title: Effect of passive smoking on growth and infection rates of breast-fed and non-breast-fed infants.
abstract: BACKGROUND
  The aim of the present study was to determine the effect of passive tobacco smoking on growth and infection rate of infants, and to evaluate whether breast-feeding might be protective against harmful effects of cigarette smoke.
  
  
  METHODS
  A cross-sectional study on 254 6-7-month-old infants was carried out. A questionnaire was given to mothers; and infants' head circumference, bodyweight, height, and urinary cotinine levels were measured.
  
  
  RESULTS
  Multivariate analysis of factors influencing lower respiratory tract infections showed that smoking mothers increased the rate by 9.1-fold; breast-feeding decreased it by 3.3-fold; formula feeding at birth increased it by a factor of 15.2; another smoker at home increased it by a factor of 40.1. Multivariate analysis of factors influencing upper respiratory tract infections showed that smoking mothers increased the rate by a factor of 23; early formula feeding increased it by a factor of 62; breast-feeding decreased it by a factor of 5; smoking fathers increased it by a factor of 15. Multivariate analysis of factors influencing otitis media found that smoking mothers and fathers increased it by a factor of 9.4 and 6.15, respectively, and breast-feeding decreased it by a factor of 5.4.
  
  
  CONCLUSIONS
  Tobacco smoke exposure of infants has negative consequences on growth, otitis media, and upper and lower respiratory tract infections. Breast-feeding promoted the growth of infants who were passively exposed to tobacco smoke and protected them against infections. Smoking should not be permitted in households with infants. When this is impossible, breast-feeding should be promoted to protect the infants against the health hazards of passive smoking.
authors.affiliation: Department of Pediatrics, Keçiören Training and Research Hospital, Ankara, Turkey. gonca.yilmaz@tr.net
authors.forename: Gonca
authors.initials: G
authors.lastname: Yilmaz
authors.forename: Samil
authors.initials: S
authors.lastname: Hizli
authors.forename: Candemir
authors.initials: C
authors.lastname: Karacan
authors.forename: Kadriye
authors.initials: K
authors.lastname: Yurdakök
authors.forename: Turgay
authors.initials: T
authors.lastname: Coşkun
authors.forename: Uğur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D001942:Breast Feeding; D003367:Cotinine / Q000652:urine; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D010033:Otitis Media / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012923:Social Class; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data*
chemical_list: D014028:Tobacco Smoke Pollution; D003404:Creatinine; D003367:Cotinine