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Breast-feeding and Childhood Hospitalizations for Infections

Tarrant, Mariea; Kwok, Man-Kib; Lam, Tai-Hingb; Leung, Gabriel M.b; Schooling, C. Maryb

doi: 10.1097/EDE.0b013e3181f55803
Infectious Disease: Original Article

Background: Infectious disease is a leading cause of morbidity and hospitalization for infants and children. During infancy, breast-feeding protects against infectious diseases, particularly respiratory infections, gastrointestinal infections, and otitis media. Little is known about the longer-term impact of breast-feeding on infectious disease in children.

Methods: We investigated the relationship between infant feeding and childhood hospitalizations from respiratory and gastrointestinal infections in a population-based birth cohort of 8327 children born in 1997 and followed for 8 years. The main outcomes were public hospital admissions for respiratory infections, gastrointestinal infections, and all infectious diseases. Cox regression was used to assess time to first hospitalization.

Results: Breast-feeding only (no formula-feeding) for 3 or more months was associated with a lower risk of hospital admission in the first 6 months of life for respiratory infections (hazard ratio = 0.64 [95% confidence interval = 0.42–0.97]), gastrointestinal infections (0.51 [0.25–1.05]), and any infection (0.61 [0.44–0.85]), adjusted for sex, type of hospital at birth, and household income. Partial breast-feeding (both breast-feeding and formula-feeding) in the first 3 months also reduced hospitalizations from infections but with smaller effect sizes. Beyond 6 months of age, there was no association between breast-feeding status at 3 months and hospitalization for infectious disease.

Conclusions: Giving breast milk and no formula for at least 3 months substantially reduced hospital admissions for many infectious diseases in the first 6 months of life, when children are most vulnerable.

From the aSchool of Nursing, The University of Hong Kong, Hong Kong SAR, China; and bDepartment of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong SAR, China.

Submitted 1 November 2009; accepted 25 June 2010.

Supported by the Research Fund for the Control of Infectious Diseases, Government of the Hong Kong Special Administrative Region (Grants: 06060592, 04050172); the Hong Kong Health Care and Promotion Fund (Grant: 216106); the Health and Health Services Research Fund (Grant: 03040711); and the University of Hong Kong (Grant: 10206700).

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article (www.epidem.com).

Correspondence: Marie Tarrant, Li Ka Shing Faculty of Medicine, University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Rd, Hong Kong SAR, China. E-mail: tarrantm@hku.hk.

© 2010 Lippincott Williams & Wilkins, Inc.