Impact of breastfeeding on hospitalizations from infectious diseases in Hong Kong Chinese children up to eight years of age

Abstract

BACKGROUND: Infectious disease is a leading cause of morbidity and hospitalization in Hong Kong children. During infancy, breastfeeding protects against infectious diseases, in particular respiratory infections, gastrointestinal infections, and otitis media but little research has examined the impact of breastfeeding on infectious disease in older children. AIM AND OBJECTIVE: To investigate the relationship between infant feeding method and childhood hospitalizations from respiratory and gastrointestinal infections. STUDY DESIGN AND METHODS: Setting and Subjects: The Hong Kong “Children of 1997” birth cohort, which is a prospective, population based study of 8327 mother-child pairs comprising 88% of births in April and May 1997, followed up until the end of 2005 • Main Outcome Measures: Public hospital admissions for respiratory infections, gastrointestinal infections, and all infectious diseases. Method: We used multivariable Cox regression to assess the relation between infant feeding and risk of admission to public hospital for infectious illnesses from birth to 8 years of age. RESULTS: Overall, exclusive breastfeeding for ≥3 months was associated with a reduced risk of first hospital admission for respiratory infections (HR 0.64, 95% CI 0.42 to 0.97), gastrointestinal infections (HR 0.51, 95% CI 0.25 to 1.05), and any infections (HR 0.61, 95% CI 0.44 to 0.85) in the first 6 months of life, after adjustment for sex, type of hospital at birth, and household income. The point estimates and 95% CIs for the associations between breastfeeding and ever admission, number of admissions, and number of hospital days were similar. Partial breastfeeding for any length of time or exclusive breastfeeding for < 3 months also reduced the risk of hospitalization from respiratory (HR 0.79, 95% CI 0.64 to 0.97) and other infections (HR 0.80, 95% CI 0.69 to 0.94). There was no association between breastfeeding and reduced risk of hospitalisation for infectious disease beyond 6 months of age. CONCLUSION: Breastfeeding for any duration substantially and significantly reduces hospital admissions for many infectious diseases in the first 6 months of life, when children are most vulnerable. IMPLICATIONS: Policies and programs to increase breastfeeding initiation, duration, and exclusivity would provide substantial public health benefits and improve the health of young children in Hong Kong.