediatric Allergy and Immunology 18 (6), 495–502

Abstract

Although epidemiological evidence is generally supportive of a causal association between respiratory syncytial virus (RSV) bronchiolitis during infancy and the development of persistent wheeze/asthma, if not allergy, the mechanism by which this occurs and an explanation for why all children do not succumb remains to be elucidated. Breast feeding has been found to confer a protective effect against respiratory infections such as RSV bronchiolitis and allergy; however, again there is little direct evidence and no clear mechanism. In this study, we examined whether human milk immunomodulatory factors (cells, cytokines) change in response to clinically diagnosed, severe bronchiolitis in the recipient breast-fed infant.
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Outcomes of Breastfeeding versus Formula Feeding

A csecsemőtáplálás módjának a csecsemő és az anya egészségére gyakorlt hatásával kapcsolatos kutatási eredmények jól áttekinthető összefoglalása.

Letölthető a La leche League International oldaláról.
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Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries

Stanley Ip, M.D., Mei Chung, M.P.H., Gowri Raman, M.D., Priscilla Chew, M.P.H., Nombulelo Magula, M.D., Deirdre DeVine, M.Litt., Thomas Trikalinos, M.D., Ph.D., Joseph Lau, M.D.

Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, April 2007

Structured Abstract

Objectives: We reviewed the evidence on the effects of breastfeeding on short- and long-term infant and maternal health outcomes in developed countries.

Data Sources: We searched MEDLINE®, CINAHL, and the Cochrane Library in November of 2005. Supplemental searches on selected outcomes were searched through May of 2006. We also identified additional studies in bibliographies of selected reviews and by suggestions from technical experts.
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Breastfeeding and Hospitalization for Diarrheal and Respiratory Infection in the United Kingdom Millennium Cohort Study

Maria A. Quigley, MSc, Yvonne J. Kelly, PhD and Amanda Sacker, PhDb

PEDIATRICS Vol. 119 No. 4 April 2007, pp. e837-e842

Abstract

OBJECTIVE. The objective of this study was to measure the effect of breastfeeding on hospitalization for diarrheal and lower respiratory tract infections in the first 8 months after birth in contemporary United Kingdom.

METHODS. The study was a population-based survey (sweep 1 of the United Kingdom Millennium Cohort Study). Data on infant feeding, infant health, and a range of confounding factors were available for 15890 healthy, singleton, term infants who were born in 2000–2002. The main outcome measures were parental report of hospitalization for diarrhea and lower respiratory tract infection in the first 8 months after birth.
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