A47 Breastfeeding protects infants against lower respiratory tract infections caused by respiratory syncytial virus. Results from the Italian Cohort Study Group on RSV

Prinelli, Federica; Musico, M.; Adorni, Fulvio; Silvestri, Michela; Coscia, Alessandra; Carlucci, Annalisa; Zorzi, Giulia; Fabio, Simonetta Di; Faccia, P.; Laforgia, Nicola; Loprieno, S.; Vecchio, Antonio Del; Corso, Giovanni; Orfeo, Luigi; Lucà, Maria Grazia; Faldella, Giacomo; Spinelli, Margaret G.; Bottau, Paolo; Fanos, Vassilios; Puddu, Melania; Rinaldi, Matteo; Barberi, Ignazio; Pagano, G; Scarcella, A; Umbaldo, Angela; Corsello, Giovanni; Gabriele, Bruna; Barboni, G; Molinari, Luisa; Boldrini, Antonio; Vuerich, Marta; Ngalikpima, C.J.; Gargano, Giancarlo; Braibanti, Silvia; Romagnoli, Cecilia; Aurilia, Cinzia; Paolillo, Piermichele; Picone, Simonetta; Curtis, Marco de; Natale, Francesco; Romeo, Nicola Antonio; Piano, Francesco Del; Nosari, N.; Sarnelli, Paola; Parmigiani, Stefano; Corona, Maria; Fabris, Carlo; Gaudino, Mario; Bonomi, Angelo Bianchi; Ladetto, L.; Memo, Luigi; Nicolini, G.; Macagno, F; Rodaro, E.; Dall’Agnola, A; Zardini, F; Manzoni, Paolo; Lanari, Marcello

doi:10.1016/s0378-3782(12)70073-7

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“…A study from Italy evaluated 1814 infants and concluded that crude risk ratio of never breast-fed infants was 7%, compared with 3.9% in ever breast-fed infants (never vs ever) 30 31. Authors also suggested both exclusive and partial breastfeeding exhibiting a protective effect.…”

Section: Resultsmentioning

confidence: 99%

“…Authors also suggested both exclusive and partial breastfeeding exhibiting a protective effect. Five out of the six studies that analysed incidence rates suggested that RSV bronchiolitis episodes among breast-fed infants was significantly lower compared with those with non-breast-feeding practices 30–34. A Brazilian cross-sectional study of 175 infants reported breastfeeding for <1 month increased rate of RSV bronchiolitis 30.…”

Section: Resultsmentioning

confidence: 99%

“…Five out of the six studies that analysed incidence rates suggested that RSV bronchiolitis episodes among breast-fed infants was significantly lower compared with those with non-breast-feeding practices. [30][31][32][33][34] A Brazilian cross-sectional study of 175 infants reported breastfeeding for <1 month increased rate of RSV bronchiolitis. 30 A multicentre prospective cohort study from Italy observed that breastfeeding might confer protection from RSV bronchiolitis in both exclusively or partially breast-fed infants, even after weaning.…”

Section: General Characteristicsmentioning

confidence: 99%

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Impact of breastfeeding on the incidence and severity of respiratory syncytial virus (RSV)-associated acute lower respiratory infections in infants: a systematic review highlighting the global relevance of primary prevention

et al. 2023

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BackgroundRespiratory syncytial virus (RSV) is the principal cause of acute lower respiratory infections (ALRI) among infants worldwide, and an important cause of morbidity, hospitalisation and mortality. While infants are universally exposed to RSV, most mortality occurs among normal term infants from low-income and middle-income countries. Breastfeeding has been suggested to have a protective effect against RSV infection. This study aims to determine the association of breastfeeding on the frequency and severity of RSV-associated ALRI among infants.MethodsA systematic review was conducted using keywords and Medical Subject Headings on MEDLINE, PubMed, Google Scholar, EMBASE, MedRxiv and Cochrane Central Register of Controlled Trials. Full-text articles published in English from 2000 to 2021 that studied exclusively or partially breastfed infants who developed RSV-associated ALRI <12 months of age were included. Covidence software-based evidence extraction and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines were followed. Quality of evidence was analysed using UK National Service Framework grading and the risk-of-bias assessment using Robvis.ResultsAmong 1368 studies screened, 217 qualified full-text review and 198 were excluded based on pre-agreed criteria. Nineteen articles published from 12 countries that included 16 787 infants from 31 countries (of which 8 middle-income) were retained for analysis. Results indicate that non-breastfeeding practices pose a significant risk for severe RSV-associated ALRI and hospitalisation. Exclusive breastfeeding for >4–6 months significantly lowered hospitalisation, length of stay, supplemental oxygen demand and admission to intensive care units.ConclusionIn the context of no effective or standardised treatment for established RSV-associated ALRI, available evidence suggest that breastfeeding is associated with lower frequency and severity of RSV-associated ALRI, based on observational studies of variable grades of evidence and risk-of-bias. With both exclusive and partial breastfeeding benefiting infants who develop RSV-associated ALRI, breastfeeding should be promoted globally as an adjunct primary prevention; in addition to emerging immunoprophylaxis and maternal immunisation strategies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%