A systematic review of infant feeding experience and hospitalisation in developed countries

Investigating the influence of breastfeeding on asthma in children under 12 years old in the UK Biobank

Background

Childhood-onset asthma (COA) has become a major and growing problem worldwide and imposes a heavy socioeconomic burden on individuals and families; therefore, understanding the influence of early-life experiences such as breastfeeding on COA is of great importance for early prevention.

Objectives

To investigate the impact of breastfeeding on asthma in children under 12 years of age and explore its role at two different stages of age in the UK Biobank cohort.

Methods

A total of 7,157 COA cases and 158,253 controls were obtained, with information regarding breastfeeding, COA, and other important variables available through questionnaires. The relationship between breastfeeding and COA were examined with the logistic regression while adjusting for available covariates. In addition, a sibling analysis was performed on 398 pairs of siblings to explain unmeasured family factors, and a genetic risk score analysis was performed to control for genetic confounding impact. Finally, a power evaluation was conducted in the sibling data.

Results

In the full cohort, it was identified that breastfeeding had a protective effect on COA (the adjusted odds ratio (OR)=0.875, 95% confidence intervals (CIs): 0.831~0.922; P=5.75×10^-7). The impact was slightly pronounced in children aged 6-12 years (OR=0.852, 95%CIs: 0.794~0.914, P=7.41×10^-6) compared to those aged under six years (OR=0.904, 95%CIs: 0.837~0.975, P=9.39×10^-3), although such difference was not substantial (P=0.266). However, in the sibling cohort these protective effects were no longer significant largely due to inadequate samples as it was demonstrated that the power was only 23.8% for all children in the sibling cohort under our current setting. The protective effect of breastfeeding on COA was nearly unchanged after incorporating the genetic risk score into both the full and sibling cohorts.

Conclusions

Our study offered supportive evidence for the protective effect of breastfeeding against asthma in children less than 12 years of age; however, sibling studies with larger samples were warranted to further validate the robustness our results against unmeasured family confounders. Our findings had the potential to encourage mothers to initiate and prolong breastfeeding.

The Effect of Exclusive Breastfeeding on Hospital Stay and Morbidity due to Various Diseases in Infants under 6 Months of Age: A Prospective Observational Study

Background. Mother's milk is the best for the babies. Protective and preventive role of breast milk was evaluated in this study by assessing the relation of type of feeding and duration of hospital stay or morbidity. Methods. This prospective study was conducted in a tertiary care hospital and 232 infants in the age group of 14 weeks to 6 months formed the sample. There are two groups of infants, that is, one for breastfed and one for top fed infants. Statistical analysis was done and results were calculated up to 95% to 99% level of significance to find effect of feeding pattern on hospital stay due to various diseases and morbidity. Results. Prolonged hospital stay, that is, >7 days, was lesser in breastfed infants and results were statistically significant in case of gastroenteritis (p value < 0.001), bronchopneumonia (p value = 0.0012), bronchiolitis (p value = 0.005), otitis media (p value = 0.003), and skin diseases (p value = 0.047). Lesser morbidity was seen in breastfed infants with gastroenteritis (p value 0.0414), bronchopneumonia (p value 0.03705), bronchiolitis (p value 0.036706), meningitis (p value 0.043), and septicemia (p value 0.04). Conclusions. Breastfed infants have shorter hospital stay and lesser morbidity in regard to various diseases as compared to top fed infants.

Breastfeeding is associated with reduced childhood hospitalization: evidence from a Scottish Birth Cohort (1997-2009)

OBJECTIVE

To evaluate the risk of childhood hospitalization associated with infant feeding patterns at 6-8 weeks of age in Scotland.

STUDY DESIGN

A retrospective population level study based on the linkage of birth, death, maternity, infant health, child health surveillance, and admission records for children born as single births in Scotland between 1997 and 2009 (n = 502 948) followed up to March 2012. Descriptive analyses, Kaplan Meier tests, and Cox regression were used to quantify the association between the mode of infant feeding and risk of childhood hospitalization for respiratory, gastrointestinal, and urinary tract infections, and other common childhood ailments during the study period.

RESULTS

Within the first 6 months of life, there was a greater hazard ratio (HR) of hospitalization for common childhood illnesses among formula-fed infants (HR 1.40; 95% CI 1.35-1.45) and mixed-fed infants (HR 1.18; 95% CI 1.11-1.25) compared with infants exclusively breastfed after adjustment for parental, maternal, and infant health characteristics. Within the first year of life and beyond, a greater relative risk of hospitalization was observed among formula-fed infants for a range of individual illnesses reported in childhood including gastrointestinal, respiratory, and urinary tract infections, otitis media, fever, asthma, diabetes, and dental caries.

CONCLUSIONS

Using linked administrative data, we found greater risks of hospitalization in early childhood for a range of common childhood illnesses among Scottish infants who were not exclusively breastfed at 6-8 weeks of age.

Predictors of early introduction of complementary feeding: longitudinal study

BACKGROUND

Early introduction of complementary foods prior to 6 months of age may shorten breast-feeding duration and expose the infant to increased risk of morbidity and mortality. The aims of this study were to document the ages of complementary food introduction and to identify the determinants associated with early introduction of complementary feeding in Sichuan Province.

METHODS

A prospective study on infant feeding practices was conducted during 2010-2011 in Jiangyou, China. A total of 695 mothers were recruited and interviewed at discharge. The follow-up interviews were carried out by telephone at 1, 3 and 6 months postpartum. Cox regression analysis was performed to determine factors related to early introduction of complementary feeding.

RESULTS

The median age at start of complementary feeding was 4.5 months (95% confidence interval [CI]: 4.4-4.6 months). Mothers who perceived that most of their friends breast-fed (adjusted hazard ratio [HR], 0.70; 95%CI: 0.58-0.84) and those who returned to work when the infants were at least 6 months old were less likely to initiate complementary feeding early (adjusted HR, 0.73; 95%CI: 0.58-0.91), while infants who had been introduced to infant formula regularly before 6 months of age were at a higher risk of receiving complementary foods prematurely (adjusted HR, 1.81; 95%CI: 1.42-2.31).

CONCLUSIONS

Introducing complementary feeding before 6 months postpartum was widely practiced in Jiangyou. The appropriate age at which to introduce complementary foods and its benefits need to be emphasized in the future breast-feeding education strategies in Sichuan.