Encouraging breastfeeding for at least the first six months among infants is an important public health strategy to improve overall child health. The benefits of breastfeeding for both the mother and the child are well established. It boosts the child’s immunity while cutting down on the frequency of hospitalisation.
In a new study, experts said that when compared to children with fully formula feeding, the hospital admission rate was 12 per cent lower in those with partially breastfeeding and 15 per cent lower in those with exclusive breastfeeding.
These decreased risks of subsequent hospital admission remained significant until the child was 3 – 4 years old for non-infection respiratory, oral cavity, and non-infection genitourinary tracts, and 10 years old for infection and non-infection gastrointestinal tracts. However, breastfeeding did not reduce the risk of hospitalisation due to mental health or injury.
The 2023 Korean nationwide birth cohort study in Nature Communications proved that though the effect of breastfeeding was reduced over time, the protective effect of breastfeeding on infections persisted until 10 years old.
This study looked at how breastfeeding impacted childhood hospital admissions between January 1, 2009, and December 31, 2019. It is based on the nationwide birth cohort in Korea, which includes data on all infants born from 2009 to 2015. The 1,608,540 children, consisting of 54.5 per cent of the rural residents, were followed up for between 6.76 and 10.06 years.
The types of infant feeding were categorised into three groups − exclusive breastfeeding, partially breastfeeding, and fully formula feeding.
During the full follow-up period, the distribution of hospital admissions for infections, respiratory tract, gastrointestinal tract, oral cavity, mental health, injury/external causes, and genitourinary tract was assessed.
Based on the study, in comparison with children with fully formula feeding, the hospitalisation rate was 12 per cent lower in those with partially breastfeeding and 15 per cent lower in those with exclusive breastfeeding.
The hospital admission rate was 25.15 for fully formula feeding vs. 21.78 for partially breastfeeding vs. 20.30 for exclusive breastfeeding.
Similar effect sizes and patterns of hospital admission rates were found in all different groups following stratification by sex, birth season, and region of residence.
As the participants grew older, the protective effect on hospitalisation of exclusive breastfeeding gradually decreased (18 per cent, 17 per cent, 13 per cent, 12 per cent, and 14 per cent lower in those with exclusive breastfeeding aged less than 1, 1 − 2, 3 − 4, 5 − 6, and 7 − 10 years, respectively, compared to those with fully formula feeding.
The highest risk of hospitalisation was due to ailments of the oral cavity, gastrointestinal tract, respiratory, and genitourinary tract and infection during infancy, and the risk of hospitalisation declined with age.
These excess risks remained until 3 – 4 years (respiratory, genitourinary, and oral cavity) and persisted until 10 years (gastrointestinal tract and infection).
In addition, the findings of the study showed that even though breastfeeding may have protective effects on cognition, mental health, and behaviour in children, breastfeeding is not associated with a reduced risk of hospitalisation for serious psychiatric disorders, such as psychosis.
Although the effect of breastfeeding was reduced over time, the protective effect of breastfeeding on infections persisted until 10 years old. It also showed protective effects on other causes of disease, like the oral cavity, non-infection genitourinary tract, non-infection respiratory tract, and non-infection gastrointestinal tract.
Professor Adebola Orimadegun, the director of the Institute of Child Health and a consultant pediatrician, stated in a comment that breastfed babies are less frequently ill compared with those who are not sufficiently breastfed because breastfeeding, particularly in the first year of life, has a lot of benefits.
“The nutrients that can protect children against infections are transferred from mothers to their babies through breast milk. There are antibodies and other biological molecules that are relevant to immune defence and the immunity of the babies that any well-breasted baby will receive from the mother, apart from the fact that the nutrients in it and the protective molecules or substances are sufficient for babies in the first 4 to 6 months of life.
“Beyond that time, babies who are breastfed are always attached to their mom in particular. This allows the mother to also transfer certain starting microbiomes, organisms, or bacteria that are resident on the mother’s body to the baby, thereby also helping the baby to stimulate his or her own natural immunity. So, in that way, breastfeeding limits babies chances of having infections, particularly bacterial and viral infections.
“Now, in addition to that, breast milk is very clean, so when you compare a baby that is breastfed with a baby that is bottle-fed, you will notice that babies that are breastfed are likely to have a high frequency of diarrhoea, even including the upper respiratory tract infection, compared with those that are not breastfed and that are placed on formula.
“Now for many reasons, this is so because the baby acquires immunity from the mother, and the baby is also less frequently exposed to outside materials, food, or anything that goes into the body that is less likely to be as sterile as breast milk.”
Previous studies on breastfeeding and the risk of subsequent hospital admission have shown beneficial associations in many other countries, like the United Kingdom for infection, allergic disorders, dental caries, and respiratory and gastrointestinal tract infections; in Australia for respiratory diseases; in Spain for infection and gastrointestinal tract diseases; in Italy for fever; in China for fever; and in India for infection.
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