Abstract
OBJECTIVES: The purpose of this study was to determine whether breast-feeding has a dose-related protective effect against illness and whether it confers special health benefits to poor infants. METHODS: The association between breast-feeding dose and illnesses in the first 6 months of life was analyzed with generalized estimating equations regression for 7092 infants from the National Maternal and Infant Health Survey. Breast-feeding dose (ratio of breast-feedings to other feedings) was categorized as full, most, equal, less, or no breast-feeding. RESULTS: Compared with no breast-feeding, full breast-feeding infants had lower odds ratios of diarrhea, cough or wheeze, and vomiting and lower mean ratios of illness months and sick baby medical visits. Most breast-feeding infants had lower odds ratios of diarrhea and cough or wheeze, and equal breast-feeding infants had lower odds ratios of cough or wheeze. Full, most, and equal breast-feeding infants without siblings had lower odds ratios of ear infections and certain other illnesses, but those with siblings did not. Less breast-feeding infants had no reduced odds ratios of illness. Findings did not vary by income. CONCLUSIONS: Full breast-feeding was associated with the lowest illness rates. Minimal (less) breast-feeding was not protective. Breast-feeding conferred similar health benefits in all economic groups.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aniansson G., Alm B., Andersson B., Håkansson A., Larsson P., Nylén O., Peterson H., Rignér P., Svanborg M., Sabharwal H. A prospective cohort study on breast-feeding and otitis media in Swedish infants. Pediatr Infect Dis J. 1994 Mar;13(3):183–188. doi: 10.1097/00006454-199403000-00003. [DOI] [PubMed] [Google Scholar]
- Bauchner H., Leventhal J. M., Shapiro E. D. Studies of breast-feeding and infections. How good is the evidence? JAMA. 1986 Aug 15;256(7):887–892. [PubMed] [Google Scholar]
- Brent N. B., Redd B., Dworetz A., D'Amico F., Greenberg J. J. Breast-feeding in a low-income population. Program to increase incidence and duration. Arch Pediatr Adolesc Med. 1995 Jul;149(7):798–803. doi: 10.1001/archpedi.1995.02170200088014. [DOI] [PubMed] [Google Scholar]
- Brown K. H., Black R. E., Lopez de Romaña G., Creed de Kanashiro H. Infant-feeding practices and their relationship with diarrheal and other diseases in Huascar (Lima), Peru. Pediatrics. 1989 Jan;83(1):31–40. [PubMed] [Google Scholar]
- Chen Y., Yu S. Z., Li W. X. Artificial feeding and hospitalization in the first 18 months of life. Pediatrics. 1988 Jan;81(1):58–62. [PubMed] [Google Scholar]
- Cunningham A. S., Jelliffe D. B., Jelliffe E. F. Breast-feeding and health in the 1980s: a global epidemiologic review. J Pediatr. 1991 May;118(5):659–666. doi: 10.1016/s0022-3476(05)80023-x. [DOI] [PubMed] [Google Scholar]
- Cushing A. H., Anderson L. Diarrhea in breast-fed and non-breast-fed infants. Pediatrics. 1982 Dec;70(6):921–925. [PubMed] [Google Scholar]
- Duncan B., Ey J., Holberg C. J., Wright A. L., Martinez F. D., Taussig L. M. Exclusive breast-feeding for at least 4 months protects against otitis media. Pediatrics. 1993 May;91(5):867–872. [PubMed] [Google Scholar]
- Eaton-Evans J., Dugdale A. E. Recall by mothers of the birth weights and feeding of their children. Hum Nutr Appl Nutr. 1986 Jun;40(3):171–175. [PubMed] [Google Scholar]
- Freed G. L., Clark S. J., Sorenson J., Lohr J. A., Cefalo R., Curtis P. National assessment of physicians' breast-feeding knowledge, attitudes, training, and experience. JAMA. 1995 Feb 8;273(6):472–476. doi: 10.1001/jama.1995.03520300046035. [DOI] [PubMed] [Google Scholar]
- Githens P. B., Glass C. A., Sloan F. A., Entman S. S. Maternal recall and medical records: an examination of events during pregnancy, childbirth, and early infancy. Birth. 1993 Sep;20(3):136–141. doi: 10.1111/j.1523-536x.1993.tb00438.x. [DOI] [PubMed] [Google Scholar]
- Hoekelman R. A., Kelly J., Zimmer A. W. The reliability of maternal recall. Mother's remembrance of their infant's health and illness. Clin Pediatr (Phila) 1976 Mar;15(3):261–265. doi: 10.1177/000992287601500305. [DOI] [PubMed] [Google Scholar]
- Howie P. W., Forsyth J. S., Ogston S. A., Clark A., Florey C. D. Protective effect of breast feeding against infection. BMJ. 1990 Jan 6;300(6716):11–16. doi: 10.1136/bmj.300.6716.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Huttly S. R., Barros F. C., Victora C. G., Beria J. U., Vaughan J. P. Do mothers overestimate breast feeding duration? An example of recall bias from a study in southern Brazil. Am J Epidemiol. 1990 Sep;132(3):572–575. doi: 10.1093/oxfordjournals.aje.a115693. [DOI] [PubMed] [Google Scholar]
- Kistin N., Abramson R., Dublin P. Effect of peer counselors on breastfeeding initiation, exclusivity, and duration among low-income urban women. J Hum Lact. 1994 Mar;10(1):11–15. doi: 10.1177/089033449401000121. [DOI] [PubMed] [Google Scholar]
- Labbok M., Krasovec K. Toward consistency in breastfeeding definitions. Stud Fam Plann. 1990 Jul-Aug;21(4):226–230. [PubMed] [Google Scholar]
- Launer L. J., Forman M. R., Hundt G. L., Sarov B., Chang D., Berendes H. W., Naggan L. Maternal recall of infant feeding events is accurate. J Epidemiol Community Health. 1992 Jun;46(3):203–206. doi: 10.1136/jech.46.3.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Leventhal J. M., Shapiro E. D., Aten C. B., Berg A. T., Egerter S. A. Does breast-feeding protect against infections in infants less than 3 months of age? Pediatrics. 1986 Nov;78(5):896–903. [PubMed] [Google Scholar]
- Liang K. Y., Zeger S. L. Regression analysis for correlated data. Annu Rev Public Health. 1993;14:43–68. doi: 10.1146/annurev.pu.14.050193.000355. [DOI] [PubMed] [Google Scholar]
- MEDNICK S. A., SHAFFER J. B. Mothers' retrospective reports in child-rearing research. Am J Orthopsychiatry. 1963 Apr;33:457–461. doi: 10.1111/j.1939-0025.1963.tb00379.x. [DOI] [PubMed] [Google Scholar]
- Owen M. J., Baldwin C. D., Swank P. R., Pannu A. K., Johnson D. L., Howie V. M. Relation of infant feeding practices, cigarette smoke exposure, and group child care to the onset and duration of otitis media with effusion in the first two years of life. J Pediatr. 1993 Nov;123(5):702–711. doi: 10.1016/s0022-3476(05)80843-1. [DOI] [PubMed] [Google Scholar]
- Palti H., Mansbach I., Pridan H., Adler B., Palti Z. Episodes of illness in breast-fed and bottle-fed infants in Jerusalem. Isr J Med Sci. 1984 May;20(5):395–399. [PubMed] [Google Scholar]
- Popkin B. M., Adair L., Akin J. S., Black R., Briscoe J., Flieger W. Breast-feeding and diarrheal morbidity. Pediatrics. 1990 Dec;86(6):874–882. [PubMed] [Google Scholar]
- Porro E., Indinnimeo L., Antognoni G., Midulla F., Criscione S. Early wheezing and breast feeding. J Asthma. 1993;30(1):23–28. doi: 10.3109/02770909309066376. [DOI] [PubMed] [Google Scholar]
- Rubin D. H., Leventhal J. M., Krasilnikoff P. A., Kuo H. S., Jekel J. F., Weile B., Levee A., Kurzon M., Berget A. Relationship between infant feeding and infectious illness: a prospective study of infants during the first year of life. Pediatrics. 1990 Apr;85(4):464–471. [PubMed] [Google Scholar]
- Ryan A. S., Pratt W. F., Wysong J. L., Lewandowski G., McNally J. W., Krieger F. W. A comparison of breast-feeding data from the National Surveys of Family Growth and the Ross Laboratories Mothers Surveys. Am J Public Health. 1991 Aug;81(8):1049–1052. doi: 10.2105/ajph.81.8.1049. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ryan A. S., Rush D., Krieger F. W., Lewandowski G. E. Recent declines in breast-feeding in the United States, 1984 through 1989. Pediatrics. 1991 Oct;88(4):719–727. [PubMed] [Google Scholar]
- Sanderson M., Placek P. J., Keppel K. G. The 1988 National Maternal and Infant Health Survey: design, content, and data availability. Birth. 1991 Mar;18(1):26–32. doi: 10.1111/j.1523-536x.1991.tb00050.x. [DOI] [PubMed] [Google Scholar]
- Schwartz J. B., Popkin B. M., Tognetti J., Zohoori N. Does WIC participation improve breast-feeding practices? Am J Public Health. 1995 May;85(5):729–731. doi: 10.2105/ajph.85.5.729. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Simopoulos A. P., Grave G. D. Factors associated with the choice and duration of infant-feeding practice. Pediatrics. 1984 Oct;74(4 Pt 2):603–614. [PubMed] [Google Scholar]
- Winikoff B. Issues in the design of breastfeeding research. Stud Fam Plann. 1981 Apr;12(4):177–184. [PubMed] [Google Scholar]
- Wright A. L., Holberg C. J., Taussig L. M., Martinez F. D. Relationship of infant feeding to recurrent wheezing at age 6 years. Arch Pediatr Adolesc Med. 1995 Jul;149(7):758–763. doi: 10.1001/archpedi.1995.02170200048006. [DOI] [PubMed] [Google Scholar]
- Zeger S. L., Liang K. Y. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986 Mar;42(1):121–130. [PubMed] [Google Scholar]
