Full breastfeeding duration and associated decrease in respiratory tract infection in US children

Caroline J Chantry, Cynthia R. Howard, Peggy Auinger

Research output: Contribution to journalArticle

243 Citations (Scopus)

Abstract

OBJECTIVE. The American Academy of Pediatrics recommends exclusive breastfeeding for an infant's first 6 months of life. When compared with exclusive breastfeeding for 4 months, greater protection against gastrointestinal infection, but not respiratory tract infection, has been demonstrated for the 6-month duration. The objective of this study was to ascertain if full breastfeeding of ≥6 months compared with 4 to <6 months in the United States provides greater protection against respiratory tract infection. METHODS. Secondary analysis of data from the National Health and Nutrition Examination Survey III, a nationally representative cross-sectional home survey conducted from 1988 to 1994, was performed. Data from 2277 children aged 6 to <24 months, who were divided into 5 groups according to breastfeeding status, were compared. Children who required neonatal intensive care were excluded. SUDAAN software was used to account for the complex sampling design. Logistic regression adjusted for confounding factors. Outcome measures included adjusted odds of acquiring pneumonia, ≥3 episodes of cold/influenza, ≥3 episodes of otitis media (OM), or wheezing in the past year or acquiring first OM at <12 months of age. RESULTS. In unadjusted analyses, infants who were fully breastfed for 4 to <6 months (n = 223) were at greater risk for pneumonia than those who were fully breastfed for ≥6 months (n = 136) (6.5% vs 1.6%). There were not statistically significant differences in ≥3 episodes of cold/influenza (45% vs 41%), wheezing (23% vs 24%), ≥3 episodes of OM (27% vs 20%), or first OM at <12 months of age (49% vs 47%). Adjusting for demographic variables, childcare, and smoke exposure revealed statistically significant increased risk for both pneumonia (odds ratio [OR]: 4.27; 95% confidence interval [CI]: 1.27-14.35) and ≥3 episodes of OM (OR: 1.95; 95% CI: 1.06-3.59) in those who were fully breastfed for 4 to ≥6 months compared with <6 months. CONCLUSIONS. This nationally representative study documents increased risk of respiratory tract infection including pneumonia and recurrent OM in children who were fully breastfed for 4 vs 6 months. These findings support current recommendations that infants receive only breast milk for the first 6 months of life.

Original languageEnglish (US)
Pages (from-to)425-432
Number of pages8
JournalPediatrics
Volume117
Issue number2
DOIs
StatePublished - Feb 2006

Fingerprint

Otitis Media
Breast Feeding
Respiratory Tract Infections
Pneumonia
Respiratory Sounds
Human Influenza
Odds Ratio
Confidence Intervals
Neonatal Intensive Care
Nutrition Surveys
Human Milk
Smoke
Software
Cross-Sectional Studies
Logistic Models
Demography
Outcome Assessment (Health Care)
Pediatrics
Infection

Keywords

  • Benefits
  • Breastfeeding
  • Infant feeding
  • Nutrition-infant
  • Respiratory infections

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Full breastfeeding duration and associated decrease in respiratory tract infection in US children. / Chantry, Caroline J; Howard, Cynthia R.; Auinger, Peggy.

In: Pediatrics, Vol. 117, No. 2, 02.2006, p. 425-432.

Research output: Contribution to journalArticle

Chantry, Caroline J ; Howard, Cynthia R. ; Auinger, Peggy. / Full breastfeeding duration and associated decrease in respiratory tract infection in US children. In: Pediatrics. 2006 ; Vol. 117, No. 2. pp. 425-432.
@article{43d18fd0e23744199e173d59d0cfb15e,
title = "Full breastfeeding duration and associated decrease in respiratory tract infection in US children",
abstract = "OBJECTIVE. The American Academy of Pediatrics recommends exclusive breastfeeding for an infant's first 6 months of life. When compared with exclusive breastfeeding for 4 months, greater protection against gastrointestinal infection, but not respiratory tract infection, has been demonstrated for the 6-month duration. The objective of this study was to ascertain if full breastfeeding of ≥6 months compared with 4 to <6 months in the United States provides greater protection against respiratory tract infection. METHODS. Secondary analysis of data from the National Health and Nutrition Examination Survey III, a nationally representative cross-sectional home survey conducted from 1988 to 1994, was performed. Data from 2277 children aged 6 to <24 months, who were divided into 5 groups according to breastfeeding status, were compared. Children who required neonatal intensive care were excluded. SUDAAN software was used to account for the complex sampling design. Logistic regression adjusted for confounding factors. Outcome measures included adjusted odds of acquiring pneumonia, ≥3 episodes of cold/influenza, ≥3 episodes of otitis media (OM), or wheezing in the past year or acquiring first OM at <12 months of age. RESULTS. In unadjusted analyses, infants who were fully breastfed for 4 to <6 months (n = 223) were at greater risk for pneumonia than those who were fully breastfed for ≥6 months (n = 136) (6.5{\%} vs 1.6{\%}). There were not statistically significant differences in ≥3 episodes of cold/influenza (45{\%} vs 41{\%}), wheezing (23{\%} vs 24{\%}), ≥3 episodes of OM (27{\%} vs 20{\%}), or first OM at <12 months of age (49{\%} vs 47{\%}). Adjusting for demographic variables, childcare, and smoke exposure revealed statistically significant increased risk for both pneumonia (odds ratio [OR]: 4.27; 95{\%} confidence interval [CI]: 1.27-14.35) and ≥3 episodes of OM (OR: 1.95; 95{\%} CI: 1.06-3.59) in those who were fully breastfed for 4 to ≥6 months compared with <6 months. CONCLUSIONS. This nationally representative study documents increased risk of respiratory tract infection including pneumonia and recurrent OM in children who were fully breastfed for 4 vs 6 months. These findings support current recommendations that infants receive only breast milk for the first 6 months of life.",
keywords = "Benefits, Breastfeeding, Infant feeding, Nutrition-infant, Respiratory infections",
author = "Chantry, {Caroline J} and Howard, {Cynthia R.} and Peggy Auinger",
year = "2006",
month = "2",
doi = "10.1542/peds.2004-2283",
language = "English (US)",
volume = "117",
pages = "425--432",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "2",

}

TY - JOUR

T1 - Full breastfeeding duration and associated decrease in respiratory tract infection in US children

AU - Chantry, Caroline J

AU - Howard, Cynthia R.

AU - Auinger, Peggy

PY - 2006/2

Y1 - 2006/2

N2 - OBJECTIVE. The American Academy of Pediatrics recommends exclusive breastfeeding for an infant's first 6 months of life. When compared with exclusive breastfeeding for 4 months, greater protection against gastrointestinal infection, but not respiratory tract infection, has been demonstrated for the 6-month duration. The objective of this study was to ascertain if full breastfeeding of ≥6 months compared with 4 to <6 months in the United States provides greater protection against respiratory tract infection. METHODS. Secondary analysis of data from the National Health and Nutrition Examination Survey III, a nationally representative cross-sectional home survey conducted from 1988 to 1994, was performed. Data from 2277 children aged 6 to <24 months, who were divided into 5 groups according to breastfeeding status, were compared. Children who required neonatal intensive care were excluded. SUDAAN software was used to account for the complex sampling design. Logistic regression adjusted for confounding factors. Outcome measures included adjusted odds of acquiring pneumonia, ≥3 episodes of cold/influenza, ≥3 episodes of otitis media (OM), or wheezing in the past year or acquiring first OM at <12 months of age. RESULTS. In unadjusted analyses, infants who were fully breastfed for 4 to <6 months (n = 223) were at greater risk for pneumonia than those who were fully breastfed for ≥6 months (n = 136) (6.5% vs 1.6%). There were not statistically significant differences in ≥3 episodes of cold/influenza (45% vs 41%), wheezing (23% vs 24%), ≥3 episodes of OM (27% vs 20%), or first OM at <12 months of age (49% vs 47%). Adjusting for demographic variables, childcare, and smoke exposure revealed statistically significant increased risk for both pneumonia (odds ratio [OR]: 4.27; 95% confidence interval [CI]: 1.27-14.35) and ≥3 episodes of OM (OR: 1.95; 95% CI: 1.06-3.59) in those who were fully breastfed for 4 to ≥6 months compared with <6 months. CONCLUSIONS. This nationally representative study documents increased risk of respiratory tract infection including pneumonia and recurrent OM in children who were fully breastfed for 4 vs 6 months. These findings support current recommendations that infants receive only breast milk for the first 6 months of life.

AB - OBJECTIVE. The American Academy of Pediatrics recommends exclusive breastfeeding for an infant's first 6 months of life. When compared with exclusive breastfeeding for 4 months, greater protection against gastrointestinal infection, but not respiratory tract infection, has been demonstrated for the 6-month duration. The objective of this study was to ascertain if full breastfeeding of ≥6 months compared with 4 to <6 months in the United States provides greater protection against respiratory tract infection. METHODS. Secondary analysis of data from the National Health and Nutrition Examination Survey III, a nationally representative cross-sectional home survey conducted from 1988 to 1994, was performed. Data from 2277 children aged 6 to <24 months, who were divided into 5 groups according to breastfeeding status, were compared. Children who required neonatal intensive care were excluded. SUDAAN software was used to account for the complex sampling design. Logistic regression adjusted for confounding factors. Outcome measures included adjusted odds of acquiring pneumonia, ≥3 episodes of cold/influenza, ≥3 episodes of otitis media (OM), or wheezing in the past year or acquiring first OM at <12 months of age. RESULTS. In unadjusted analyses, infants who were fully breastfed for 4 to <6 months (n = 223) were at greater risk for pneumonia than those who were fully breastfed for ≥6 months (n = 136) (6.5% vs 1.6%). There were not statistically significant differences in ≥3 episodes of cold/influenza (45% vs 41%), wheezing (23% vs 24%), ≥3 episodes of OM (27% vs 20%), or first OM at <12 months of age (49% vs 47%). Adjusting for demographic variables, childcare, and smoke exposure revealed statistically significant increased risk for both pneumonia (odds ratio [OR]: 4.27; 95% confidence interval [CI]: 1.27-14.35) and ≥3 episodes of OM (OR: 1.95; 95% CI: 1.06-3.59) in those who were fully breastfed for 4 to ≥6 months compared with <6 months. CONCLUSIONS. This nationally representative study documents increased risk of respiratory tract infection including pneumonia and recurrent OM in children who were fully breastfed for 4 vs 6 months. These findings support current recommendations that infants receive only breast milk for the first 6 months of life.

KW - Benefits

KW - Breastfeeding

KW - Infant feeding

KW - Nutrition-infant

KW - Respiratory infections

UR - http://www.scopus.com/inward/record.url?scp=33644866343&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644866343&partnerID=8YFLogxK

U2 - 10.1542/peds.2004-2283

DO - 10.1542/peds.2004-2283

M3 - Article

C2 - 16452362

AN - SCOPUS:33644866343

VL - 117

SP - 425

EP - 432

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 2

ER -