Breastfeeding practice, breastfeeding policy and hospitalisations for infectious diseases in early and later childhood: a register-based study in Uppsala County, Sweden

Abstract

ObjectiveTo examine the association between breastfeeding practice and hospitalisations for infectious diseases in early and later childhood, in particular, to compare exclusive breast feeding 4–5 months with exclusive breastfeeding 6 months or more. Thereby, provide evidence to inform breastfeeding policy.DesignA register-based cohort study.SettingA cohort was created by combining the Swedish Medical Birth Register, the National Inpatient Register, the Cause of Death Register, the Total Population Register, the Longitudinal integration database for health insurance and labour market studies, with the Uppsala Preventive Child Health Care database.Patients37 825 term and post-term singletons born to women who resided in Uppsala County (Sweden) between 1998 and 2010.Main outcome measuresNumber of hospitalisations for infectious diseases in early (<2 years) and later childhood (2–4 years).ResultsThe risk of hospitalisations for infectious diseases decreased with duration of exclusive breastfeeding until 4 months of age. In early childhood, breast feeding was associated with a decreased risk of enteric and respiratory infections. In comparison with exclusive breast feeding 6 months or more, the strongest association was found between no breastfeeding and enteric infections (adjusted incidence rate ratios, aIRR 3.32 (95% CI 2.14 to 5.14)). In later childhood, breast feeding was associated with a lower risk of respiratory infections. In comparison with children exclusively breastfed 6 months or more, the highest risk was found in children who were not breastfed (aIRR 2.53 (95% CI 1.51 to 4.24)). The risk of hospitalisations for infectious diseases was comparable in children exclusively breastfed 4–5 months and children exclusively breastfed 6 months or more.ConclusionsOur results support breastfeeding guidelines that recommend exclusive breastfeeding for at least 4 months.

Exclusive Breastfeeding and Childhood Morbidity: A Narrative Review

“…Of the four studies with rotavirus as an outcome, two studies found a reduction in rotavirus infection and rotavirus diarrhea in children who were EBF, and two studies found no significant relationship [ 15 , 16 , 23 , 54 ]. All 11 papers that investigated ETEC ( n = 2), EAEC ( n = 1), giardia ( n = 1), Campylobacter infections ( n = 2), GI infections ( n = 4), and enteric infections ( n = 1) reported the protective effects of EBF [ 17 , 19 , 20 , 22 , 25 , 26 , 28 , 32 , 33 , 38 , 41 ].…”

“…One paper from Germany reported that a longer duration of EBF led to a higher risk of ARI [ 37 ]. All studies assessing lower respiratory tract infections ( n = 6), pneumonia ( n = 5), bronchiolitis ( n = 1), and broad respiratory/chest infections ( n = 5) reported a protective association with EBF [ 11 , 18 , 21 , 28 , 32 , 33 , 34 , 35 , 39 , 40 , 41 , 48 , 49 , 50 , 56 , 57 , 79 ]. A few studies found that there was no significant association between EBF and tuberculosis ( n = 1), upper respiratory tract infection ( n = 1), and pertussis ( n = 1) [ 44 , 52 , 61 ].…”

Breast is best also in high‐income countries

“…We know that breastfeeding is essential for survival in low‐income settings. But also in high‐income countries, breastfeeding is still an important factor with both direct and long‐lasting effects on growth, prevention of infections, overweight and obesity and promoting future health 13,14 …”

“…But also in high-income countries, breastfeeding is still an important factor with both direct and long-lasting effects on growth, prevention of infections, overweight and obesity and promoting future health. 13,14 Sven Arne Silfverdal…”

Breastfeeding and diseases prevalent in the first two years of a child’s life: a cross-sectional study

“…With regard to prevalent diseases, a cohort study conducted in Sweden, with the objective of assessing the association between breastfeeding and hospitalizations for infectious diseases in children up to four years of age, revealed that the risk of hospitalizations for infectious diseases decreased with EBF duration. In early childhood, breastfeeding was associated with a decreased risk of enteral and respiratory infections and, in children aged two to four years, with a lower risk of respiratory infections ( 5 ) .…”