0164

BREAST-FEEDING, RESPIRATORY INFECTION AND ILLNESS IN INFANCY: A PROSPECTIVE BIRTH COHORT STUDY

WH Oddy^1,2, PD Sly¹, NH de Klerk¹, LI Landau¹, FJ Stanley¹, GE Kendall¹, PG Holt¹

¹TVW Telethon Institute for Child Health Research, PO Box 855, West Perth, Western Australia

²Department of Nutrition, Dietetics and Food Science, Curtin University of Technology, Western Australia

Introduction: Respiratory diseases are the leading cause of morbidity in infants up to one year of age in Western Australia. The objective of this study was to examine the relationship between breast-feeding, the age other milk was introduced and morbidity due to respiratory illness and infection in infancy.

Method: A cohort study of 2,602 children enrolled prior to birth and followed prospectively, provided data on infant feeding and morbidity due to respiratory tract illness and infection in the first year of life.

Results: After adjusting for confounders (gender, gestational age maternal smoking in pregnancy, maternal education and maternal age) the introduction of milk other than breast milk before four months of age was significantly associated with a child having four or more hospital, doctor or clinic visits due to upper respiratory tract infection and any visits for wheezing lower respiratory illness. The cessation of breast-feeding before six months was significantly associated with an increased risk of four or more upper respiratory tract infections (OR 1.36 95%CI 1.04,1.77 p=.026) and any wheezing lower respiratory tract illness (OR 1.38 95%CI 1.12,1.69 p=.002) in the first year of life. If other milk was introduced before four months of age, hospitalisations due to upper respiratory tract infection (OR 2.93 95%CI 1.25,6.91 p=0.014) and wheezing lower respiratory tract illness (OR 2.48 CI 1.37,4.50 p=0.003) were significantly increased.

Conclusions: The introduction of milk other than breast milk before four months of age and/or the cessation of breast-feeding before six-months-of-age are significant risk factors for the morbidity associated with upper respiratory tract infections and wheezing lower respiratory tract illness in the first year of life. These results suggest that exclusive breast-feeding should be encouraged for at least four months and that breast-feeding should be continued for at least the first six months of life.