Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy

TLDR

The study examined how the duration of exclusive breastfeeding relates to upper respiratory, lower respiratory, and gastrointestinal infections in infants. The cohort of 4,164 infants from the Generation R Study was followed, with breastfeeding patterns recorded for the first six months and doctor‑attended infections in URTI, LRTI, and GI tracked up to 12 months via questionnaires. Infants exclusively breastfed for at least four months (and partially thereafter) had significantly lower odds of URTI, LRTI, and GI infections up to 12 months, whereas partial breastfeeding alone did not confer protection, supporting policies to promote exclusive breastfeeding for at least four months, preferably six.

Abstract

To examine the associations of duration of exclusive breastfeeding with infections in the upper respiratory (URTI), lower respiratory (LRTI), and gastrointestinal tracts (GI) in infancy.This study was embedded in the Generation R Study, a population-based prospective cohort study from fetal life onward in the Netherlands. Rates of breastfeeding during the first 6 months (never; partial for <4 months, not thereafter; partial for 4-6 months; exclusive for 4 months, not thereafter; exclusive for 4 months, partial thereafter; and exclusive for 6 months) and doctor-attended infections in the URTI, LRTI, and GI until the age of 12 months were assessed by questionnaires and available for 4164 subjects.Compared with never-breastfed infants, those who were breastfed exclusively until the age of 4 months and partially thereafter had lower risks of infections in the URTI, LRTI, and GI until the age of 6 months (adjusted odds ratio [aOR]: 0.65 [95% confidence interval (CI): 0.51-0.83]; aOR: 0.50 [CI: 0.32-0.79]; and aOR: 0.41 [CI: 0.26-0.64], respectively) and of LRTI infections between the ages of 7 and 12 months (aOR: 0.46 [CI: 0.31-0.69]). Similar tendencies were observed for infants who were exclusively breastfed for 6 months or longer. Partial breastfeeding, even for 6 months, did not result in significantly lower risks of these infections.Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants. Our findings support health-policy strategies to promote exclusive breastfeeding for at least 4 months, but preferably 6 months, in industrialized countries.