Protective effect of breast feeding against infection.

Howie, P. W.; Forsyth, J. S.; Ogston, Simon; Clark, Ann L.; Florey, Charles du V.

doi:10.1136/bmj.300.6716.11

Cited by 791 publications

(248 citation statements)

References 8 publications

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“…In the present study, breast-fed infants lived in relatively healthy circumstances (Table 1). In previous studies, similar differences between breast-fed and formula-fed infants were found (3,4) . We may hypothesise that, assuming that nowadays in the relatively rich parts of the world, socio-economic (hygiene) standards are above a certain level for healthy term children in general, this surplus of healthy circumstances in breast-fed children, or the breast-feeding itself, does not protect against infections at a scale high enough to be detected anymore.…”

Section: Discussionsupporting

confidence: 74%

“…Previous studies have compared the frequency of infections in breast-fed and formula-fed healthy term infants, all showing a lower number of infections in breast-fed children. Difficulties in interpreting these results arise from studies presenting a positive effect on a selection of symptoms and age categories only (3,5,29) , some studies do not report a comparison with formula feeding (30) , or do not present data about the prevalence of breast-feeding in the study population (29) and one study showed a large reducing effect of exclusive and prolonged breast-feeding for 6 months on hospitalisation frequency; in this study population, there was a high estimated hospitalisation frequency but a low prevalence of exclusive and prolonged breast-feeding for at least 6 months (5) . Due to the non-randomised character of the BG in all these previous studies and the present study, it remains difficult to quantify the effect of breast-feeding on the number of infections in healthy term infants in low-risk parts of the world.…”

Section: Discussionmentioning

confidence: 99%

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Do prebiotics reduce the number of fever episodes in healthy children in their first year of life: a randomised controlled trial

et al. 2011

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The objective of the present study was to assess the effect of adding specific prebiotics to standard formula feeding on the number of fever episodes in the first year of life. In the present randomised, double-blind, placebo-controlled trial in seven centres in five West European countries, 830 healthy term infants, without a first-degree family history of allergic disease, of mothers who indicated to give only formula feeding were randomised either to receive a standard non-hydrolysed cows' milk-based formula to which a mixture of specific oligosaccharides was added (prebiotics group (PG)), or to receive a similar formula without oligosaccharides (control group (CG)). A separate reference group consisted of 300 breast-fed infants. The primary outcome was the number of fever episodes prospectively documented by the parents. There was no difference in the number of fever episodes between the PG (median value 1·19; 25th -75th percentile 0·09-2·34) and CG (1·16; 25th -75th percentile 0·06-2·38). The median number of fever episodes in the separate breast-feeding reference group was 1·24 (25th -75th percentile 0·51-3·45). There was no effect of adding specific prebiotics to standard formula feeding in reducing the number of fever episodes in the present study. Key words: Infection: Infants: OligosaccharidesBreast-feeding is universally recommended as the optimal feeding for infants in the first 6 months of life (1,2) . There is clear evidence for health benefits for both mother and child. Special attention has been given to the effect regarding infections in young children (3 -5) . The protective effect of breastfeeding against infectious diseases is assumed to be provided by specific (antibody-dependent) and non-specific factors such as oligosaccharides, proteins, glycoproteins and fats. Many efforts have been made to make the composition of formula (e.g. proteins and fats) as close as possible to breast milk (6,7) .Human milk oligosaccharides, after lactose and lipids, represent the third largest solid component in breast milk, and contribute to immune modulation and infection prevention (8,9) . They exert prebiotic function by acting as soluble analogues to epithelial receptors for specific microbes, and this prevents their adhesion to the intestinal wall (10,11) . Further, they enhance mucosal barrier function with a direct effect on intestinal maturation and trophic effects on the intestinal mucosa through their fermentation products (12,13) ; lower the pH in the colon through the fermentation products (10,14) ; and interact directly with the cells of the immune system (15) .Thus, breast milk oligosaccharides are powerful candidates to be key components of human milk contributing to its protective effect against infections in infants. Clinical data about the effect of oligosaccharide supplementation to formula feeding on infections in young healthy children are scarce. Recently, two studies have been published pointing to a reduction of infections in the early life of infants who had an increased risk ...

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Do prebiotics reduce the number of fever episodes in healthy children in their first year of life: a randomised controlled trial

et al. 2011

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“…The case for breast-feeding rests on a number of health benefits, including protection against infection (of particular importance in the developing world) (59)(60)(61)(62) , allergic outcomes (63) , improved neural and psychosocial development (64,65) , as well as potentially beneficial effects on maternal health (which are reviewed elsewhere) (62) . From a cardiovascular perspective, the case for breast-feeding, and for making the nutritional content of formula feeds similar to breast milk, rests on a combination of both short-and long-term benefits.…”

Section: Discussionmentioning

confidence: 99%

Breast-feeding and cardiovascular risk factors and outcomes in later life: evidence from epidemiological studies

2011

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This paper considers the body of observational evidence examining the association of being breast-fed to cardiovascular risk factors and outcomes in later life, and whether any potentially advantageous findings are causal. Early cardiovascular consequences/correlates of breastfeeding, compared to being formula fed, include markedly higher levels of total blood cholesterol, lower levels of pre-prandial blood glucose and insulin and lower levels of adiposity. However, a key issue is whether these early differences at a period of rapid development programme/influence cardiovascular risk factors and outcomes in later life. Evidence of longterm effects of early feeding, largely from observational studies, has shown that those breastfed have lower levels of blood total cholesterol, lower risk of type-2 diabetes and marginally lower levels of adiposity and blood pressure in adult life. There is no strong evidence to suggest effects of early feeding on adult levels of blood glucose, blood insulin and CHD outcomes, although further data are needed. However, the influence of confounding factors, such as maternal body size, maternal smoking and socio-demographic factors, and exclusivity of early feeding on these potentially beneficial associations needs to be considered before inferring any causal effects. Moreover, fewer studies have examined whether duration of exclusive breastfeeding has a graded influence on these risk factors and outcomes; such data would help further in deciding upon causal associations. While strong observational evidence suggests nutritional programming of adult cholesterol levels, associations with other markers of cardiometabolic risk and their consequences in later life need to be confirmed in well-conducted observational and experimental studies.

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“…The benefits of appropriate breastfeeding for individuals and populations of mothers and children have been extensively documented, and studies highlight that breastfed infants have fewer respiratory and diarrhoeal illnesses, with an overall decrease in the hospitalization rates than nonbreastfed infants (Wright et al, 1989;Howie et al, 1990;Dewey et al, 1995;Arifeen et al, 2001a, b). The advantage of breastfeeding has long-term potential impact across the life course through its influence on childhood cognition and educational attainment (Richards et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Breastfeeding practices and associated factors among children under 24 months of age in Timor-Leste

2006

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Objective: To describe breastfeeding practices and to assess the sociodemographic factors associated with selected breastfeeding indicators. Design and setting: The 2003 Demographic and Health Survey was a multi-stage cluster sample survey of 4320 households from four different geographic areas in Timor-Leste. Subjects: A total of 2162 children aged 0-23 months. Results: A high proportion (97.6%) of infants had been ever breastfed, but only 46.1% had initiated breastfeeding within the first hour of birth. Seventy-eight percent of children o24 months were currently breastfed, 30.7% of infants o6 months were exclusively breastfed and 12.5% of infants o12 months were bottle-fed. A high proportion of infants of 6-9 months (82.0%) were receiving complementary food in addition to breast milk. Multivariate analysis revealed that exclusive breastfeeding was significantly lower in the rural west region (odds ratio (OR) ¼ 3.15) compared to the urban region, and among those from richest households (OR ¼ 1.90) compared to poorest. Mothers with primary education were significantly more likely to exclusively breastfeed than mothers with no education (OR ¼ 0.62). Increasing age of the infant was associated with significantly less current (OR ¼ 1.23) and exclusive (OR ¼ 1.35) breastfeeding. Continuation of breastfeeding at the end of the first year was significantly lower in non-working mothers (OR ¼ 1.58) compared to working mothers, and among infants born in health-care facilities (OR ¼ 2.16) than those born at home. Conclusions: Breastfeeding practices in Timor-Leste were satisfactory, except the exclusive breastfeeding at 6 months. However, more socioeconomically privileged groups demonstrated a poorer breastfeeding performance than disadvantaged groups. Further breastfeeding promotion programmes are needed across all population groups, and should include health-care providers and maternity institutions. Sponsorship: World Bank Trust Fund for East Timor.

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Protective effect of breast feeding against infection.

Cited by 791 publications

References 8 publications

Do prebiotics reduce the number of fever episodes in healthy children in their first year of life: a randomised controlled trial

Do prebiotics reduce the number of fever episodes in healthy children in their first year of life: a randomised controlled trial

Breast-feeding and cardiovascular risk factors and outcomes in later life: evidence from epidemiological studies

Breastfeeding practices and associated factors among children under 24 months of age in Timor-Leste

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