Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy.
OBJECTIVE
To examine the associations of duration of exclusive breastfeeding with infections in the upper respiratory (URTI), lower respiratory (LRTI), and gastrointestinal tracts (GI) in infancy.


METHODS
This study was embedded in the Generation R Study, a population-based prospective cohort study from fetal life onward in the Netherlands. Rates of breastfeeding during the first 6 months (never; partial for <4 months, not thereafter; partial for 4-6 months; exclusive for 4 months, not thereafter; exclusive for 4 months, partial thereafter; and exclusive for 6 months) and doctor-attended infections in the URTI, LRTI, and GI until the age of 12 months were assessed by questionnaires and available for 4164 subjects.


RESULTS
Compared with never-breastfed infants, those who were breastfed exclusively until the age of 4 months and partially thereafter had lower risks of infections in the URTI, LRTI, and GI until the age of 6 months (adjusted odds ratio [aOR]: 0.65 [95% confidence interval (CI): 0.51-0.83]; aOR: 0.50 [CI: 0.32-0.79]; and aOR: 0.41 [CI: 0.26-0.64], respectively) and of LRTI infections between the ages of 7 and 12 months (aOR: 0.46 [CI: 0.31-0.69]). Similar tendencies were observed for infants who were exclusively breastfed for 6 months or longer. Partial breastfeeding, even for 6 months, did not result in significantly lower risks of these infections.


CONCLUSIONS
Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants. Our findings support health-policy strategies to promote exclusive breastfeeding for at least 4 months, but preferably 6 months, in industrialized countries.
Duijts
Liesbeth
L
Generation R Study Group, Rotterdam, Netherlands.
Jaddoe
Vincent W V
VW
Hofman
Albert
A
Moll
Henriëtte A
HA
D000367:Age Factors; D001942:Breast Feeding / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003140:Communicable Disease Control / Q000379:methods*; D003141:Communicable Diseases / Q000453:epidemiology; D016001:Confidence Intervals; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D005759:Gastroenteritis / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands; D016017:Odds Ratio; D011322:Primary Prevention / Q000379:methods; D011446:Prospective Studies; D012016:Reference Values; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D018570:Risk Assessment; D013997:Time Factors