Protective effect of exclusive breastfeeding against hand, foot and mouth disease

Lin, Hualiang; Sun, Limei; Lin, Jun; He, Jianfeng; Deng, Aiping; Kang, Min; Zeng, Hanri; Ma, Wenjun; Zhang, Yonghui

doi:10.1186/preaccept-7344673251342033

Cited by 3 publications

(4 citation statements)

References 13 publications

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“…It is surmised that the antibodies existing in the neonatal blood from maternal blood and breast, which decline with the age growing, might provide protection against the infection. [ 8 ] The WBC, the PCT, and also the CRP, were usually normal or increased slightly, which indicated that the infection was mild and almost impossibly exacerbated. [ 9 ] Although the 5 cases we met were full-term babies, HFMD also came across preterm babies with an atypical course.…”

Section: Discussionmentioning

confidence: 99%

Case report

Chen

Yang²,

Lian³

et al. 2017

Medicine

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Rationale:Hand, foot and mouth disease (HFMD) is caused by enterovirus. The virus may exist in secretions.Patient concerns:Five neonates had symptoms of fever and maculopapular rashes involving face, trunk, breech, arms, and legs, especially scattering on palms and feet. Blood, oropharyngeal fluid, urine, and cerebrospinal fluid (CSF) samples were collected and detected for further diagnoses with the consent of the infants’ parents. Some of them suffered aseptic meningitis.Diagnoses:They were diagnosed as HFMD with CSF enterovirus positive.Interventions:All of them continued breastfeed. Water bag was used during the pyrogenic stage. Antibiotics were administrated at first and withdrawn as soon as possible.Outcomes:None of them developed into brainstem encephalitis or pulmonary edema and they all recovered well.Lessons:HFMD is more common in neonates than it has been thought. Enterovirus may exist in neonatal CSF and cause CSF cell to increase similar to purulent meningitis. Medical history, physical examination, and CSF enterovirus detection are important in making correct diagnosis. Unlike bacterial infection, HFMD is a self-limited disease. Once HFMD is determined and bacterial infection is ruled out, antibiotics should be avoided.

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Section: Discussionmentioning

confidence: 99%

Case report

Chen

Yang²,

Lian³

et al. 2017

Medicine

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“…Furthermore, younger children (<6 mo) are more likely to develop asymptomatic EV‐A71 infections, which may be due to the protection of maternal antibody against symptomatic EV‐A71 infections . Breastfeeding has been shown to have protective effects against HFMD in young children …”

Section: Host Immune Responses To Ev‐a71 Infectionmentioning

confidence: 99%

“…16,57 Breastfeeding has been shown to have protective effects against HFMD in young children. 58 Neutralizing antibodies bind and neutralize virus efficiently, thus preventing further progression of disease. Humoral immune responses are elicited when clinical symptoms appear, and 80% of HFMD patients became positive for neutralizing antibodies against EV-A71 one day after the onset of illness.…”

Section: Protective Humoral Immune Responsesmentioning

confidence: 99%

Immune responses against enterovirus A71 infection: Implications for vaccine success

Aw-Yong

NikNadia

Tan

et al. 2019

Reviews in Medical Virology

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Summary Enterovirus A71 (EV‐A71) from the Picornaviridae family is an important emerging pathogen causing hand, foot, and mouth disease (HFMD) outbreaks worldwide. EV‐A71 also caused fatal neurological complications in young children especially in Asia. On the basis of seroepidemiological studies from many Asian countries, EV‐A71 infection is very common. Children of very young age are particularly vulnerable. Large‐scale epidemics that occur every 3 to 4 years are associated with accumulation of an immunologically naive younger population. Capsid proteins especially VP1 with the presence of major B‐ and T‐cell epitopes are the most antigenic proteins. The nonstructural proteins mainly contribute to T‐cell epitopes that induce cross‐reactive immune responses against other enteroviruses. Dominant epitopes and their neutralization magnitudes differ in mice, rabbits, and humans. Neutralizing antibody is sufficient for immune protection, but poorer cellular immunity may lead to severe neurological complications and deaths. Some chemokines/cytokines are consistently found in severely ill patients, for example, IL‐6, IL‐10, IL‐17A, MCP‐1, IL‐8, MIG, IP‐10, IFN‐γ, and G‐CSF. An increase in white cell counts is a risk factor for severe HFMD. Recent clinical trials on EV‐A71 inactivated vaccine showed >90% efficacy and a robust neutralization response that was protective, indicating neutralizing antibody correlates for protection. No protection against other enteroviruses was observed. A comprehensive understanding of the immune responses to EV‐A71 infection will benefit the development of diagnostic tools, potential therapeutics, and subunit vaccine candidates. Future development of a multivalent enterovirus vaccine will require knowledge of correlates of protection, understanding of cross‐protection and memory T‐cell responses among enteroviruses.

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“…The benefits of breast-feeding for both mother and child have been widely recognized, serving as a nutritional and energy supplement, helping to prevent infections and diseases, and promoting maternal well-being ( 2 ) . Breast-feeding helps reduce the risk for breast and ovarian carcinoma and type 2 diabetes in mothers ( 3 ) , and EBF during the first 6 months of life reduces the risk of becoming overweight in the offspring ( 4 ) and can prevent such infections as rotavirus diarrhoea and hand, foot and mouth disease ( 5 , 6 ) . Globally, 37 % of infants younger than 6 months in low-income and middle-income countries receive EBF ( 7 ) .…”

mentioning

confidence: 99%

Association between gestational weight gain and exclusive breast-feeding for the first 6 months postpartum in Chinese women

Tong¹,

Jin²,

Liu³

et al. 2019

Public Health Nutr.

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ObjectiveThe association between gestational weight gain (GWG) and exclusive breast-feeding (EBF) practices remains unclear. The present study evaluated the association between GWG and EBF in the first 6 months postpartum among primiparas in rural China.DesignThe study population was drawn from a previous randomized controlled trial, and the relevant data were obtained from an electronic, population-based perinatal system and a monitoring system for child health care. GWG was categorized according to the guidelines of the Institute of Medicine.SettingFive rural counties in Hebei Province, China.ParticipantsA total of 8449 primiparas.ResultsOf the women, 58·7 % breast-fed exclusively for the first 6 months postpartum. Overweight women who gained either more or less weight than the recommended GWG tended to experience failure of EBF (OR=0·49; 95 % CI 0·34, 0·70; P<0·001 and OR=0·79; 95 % CI 0·63, 0·99; P=0·048, respectively). The same results were also observed among obese women; the OR for lower and greater weight gain were 0·28 (95 % CI 0·08, 0·94; P=0·04) and 0·55 (95 % CI 0·32, 0·95; P=0·03), respectively.ConclusionsGWG that is below or above the Institute of Medicine recommendations is associated with EBF behaviour for the first 6 months postpartum in overweight and obese primiparas in rural China.

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Protective effect of exclusive breastfeeding against hand, foot and mouth disease

Cited by 3 publications

References 13 publications

Case report

Case report

Immune responses against enterovirus A71 infection: Implications for vaccine success

Association between gestational weight gain and exclusive breast-feeding for the first 6 months postpartum in Chinese women

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