Title
Full breastfeeding protection against common enteric bacteria and viruses: Results from the MAL-ED cohort study
Date Issued
01 March 2022
Access level
open access
Resource Type
journal article
Author(s)
Mccormick B.J.J.
Richard S.A.
Murray-Kolb L.E.
Kang G.
Lima A.A.M.
Mduma E.
Rogawski Mcquade E.T.
Houpt E.R.
Bessong P.
Shrestha S.
Bhutta Z.
Ahmed T.
Caulfield L.E.
De Burga R.R.
Olotegui M.P.
Pinedo S.R.
Ahmed I.
Alam D.
Ali A.
Bhutta Z.A.
Qureshi S.
Rasheed M.
Soofi S.
Turab A.
Yousafzai A.
Zaidi A.K.M.
Bodhidatta L.
Ammu G.
Babji S.
Bose A.
George A.T.
Hariraju D.
Jennifer M.S.
John S.
Kaki S.
Karunakaran P.
Koshy B.
Lazarus R.P.
Muliyil J.
Ragasudha P.
Raghava M.V.
Raju S.
Ramachandran A.
Ramadas R.
Ramanujam K.
Rose A.
Roshan R.
Sharma S.L.
Shanmuga Sundaram E.
Thomas R.J.
Pan W.K.
Ambikapathi R.
Carreon J.D.
Doan V.
Hoest C.
Knobler S.
McCormick B.J.J.
McGrath M.
Miller M.A.
Psaki S.
Rasmussen Z.
Seidman J.C.
Gottlieb M.
Lang D.R.
Tountas K.H.
Svensen E.
Amour C.
Bayyo E.
Mduma E.R.
Mvungi R.
Nshama R.
Pascal J.
Swema B.M.
Yarrot L.
Mason C.J.
Shamsir Ahmed A.M.
Alam M.A.
Haque R.
Haque U.
Hossain M.I.
Islam M.
Mahfuz M.
Mondal D.
Nahar B.
Tofail F.
Chandyo R.K.
Shrestha P.S.
Shrestha R.
Ulak M.
Bauck A.
Black R.E.
Checkley W.
Lee G.O.
Publisher(s)
Oxford University Press
Abstract
Background: Breastfeeding is known to reduce the risk of enteropathogen infections, but protection from specific enteropathogens is not well characterized. Objective: The aim was to estimate the association between full breastfeeding (days fed breast milk exclusively or with nonnutritive liquids) and enteropathogen detection. Methods: A total of 2145 newborns were enrolled at 8 sites, of whom 1712 had breastfeeding and key enteropathogen data through 6 mo. We focused on 11 enteropathogens: adenovirus 40/41, norovirus, sapovirus, astrovirus, and rotavirus, enterotoxigenic Escherichia coli (ETEC), Campylobacter spp., and typical enteropathogenic E. coli as well as entero-aggregative E. coli, Shigella and Cryptosporidium. Logistic regression was used to estimate the risk of enteropathogen detection in stools and survival analysis was used to estimate the timing of first detection of an enteropathogen. Results: Infants with 10% more days of full breastfeeding within the preceding 30 d of a stool sample were less likely to have the 3 E. coli and Campylobacter spp. detected in their stool (mean odds: 0.92-0.99) but equally likely (0.99-1.02) to have the viral pathogens detected in their stool. A 10% longer period of full breastfeeding from birth was associated with later first detection of the 3 E. coli, Campylobacter, adenovirus, astrovirus, and rotavirus (mean HRs of 0.52-0.75). The hazards declined and point estimates were not statistically significant at 3 mo. Conclusions: In this large multicenter cohort study, full breastfeeding was associated with lower likelihood of detecting 4 important enteric pathogens in the first 6 mo of life. These results also show that full breastfeeding is related to delays in the first detection of some bacterial and viral pathogens in the stool. As several of these pathogens are risk factors for poor growth during childhood, this work underscores the importance of exclusive or full breastfeeding during the first 6 mo of life to optimize early health.
Start page
759
End page
769
Volume
115
Issue
3
Language
English
OCDE Knowledge area
Pediatría
Scopus EID
2-s2.0-85125682982
PubMed ID
Source
American Journal of Clinical Nutrition
ISSN of the container
00029165
Sponsor(s)
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 (OPP47075), the Foundation for the NIH, and the NIH/Fogarty International Center. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US NIH or Department of Health and Human Services.
Sources of information: Directorio de Producción Científica Scopus