5/31/16
The Journal of Pediatrics
TAKE-HOME MESSAGE
- Women completed a questionnaire 12 months post delivery to evaluate the association between substance and mode of infant feeding with risk of infant otitis media and diarrhea during the first year of life. The risk of otitis media in infants fed only breast milk was highest in children fed expressed milk for a long duration. The risk of diarrhea was higher in children fed with formula than in those fed expressed milk or fed at the breast.
- Both the substance used for feeding and the mode of delivery of breast milk may affect infant health. Feeding at the breast protects against otitis media, while feeding and the breast and bottle feeding with expressed milk protects against infant diarrhea.
Abstract
OBJECTIVE
To examine the associations of substance fed and mode of breast milk delivery with occurrence of otitis media and diarrhea in the first year of life.
STUDY DESIGN
At 12 months postpartum, women (n = 813; 62% response) completed a questionnaire that assessed sociodemographics, infant occurrence of otitis media and diarrhea, and the timing of starting/stopping feeding at the breast, expressed milk, and formula. Women who intended to “bottle feed” exclusively were not recruited. Logistic and negative binomial regressions were conducted in the full sample (n = 491) and no-formula (n = 106) and bottle-only (n = 49) subsamples.
RESULTS
Longer duration of expressed milk feeding was associated with increased odds of experiencing otitis media (6-month OR [OR6-month] 2.15, 95% CI 1.01-4.55) in the no-formula subsample. Longer durations of breast milk feeding (OR6-month 0.70, 95% CI 0.54-0.92; 6-month incidence rate ratio [IRR6-month] 0.74, 95% CI 0.63-0.91), and feeding at the breast (OR6-month 0.70, 95% CI 0.54-0.89; IRR6-month 0.74, 95% CI 0.63-0.88) were associated with less diarrhea, and longer formula feeding duration was associated with increased risk of diarrhea (IRR6-month 1.34, 95% CI 1.13-1.54) in the full sample.
CONCLUSION
Substance fed and mode of breast milk delivery have different contributions to infant health depending on the health outcome of interest. Feeding at the breast may be advantageous compared with expressed milk feeding for reducing the risk of otitis media, and breast milk feeding compared with formula may reduce the risk of diarrhea.