Breast-feeding and respiratory syncytial virus infection.

Pullan, C R; Toms, G. L.; Martin, A. Lynn; Gardner, P. S.; Webb, Jessica; Appleton, David R.

doi:10.1136/bmj.281.6247.1034

Cited by 113 publications

(40 citation statements)

References 5 publications

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“…The protective effect of breastfeeding has been difficult to establish. Results from developing countries are consistent with a protective effect of breastfeeding [16][17][18], while studies undertaken in industrialized societies have shown conflicting results [19][20][21][22][23][24][25][26][27][28][29][30][31]. There is recent evidence from a cross-sectional study of Australian children that breastfeeding protects from the adverse effects of passive smoking on acute respiratory illness [29].…”

supporting

confidence: 61%

“…Some studies have presented a significant relationship between the length of breastfeeding and outcomes, such as respiratory syncytial virus infection, pneumonia, wheezy bronchitis or LRTI [22][23][24][25][26]28]. On the other hand, in a prospective cohort study, RUBIN et al [20] found no protective effect of breastfeeding on LRTIs during the first year of life.…”

Section: Discussionmentioning

confidence: 99%

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Breastfeeding, maternal smoking and lower respiratory tract infections

Nafstad¹,

Jaakkola²,

Hagen³

et al. 1996

Eur Respir J

152

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B Br re ea as st tf fe ee ed di in ng g, , m ma at te er rn na al l s sm mo ok ki in ng g a an nd d P. Nafstad*, J.J.K. Jaakkola* + , J.A. Hagen*, G. Botten*, J. Kongerud** Breastfeeding, maternal smoking and lower respiratory tract infections. P. Nafstad, J.J.K. Jaakkola, J.A. Hagen, G. Botten, J. Kongerud. ERS Journals Ltd 1996. ABSTRACT: The objective of the study was to assess the relationship between breastfeeding and lower respiratory tract infections (LRTIs) during the first year of life, with special reference to maternal smoking.A cohort of 3,754 children born in 1992-1993 in the City of Oslo, Norway was recruited and data were collected at birth, 6 and 12 months of age. Complete information was obtained from 3,238 children (follow-up rate 86%). The main outcome was an episode of a LRTI, such as pneumonia, bronchitis or bronchiolitis, based on a self-administered questionnaire addressed to parents when the child was 6 and 12 months old. The outcome was specified as physician-diagnosed.In logistic regression analysis adjusting for confounding, maternal smoking increased the risk of LRTIs in children breastfed for 0-6 months (odds ratio (AOR) 1.7; 95% confidence interval (95% CI) 1.2-2.4), but not essentially when the child was breastfed for more than 6 months (AOR 1.1; 95% CI 0.7-1.6). Short-term breastfeeding (0-6 months) and no maternal smoking was related to an adjusted AOR of LRTIs of 1.3 (95% CI 1.0-1.7), and short-term breastfeeding combined with maternal smoking was related to an adjusted AOR of 2.2 (95% CI 1.6-3.1), as compared with long-term breastfeeding and no maternal smoking.The present study indicates a protective effect of long-term breastfeeding on the risk of lower respiratory tract infection during the first year of life. The results suggest that the protective effect is strongest in children exposed to environmental tobacco smoke.

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supporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Breastfeeding, maternal smoking and lower respiratory tract infections

Nafstad¹,

Jaakkola²,

Hagen³

et al. 1996

Eur Respir J

152

View full text Add to dashboard Cite

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“…162 In one study the relative risk of hospital admission with RSV was 2.2 in children who were not being breastfed. 163 In another study, 8 (7%) of 115 children hospitalized with RSV were breastfed, and 46 (27%) of 167 controls were breastfed. 164 A meta-analysis of the relationship of breastfeeding and hospitalization for LRTD in early infancy 165 examined 33 studies, all of which showed a protective association between breastfeeding and the risk of hospitalization for LRTD.…”

Section: Breastfeedingmentioning

confidence: 99%

Diagnosis and Management of Bronchiolitis

2006

Pediatrics

880

293

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Bronchiolitis is a disorder most commonly caused in infants by viral lower respiratory tract infection. It is the most common lower respiratory infection in this age group. It is characterized by acute inflammation, edema, and necrosis of epithelial cells lining small airways, increased mucus production, and bronchospasm.The American Academy of Pediatrics convened a committee composed of primary care physicians and specialists in the fields of pulmonology, infectious disease, emergency medicine, epidemiology, and medical informatics. The committee partnered with the Agency for Healthcare Research and Quality and the RTI International-University of North Carolina Evidence-Based Practice Center to develop a comprehensive review of the evidence-based literature related to the diagnosis, management, and prevention of bronchiolitis. The resulting evidence report and other sources of data were used to formulate clinical practice guideline recommendations.This guideline addresses the diagnosis of bronchiolitis as well as various therapeutic interventions including bronchodilators, corticosteroids, antiviral and antibacterial agents, hydration, chest physiotherapy, and oxygen. Recommendations are made for prevention of respiratory syncytial virus infection with palivizumab and the control of nosocomial spread of infection. Decisions were made on the basis of a systematic grading of the quality of evidence and strength of recommendation. The clinical practice guideline underwent comprehensive peer review before it was approved by the American Academy of Pediatrics.This clinical practice guideline is not intended as a sole source of guidance in the management of children with bronchiolitis. Rather, it is intended to assist clinicians in decision-making. It is not intended to replace clinical judgment or establish a protocol for the care of all children with this condition. These recommendations may not provide the only appropriate approach to the management of children with bronchiolitis. INTRODUCTIONTHIS GUIDELINE EXAMINES the published evidence on diagnosis and acute management of the child with bronchiolitis in both outpatient and hospital settings, including the roles of supportive therapy, oxygen, bronchodilators, antiinflammatory agents, antibacterial agents, and antiviral agents and make recommendations to influence clinician behavior on the basis of the evidence. Methods of prevention All clinical practice guidelines from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.The recommendations in this guideline do not indicate an exclusive course of treatment or serve as a standard of care. Variations, taking into account individual circumstances, may be appropriate. Key Word bronchiolitisAbbreviations CAM-complementary and alternative medicine LRTI-lower respiratory tract infection AHRQ-Agency for Healthcare Research and Quality RSV-respiratory syncytial virus AAP-American Academy of Pediatrics AAFP-American Academy...

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“…9 The method used was blind to case patient or control subject status. For the present analyses, infant hospital and health center encounters up to 45 days after birth were included, to ensure complete capture of follow-up visits routinely scheduled at 1 month (30 days).…”

Section: Infant Feeding Practicementioning

confidence: 99%

Reduced Risk of Neonatal Respiratory Infections Among Breastfed Girls but Not Boys

et al. 2003

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ABSTRACT.Objective. The effect of breastfeeding on community-acquired neonatal infections has not been well studied, although the neonatal period is one of special vulnerability to infectious pathogens. Respiratory tract infections are the neonatal infection most commonly diagnosed after nursery discharge. We therefore chose respiratory tract infections diagnosed after nursery discharge as representative of neonatal community-acquired infection and studied the impact of breastfeeding on this neonatal infection syndrome.Methods. An unmatched nested case-control study was performed within a previously defined study cohort of 13 224 mother-infant pairs delivering between October 1, 1990, and March 31, 1998. Infants who were delivered at < 37 weeks' gestation were excluded. Neonatal respiratory tract infections were defined using modified National Nosocomial Infections Surveillance System criteria and were included in the case series when diagnosed after nursery discharge and at age <30 days. Infant feeding status during the first month of life was ascertained using automated text search of electronic medical records and was categorized as exclusive breastfeeding, mixed feeding, or exclusive formula feeding.Results. A total of 241 neonatal respiratory tract infections were found, and 1205 control subjects were selected. Compared with control subjects, case infants were more often born during the winter respiratory syncytial virus season (48% vs 33%), more likely to have a sibling present (70% vs 54%), and more likely to be a member of a socioeconomically at-risk family (24% vs 18%). Case patients were less likely to be exclusively breastfed (38% vs 44%) and equally likely to be exposed to mixed feeding (35% vs 34%) relative to control subjects. When compared with formula feeding only, the odds ratio (OR) of exclusive breastfeeding was 0.70 (95% confidence interval [CI]: 0.49 -0.99) and that of mixed feeding was 0.83 (95% CI: 0.58 -1.2). However, when stratified by infant sex, the inverse association between breastfeeding and risk of neonatal respiratory tract infection was confined to neonatal girls, for whom the unadjusted ORs associated with breastfeeding only and mixed feeding were 0.5 (95% CI: 0.29 -0.78) and 0.6 (95% CI: 0.35-0.93), respectively. There was no meaningful association between breastfeeding and risk of neonatal respiratory tract infection among neonatal boys, for whom the unadjusted ORs associated with breastfeeding only and mixed feeding were 1.1 (95% CI: 0.63-1.8) and 1.3 (95% CI: 0.74 -2.1), respectively. After adjustment for year of birth, season of birth, siblings, and socioeconomic status, both exclusive breastfeeding and mixed feeding remained protective among girls, with ORs of 0.5 (0.29 -0.78) and 0.6 (0.34 -0.93), respectively. The corresponding ORs for boys were 1.1 (0.64 -2.0) and 1.4 (0.78 -2.4).Conclusions. charge, 6 and they are typically not caused by congenital structural anomalies, as might be the case for other syndromes such as urinary tract infections. We therefore chose respir...

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Breast-feeding and respiratory syncytial virus infection.

Cited by 113 publications

References 5 publications

Breastfeeding, maternal smoking and lower respiratory tract infections

Breastfeeding, maternal smoking and lower respiratory tract infections

Diagnosis and Management of Bronchiolitis

Reduced Risk of Neonatal Respiratory Infections Among Breastfed Girls but Not Boys

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