The effect of exclusive breast-feeding on respiratory illness in young infants in a maternal immunization trial in Bangladesh

Emily Henkle, Mark C. Steinhoff, Saad B. Omer, Eliza Roy, Shams E. Arifeen, Rubhana Raqib, Robert E. Breiman, Laura E. Caulfield, William J. Moss, Khalequ Zaman

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Exclusive breast-feeding reduces the risk of respiratory illness in infants younger than 6 months of age in developing countries by approximately half. We evaluated the effect of exclusive breast-feeding on respiratory illness with fever (RIF) in Bangladeshi infants in the context of a randomized maternal influenza immunization trial. Methods: Infants in a maternal vaccine trial in Dhaka, Bangladesh, were prospectively assessed at weekly intervals for 6 months after birth for breastfeeding practices and RIF. We estimated the risk of an RIF episode for infants who were exclusively breast-fed the prior week compared with infants not exclusively breast-fed the prior week using generalized estimating equations. Results: We followed a total of 331 infants from birth to 24 weeks of age. The median weeks infants were exclusively breast-fed was 15 (interquartile range, 6-21). The adjusted independent odds of respiratory illness for exclusively breast-fed infants compared with nonexclusively breast-fed infants was 0.59 (95% confidence interval: 0.45-0.77) for an RIF episode. After adjusting for exclusive breast-feeding, we confirmed the previous report that maternal immunization with influenza vaccine had an independent protective effect against RIF (odds ratio, 0.72; 95% confidence interval: 0.55-0.93). No significant difference in the protective effect of exclusive breast-feeding was seen by maternal influenza immunization status. Conclusions: Exclusive breast-feeding during the first 6 months of life and maternal immunization with influenza vaccine independently and substantially reduced respiratory illness with fever in infants.

Original languageEnglish (US)
Pages (from-to)431-435
Number of pages5
JournalPediatric Infectious Disease Journal
Volume32
Issue number5
DOIs
StatePublished - May 2013

Keywords

  • Breast-feeding
  • Infants
  • Respiratory illness

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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