Peer-reviewed article
The relationship between breastfeeding and reported respiratory and gastrointestinal infection rates in young children
for the TEDDY Study Group, Nicole Frank, Kristian Francis Lynch, Ulla M. Uusitalo, Jimin Yang et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether breastfeeding protects young children from respiratory and gastrointestinal infections using data from 6,861 children aged 3-18 months and 5,666 children up to age 4 years in the TEDDY longitudinal study. Breastfeeding was associated with lower odds of ear infections, gastroenteritis, and some respiratory infections in children aged 3-6 months, with some protective effects continuing beyond 6 months. The duration of exclusive breastfeeding showed lasting protective effects against ear infections even after breastfeeding stopped. However, breastfeeding was associated with more reported common colds in the 6-18 month age group.
Key points
- At 3-6 months, breastfeeding reduced odds of respiratory infections with fever (OR=0.82), otitis media (OR=0.76), and infective gastroenteritis (OR=0.55)
- Protective effects against ear infections and gastroenteritis continued between 6-18 months, but breastfeeding was associated with increased common colds in this period
- Duration of exclusive breastfeeding remained inversely associated with otitis media risk up to 48 months after breastfeeding stopped (OR=0.97)
- The protective association with respiratory infections during winter months was observed only in girls aged 3-6 months
- Breastfeeding appeared protective against conjunctivitis, laryngitis and tracheitis between 6-18 months
Limitations
The study relied on reported illness events rather than clinical diagnosis, which may introduce reporting bias. Some analyses showed sex and seasonal variation that are not fully explained, limiting generalizability across all populations and time periods.
Abstract
BACKGROUND: Although breastfeeding is touted as providing many health benefits to infants, some aspects of this relationship remain poorly understood. METHODS: The Environmental Determinants of Diabetes in the Young (TEDDY) is a prospective longitudinal study that follows children from birth through childhood, and collects data on illness events, breastfeeding duration, and time to introduction of formula or foods at 3 month intervals up until 4 years of age and at 6 months intervals thereafter. Exclusive and non-exclusive breastfeeding is examined in relation to the 3-month odds of a respiratory or gastrointestinal infection for 6861 children between the ages of 3-18 months, and 5666 children up to the age of 4 years. Analysis was performed using logistic regression models with generalized estimating equation methodology. All models were adjusted for potential confounding variables. RESULTS: At 3-6 months of age, breastfeeding was found to be inversely associated with the odds of respiratory infections with fever (OR = 0.82, 95% CI = 0.70-0.95), otitis media (OR = 0.76, 95% CI = 0.62-0.94), and infective gastroenteritis (OR = 0.55, 95% CI = 0.46-0.70), although the inverse association with respiratory illnesses was observed only for girls during the winter months. Between 6 and 18 months of age, breastfeeding within any 3 month period continued to be inversely associated with the odds of ear infection and infective gastroenteritis, and additionally with the odds of conjunctivitis, and laryngitis and tracheitis, over the same 3 month period within this age range. However, breastfeeding in this group was associated with increased reports of common cold. Duration of exclusive breastfeeding was inversely associated with the odds of otitis media up to 48 months of age (OR = 0.97, 95% CI = 0.95-0.99) after breastfeeding had stopped. CONCLUSIONS: This study demonstrates that breastfeeding can be protective against multiple respiratory and gastrointestinal acute illnesses in some children up to at least 6 months of age, with duration of exclusive breastfeeding being somewhat protective of otitis media even after breastfeeding has stopped. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00279318 . Date of registration: January 17, 2006 (proactively registered). First Posted: January 19, 2006.