Published online February 1, 2006
PEDIATRICS Vol. 117 No. 2 February 2006, pp. 425-432 (doi:10.1542/peds.2004-2283)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (16)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Chantry, C. J.
Right arrow Articles by Auinger, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Chantry, C. J.
Right arrow Articles by Auinger, P.
Related Collections
Right arrow Infectious Disease & Immunity

Full Breastfeeding Duration and Associated Decrease in Respiratory Tract Infection in US Children

Caroline J. Chantry, MDa, Cynthia R. Howard, MD, MPHb and Peggy Auinger, MSb,c

a Department of Pediatrics, University of California Davis Medical Center, Sacramento, California
b Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
c American Academy of Pediatrics Center for Child Health Research, Rochester, New York

OBJECTIVE. The American Academy of Pediatrics recommends exclusive breastfeeding for an infant's first 6 months of life. When compared with exclusive breastfeeding for 4 months, greater protection against gastrointestinal infection, but not respiratory tract infection, has been demonstrated for the 6-month duration. The objective of this study was to ascertain if full breastfeeding of ≥6 months compared with 4 to <6 months in the United States provides greater protection against respiratory tract infection.

METHODS. Secondary analysis of data from the National Health and Nutrition Examination Survey III, a nationally representative cross-sectional home survey conducted from 1988 to 1994, was performed. Data from 2277 children aged 6 to <24 months, who were divided into 5 groups according to breastfeeding status, were compared. Children who required neonatal intensive care were excluded. SUDAAN software was used to account for the complex sampling design. Logistic regression adjusted for confounding factors. Outcome measures included adjusted odds of acquiring pneumonia, ≥3 episodes of cold/influenza, ≥3 episodes of otitis media (OM), or wheezing in the past year or acquiring first OM at <12 months of age.

RESULTS. In unadjusted analyses, infants who were fully breastfed for 4 to <6 months (n = 223) were at greater risk for pneumonia than those who were fully breastfed for ≥6 months (n = 136) (6.5% vs 1.6%). There were not statistically significant differences in ≥3 episodes of cold/influenza (45% vs 41%), wheezing (23% vs 24%), ≥3 episodes of OM (27% vs 20%), or first OM at <12 months of age (49% vs 47%). Adjusting for demographic variables, childcare, and smoke exposure revealed statistically significant increased risk for both pneumonia (odds ratio [OR]: 4.27; 95% confidence interval [CI]: 1.27–14.35) and ≥3 episodes of OM (OR: 1.95; 95% CI: 1.06–3.59) in those who were fully breastfed for 4 to <6 months compared with ≥6 months.

CONCLUSIONS. This nationally representative study documents increased risk of respiratory tract infection including pneumonia and recurrent OM in children who were fully breastfed for 4 vs 6 months. These findings support current recommendations that infants receive only breast milk for the first 6 months of life.

Key Words: breastfeeding • benefits • respiratory infections • infant feeding • nutrition-infant

Abbreviations: WHO—World Health Organization • URI—upper respiratory infection • OM—otitis media • NHANES—National Health and Nutrition Examination Survey • ROM—recurrent otitis media • OM<12—otitis media at <12 months of age • FullBF<1—fully breastfed for <1 month • FullBF1-3—fully breastfed for 1 to <4 months • FullBF4-5—fully breastfed for 4 to <6 months • FullBF≥6—fully breastfed for ≥6 months • OR—odds ratio • CI—confidence interval • no BF—not breastfed

Accepted Jun 3, 2005.




This article has been cited by other articles:


Home page
 J Hum LactHome page
K. Freeman, K. A. Bonuck, and M. Trombley
Breastfeeding and Infant Illness in Low-Income, Minority Women: A Prospective Cohort Study of the Dose-Response Relationship
J Hum Lact, February 1, 2008; 24(1): 14 - 22.
[Abstract] [PDF]

Home page
 Annals of Clinical & Laboratory ScienceHome page
T. A. Smith-Norowitz, H. Drew, H. M. Norowitz, M. Nowakowski, E. F. Bluth, H. G. Durkin, and M. H. Bluth
Detection of IgE Anti-Parvovirus Antibodies in Human Breast Milk
Ann. Clin. Lab. Sci., January 1, 2008; 38(2): 168 - 173.
[Abstract] [Full Text] [PDF]

Home page
 J. Nutr.Home page
S. Arslanoglu, G. E. Moro, and G. Boehm
Early Supplementation of Prebiotic Oligosaccharides Protects Formula-Fed Infants against Infections during the First 6 Months of Life
J. Nutr., November 1, 2007; 137(11): 2420 - 2424.
[Abstract] [Full Text] [PDF]

Home page
 J Trop PediatrHome page
T. Slusher, I. L. Slusher, M. Biomdo, F. Bode-Thomas, B. A. Curtis, and P. Meier
Electric Breast Pump Use Increases Maternal Milk Volume in African Nurseries
J Trop Pediatr, April 1, 2007; 53(2): 125 - 130.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Clin. Nutr.Home page
M. S Fewtrell, J. B Morgan, C. Duggan, G. Gunnlaugsson, P. L Hibberd, A. Lucas, and R. E Kleinman
Optimal duration of exclusive breastfeeding: what is the evidence to support current recommendations?
Am. J. Clinical Nutrition, February 1, 2007; 85(2): 635S - 638S.
[Abstract] [Full Text] [PDF]

Home page
 AAP Grand RoundsHome page
W. Slusser
What Determines Duration of Breastfeeding?
AAP Grand Rounds, February 1, 2007; 17(2): 21 - 21.
[Full Text] [PDF]

Home page
 J. Nutr.Home page
L. Schack-Nielsen and K. F. Michaelsen
Advances in Our Understanding of the Biology of Human Milk and Its Effects on the Offspring
J. Nutr., February 1, 2007; 137(2): 503S - 510S.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. L. Dee, R. Li, L.-C. Lee, and L. M. Grummer-Strawn
Associations Between Breastfeeding Practices and Young Children's Language and Motor Skill Development
Pediatrics, February 1, 2007; 119(Supplement_1): S92 - S98.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
K. A. Bonuck, K. Freeman, and M. Trombley
Randomized controlled trial of a prenatal and postnatal lactation consultant intervention on infant health care use.
Arch Pediatr Adolesc Med, September 1, 2006; 160(9): 953 - 960.
[Abstract] [Full Text] [PDF]