Title
Relationships among common illness symptoms and the protective effect of breastfeeding in early childhood in MAL-ED: An eight-country cohort study
Date Issued
01 January 2018
Access level
open access
Resource Type
journal article
Author(s)
Richard S.A.
McCormick B.J.J.
Seidman J.C.
Rasmussen Z.
Rogawski E.T.
Petri W.
Bose A.
Mduma E.
Maciel B.L.L.
Chandyo R.K.
Bhutta Z.
Turab A.
Bessong P.
Mahfuz M.
Caulfield L.E.
De Burga R.R.
Olotegui M.P.
Pinedo S.R.
Ahmed I.
Alam D.
Ali A.
Qureshi S.
Rasheed M.
Soofi S.
Zaidi A.K.M.
Bodhidatta L.
Mason C.J.
Babji S.
George A.T.
Hariraju D.
Jennifer M.S.
John S.
Kaki S.
Kang G.
Karunakaran P.
Koshy B.
Lazarus R.P.
Muliyil J.
Raghava M.V.
Raju S.
Ramachandran A.
Ramadas R.
Ramanujam K.
Roshan R.
Sharma S.L.
SundaramE S.
Thomas R.J.
Pan W.K.
Ambikapathi R.
Carreon J.D.
Charu V.
Doan V.
Graham J.
Hoest C.
Knobler S.
Lang D.R.
McGrath M.
Miller M.A.
Mohale A.
Nayyar G.
Psaki S.
Wang V.
Blank R.
Gottlieb M.
Tountas K.H.
Amour C.
Bayyo E.
Mvungi R.
Nshama R.
Pascal J.
Swema B.M.
Yarrot L.
Ahmed T.
Ahmed A.M.S.
Haque R.
Hossain I.
Islam M.
Mondal D.
Tofail F.
Shrestha P.S.
Shrestha R.
Ulak M.
Bauck A.
Black R.E.
Checkley W.
Lee G.O.
Schulze K.
Yori P.P.
Murray-Kolb L.E.
Ross A.C.
Schaefer B.
Simons S.
Pendergast L.
Publisher(s)
American Society of Tropical Medicine and Hygiene
Abstract
Children in low-income countries experience multiple illness symptoms in early childhood. Breastfeeding is protective against diarrhea and respiratory infections, and these illnesses are thought to be risk factors of one another, but these relationships have not been explored simultaneously. In the eight-site MAL-ED study, 1,731 infants were enrolled near birth and followed for 2 years. We collected symptoms and diet information through twice-weekly household visits. Poisson regression was used to determine if recent illness history was associated with incidence of diarrhea or acute lower respiratory infections (ALRI), accounting for exclusive breastfeeding. Recent diarrhea was associated with higher risk of incident diarrhea after the first 6 months of life (relative risk [RR] 1.10, 95% confidence interval [CI] 1.04, 1.16) and with higher risk of incident ALRI in the 3- to 5-month period (RR 1.23,95%CI 1.03, 1.47). Fever was a consistent risk factor for both diarrhea and ALRI. Exclusive breastfeeding 0-6 months was protective against diarrhea (0-2 months: RR 0.39, 95% CI 0.32, 0.49; 3-5 months: RR 0.83, 95% CI 0.75, 0.93) and ALRI (3-5 months: RR 0.81, 95% CI 0.68, 0.98). Children with recent illness who were exclusively breastfed were half as likely as those not exclusively breastfed to experience diarrhea in the first 3 months of life. Recent illness was associated with greater risk of new illness, causing illnesses to cluster within children, indicating that specific illness-prevention programs may have benefits for preventing other childhood illnesses. The results also underscore the importance of exclusive breastfeeding in the first 6 months of life for disease prevention.
Start page
904
End page
912
Volume
98
Issue
3
Language
English
OCDE Knowledge area
Pediatría
Scopus EID
2-s2.0-85043514029
PubMed ID
Source
American Journal of Tropical Medicine and Hygiene
ISSN of the container
00029637
Sponsor(s)
Financial support: The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) is carried out as a collaborative project supported by the Bill & Melinda Gates Foundation, the Foundation for the NIH, and the National Institutes of Health/ Fogarty International Center.
Sources of information: Directorio de Producción Científica Scopus