title: Characteristics of diarrheal illnesses in non-breast fed infants attending a large urban diarrheal disease hospital in Bangladesh.
abstract: BACKGROUND
  Lack of breast feeding is associated with higher morbidity and case-fatality from both bacterial and viral etiologic diarrheas. However, there is very limited data on the characteristics of non-breastfed infants attending hospital with diarrheal illnesses caused by common bacterial and viral pathogens. Our objective was to assess the impact of lack of breast feeding on diarrheal illnesses in infants living in urban Bangladesh.
  
  
  METHODS
  We extracted data of infants (0-11 months) for analyses from the data archive of Diarrheal Disease Surveillance System (DDSS) of the Dhaka Hospital of icddr,b for the period 2008-2011.
  
  
  RESULTS
  The prevalence of breastfeeding in infants attending the hospital with diarrhea reduced from 31% in 2008 to 17% in 2011, with corresponding increase in the prevalence of non-breastfed (chi square for trend <0.001). Among breastfed infants, the incidence of rotavirus infections was higher (43%) among the 0-5 months age group than infants aged 9-11 months (18%). On the other hand, among non-breastfed infants, the incidence of rotavirus infections was much higher (82%) among 9-11 months old infants compared to those in 0-5 months age group (57%) (chi square for trend <0.001). Very similar trends were also observed in the incidence of cholera and ETEC diarrheas among different age groups of breastfed and non-breastfed infants (chi square for trend 0.020 and 0.001 respectively). However, for shigellosis, the statistical difference remained unchanged among both the groups (chi square for trend 0.240).
  
  
  CONCLUSIONS
  We observed protective role of breastfeeding in infantile diarrhea caused by the major viral and common bacterial agents. These findings underscore the importance of promotion and expansion of breastfeeding campaigns in Bangladesh and elsewhere.
authors.affiliation: Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
authors.forename: Sanjoy Kumer
authors.initials: SK
authors.lastname: Dey
authors.forename: Mohammod Jobayer
authors.initials: MJ
authors.lastname: Chisti
authors.forename: Sumon Kumar
authors.initials: SK
authors.lastname: Das
authors.forename: Chandan Kumar
authors.initials: CK
authors.lastname: Shaha
authors.forename: Farzana
authors.initials: F
authors.lastname: Ferdous
authors.forename: Fahmida Dil
authors.initials: FD
authors.lastname: Farzana
authors.forename: Shahnawaz
authors.initials: S
authors.lastname: Ahmed
authors.forename: Mohammad Abdul
authors.initials: MA
authors.lastname: Malek
authors.forename: Abu Syed Golam
authors.initials: AS
authors.lastname: Faruque
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.forename: Mohammed Abdus
authors.initials: MA
authors.lastname: Salam
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D001903:Bottle Feeding / Q000009:adverse effects*; D001942:Breast Feeding; D002771:Cholera / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D003968:Diarrhea, Infantile / Q000453:epidemiology* / Q000209:etiology; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D008297:Male