WHAT'S KNOWN ON THIS SUBJECT:Exclusive breastfeeding seems to decrease the risk of infectious diseases in infancy. However, the World Health Organization has called for more research regarding the benefits for 6 months instead of 4 months of exclusive breastfeeding.
WHAT THIS STUDY ADDS:Exclusive breastfeeding to the age of 6 months tended to be more protective than exclusive breastfeeding until the age of 4 months and partially thereafter. Our findings support health-policy strategies that promote exclusive breastfeeding for 6 months in industrialized countries. 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 Ͻ4 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.
RESULTS:Compared with never-breastfed infants, those who were breastfed exclusively until the age of 4 months and partially thereafter had lower risks of infections in the URTI, LRTI, and GI until the age of 6 months (adjusted odds ratio . Similar tendencies were observed for infants who were exclusively breastfed for 6 months or longer. Partial breastfeeding, even for 6 months, did not result in significantly lower risks of these infections.
CONCLUSIONS:Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants. Our findings support healthpolicy strategies to promote exclusive breastfeeding for at least 4 months, but preferably 6 months, in industrialized countries.