Assosiation between breastfeeding regimen and duration with the occurrence of infectious disesases in infants and toddlers
Author
Mantovani, Eleonora
Co-author
Latvijas Universitāte. Medicīnas fakultāte
Advisor
Daugule, Ilva
Date
2021Metadata
Show full item recordAbstract
Mērķis: Noteikt eksluzīvas krūts barošanas (EKB) biežumu zīdaiņiem Itālijā, kā arī analizēt saistību starp krūts barošanas ilgumu un infekciju un alerģiju biežumu bērniem pirmajos divos dzīves gados. Materiāli un metodes: Šķērsgriezuma pētījums veikts Itālijā, aptaujājot māmiņas ar bērniem vecumā no 2-5 gadiem. Anonīmā anketā bija ietverti jautājumi par krūts barošanas ilgumu, infekciju slimībām (gastrointestinālām, respiratorām un vidusauss iekaisumu) un alerģiju pirmo divu dzīves gadu laiā, kā arī informāciju par mates izglītību , vecumu, slimībām. Salīdzināti EKB ilgums ar respiratoru, gastrointestinālu slimību, kā arī alerģiju biežumu. Statistiskie test: x2, tests, regresijas tests, aprēķināts gadījumu izredžu attiecība (OR) un 95% ticamības intervāls (TI). Rezultāti: kopumā pētījumā iekļauta informācija par 320 bērniem. Krūts barošanu saņēmuši pavisam 97.0% (311/320) zīdaiņu, EKB vismaz 6 mēnešus bijusi 68.0% (218/320) zīdaiņu. Kopējā dalībnieku paraugā statistiski ticamu saistību starp EKB un infekciju slimībām pirmajos divos dzīves gados neatradām. Gastrointestiālu infeckiju biežums pirmajā dzīves gadā bija augstāks zīdaiņiem ar EKB< 4 mēnešiem, salīdzinot ar tiem, kas saņēma EKB 4 – 6 mēnešus vai ilgāk par 6 mēnešem: 13.3% (4/30) vs. 5,6%(4/72) un 8.7% (19/218); (p virzienam =0.07); kā arī bija biežāk ārstu apmeklējumi/konsultācijas gastrointestinālas infekcijas dēļ : 10.53% (2/19) vs 0.0% (0/37) 0.1% (1/117); (p=0.0153), attiecīgi. Alerģisku slimību biežums bija augstāks bērniem ar EKB < 4 mēnešiem, salīdzinot ar EKB 4-6 mēnešus un > 6 mēnešiem: 16.67% vs. 5.56 un 5.05%; (p=0.0461) attiecīgi; OR=0.5541; KI . Secinājumi: Kopumā pētītajā populācija EKB ilgums vismaz 6 mēnešus bija salīdzinoši augsts, tomēr tas var būt skaidrojums ar aptaujātās grupas īpatnībām un varētu atšķirties citos iedzīvotāju segmentos. EBF ilgāk par 4 mēnešiem bija saistīta ar retākām gastrointestinālām infekcijām pirmajā gadā un vieglāku slimības norisi. Ilgāka ekskluzīva krūts barošana bija saistīta ar zemāku alerģisku slimību biežumu (OR 0.5), kas būt jāņem vērā izstrādājot rekomendācijas par EKB ilgumu un papildēdiena iekļaušanu zīdaiņa uzturā. Background: The immunitary function of maternal milk has been of large interest and the correlation between breastfeeding and decreased rates of infection and allergy has been demonstrated by several studies, however, the results are controversary. Aim: The aim of the study was to analyze the prevalence of BF and EBF in an Italian sample, and the associations between different BF regimens and infections as well as allergic disorders during the first two years of children’s life. Material and Methods: Participants to the study were mothers of Italian children of 2 to 5 years who answered an online questionnaire. The study analyzed information regarding the family and children focusing on nutrition, infection episodes and allergy. The study analyzed dividing the children in groups according to breastfeeding regimen and comparing groups in relation to infections’ prevalence, timing, severity, and necessity for medical consultations, and prevalence of allergy. Statistical analysis included descriptive statistics, bivariate analysis and OR. Nominal variables were compared between each other’s by Chi-square test. Results: BF prevalence was registered at 97.0%, EBF for at least six months had a prevalence of 68.0%. No significative association was found between EBF regimen and the prevalence of infectious diseases in the first two years of life. The prevalence of GI infections during the 1st year of life was higher among infants breastfed less than four months compare to those breastfed 4-6 or more than six months: 13.3% vs 5.6% and 8.7%, respectively (p for trend=0.07). Children breastfed less than four months reported more doctor’s visits due to GI infections compared to children with EBF 4 to 6 or more than six months: 20.0% vs 11.1% and 7.8% (p=0.3940). Children with EBF less than four months reported more episodes requiring medical consultation due to GI infections compared to other EBF groups: 10.5% required more than three doctor’s visits in the first two years of life vs 0.0% vs 0.1% (p=0.0153). In the case of respiratory diseases, only children breastfed more than six months could solve the episode without needing to visit a doctor (2.29%, 5/218) (p=0.3253). Progressively lower prevalence of allergic and atopic disorder was registered in relation to longer EBF duration, with prevalence of 16.7% in the first group, 5.6% in the second and 5.5% in the third (p=0.0461), therefore longer EBF resulted protective against allergy (OR=0.5541, 95% CI=[0.3082;0.9961], p=0.0485). Conclusion: In the studied population the prevalence of BF and EBF for at least six months are high, however it is possible that this may not apply to all general Italian population. No significative association was found between EBF duration and the prevalence of infectious diseases in the first two years of life, but EBF longer than four months was associated with decreased need for medical consultations for GI infections. Longer EBF was found protective against allergy.