Breast‐feeding and Infant Hospitalization for Infections

Abstract

Background Breastfeeding may protect against infections, but its optimal duration remains controversial. We aimed to study the association of the duration of full and any breastfeeding with infections the first 18 months of life. Methods The Norwegian Mother and Child study (MoBa) is a prospective birth cohort which recruited expecting mothers giving birth from 2000–2009. We analyzed data from the full cohort (n=70 511) and sibling sets (n=21 220) with parental report of breastfeeding and infections. The main outcome measures were the relative risks for hospitalisation for infections from 0–18 months by age at introduction of complementary foods and duration of any breastfeeding. Results While we found some evidence for an overall association between longer duration of full breastfeeding and lower risk of hospitalisations for infections, 7.3% of breastfed children who received complementary foods at 4–6 months of age compared to 7.7% of those receiving complementary foods after 6 months were hospitalised (adjusted relative risk [RR] 0.95, 95% CI 0.88–1.03). Higher risk of hospitalisation was observed in those breastfed six months or less (10.0%) compared to ≥12 months (7.6%, adjusted RR 1.22, 95% CI 1.14–1.31), but with similar risks for 6–11 months versus ≥12 months. Matched sibling analyses, minimising the confounding from shared maternal factors, showed non-significant associations and were generally weaker compared with the cohort analyses. Conclusions Our results support the recommendation to fully breastfeed for 4 months and to continue breastfeeding beyond 6 months, and suggest that protection against infections is limited to the first 12 months.

Outcome of a public consultation on the Scientific Opinion of the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) on the appropriate age range for introduction of complementary feeding into an infant's diet†

“…9 and Guidance on ending the inappropriate promotion of foods for infants and young children, which clearly states that the appropriate age used in marketing (including package labels) to promote foods for infants should not be less than 6 months. The EFSA draft opinion will pave the way for an increased market of commercial complimentary food products.…”

“…8 The DoIs of members of the NDA Panel and of the Working Group are available in the 'DoI database' on EFSA's website. 9 In accordance with Article 21 of the Decision of the Executive Director on Competing Interest Management a waiver was granted to an expert of the Working Group until end of October 2018. Pursuant to Article 21(6) of the afore-mentioned Decision, the concerned expert was allowed to take part in the discussion and in the drafting phase of the scientific output but was not allowed to take up the role of rapporteur within that time frame.…”

Helseeffekter av amming

“…I våre data fra Den norske mor og barn-undersøkelsen fant vi ingen støtte for at fullamming ut over fire måneders alder var forbundet med ytterligere redusert risiko for sykehusinnleggelse grunnet infeksjon. I aldersgruppen 0-18 måneder ble 7,3 % av barn som var fullammet i fire måneder innlagt på sykehus for infeksjoner, sammenlignet med 7,7 % når fullamming varte seks måneder eller mer (8).…”

“…Mer enn 100 000 barn er med i Den norske mor og barn-undersøkelsen (MoBa). Rekrutteringen til denne undersøkelsen fra 1999-2008 ga en viss sosial skjevhet i utvalget, men andelen som følger norske anbefalinger om amming sammenfaller med Spedkost (8). Mødre som ammer lenge i undersøkelsen har signifikant høyere utdanning og alder, røyker mindre og har oftere født vaginalt et barn over 2 500 g til termin (8).…”

“…Rekrutteringen til denne undersøkelsen fra 1999-2008 ga en viss sosial skjevhet i utvalget, men andelen som følger norske anbefalinger om amming sammenfaller med Spedkost (8). Mødre som ammer lenge i undersøkelsen har signifikant høyere utdanning og alder, røyker mindre og har oftere født vaginalt et barn over 2 500 g til termin (8). Slik henger amming i rike land sammen med andre helsefremmende faktorer, mens det i fattige land gjerne er motsatt (9).…”