The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61802

Sharon Perry, PhD¹, Marisa Chiang, BA², Maria de Luz Sanchez, BA², Jonee Taylor, MA², Isabel Garcia, RN², Grace Hui, BA², Anabel Ruiz, BS², and Julie Parsonnet, MD². (1) Division of Geographic Medicine and Infectious Diseases, Stanford University School of Medicine, HRP (Redwood) Building, Room T225, Mail code 5405, Stanford, CA 94305, (2) Infectious Diseases, Stanford University, 300 Pasteur Drive, Grant Bldg, S131, Stanford, CA 94305, 650-498-4978, marisacg@stanford.edu

Background: Breastfeeding may be protective against acute gastroenteritic symptoms in children via nutritional, immunologic and metabolic factors. Objective: To evaluate the association of breastfeeding and risk of secondary gastroenteritis during household episodes of infectious gastroenteritis. Methods: As part of an ongoing cohort study of H. pylori transmission, Bay Area households identified by index case through cooperating clinics were interviewed regarding current breastfeeding practices, and followed for three months during which household episodes of acute primary and secondary gastroenteritis (diarrhea, vomiting, both) were documented. Logistic regression was used to compare rates of gastroenteritis among breastfed and non-breastfed children under the age of 2. Results: Of 356 children (average age: 12+/-6 months) who completed follow-up, 103 (29%) were breastfed. Households (90% Hispanic) were not significantly different in size, income, or educational attainment. Of 41 children with no gastroenteritic symptoms, 39% were breastfed, compared with 25% of 55 children with an acute secondary episode, and 28% of 264 primary cases (p=.17). In 93 children with mother reporting a primary illness, breastfeeding was associated with a 60% lower risk of secondary gastroenteritis (AOR: .40 [95% CI .16-.98] adjusting for age), while frequency of breastfeeding was not significantly different among 263 children with mothers who reported no illness (AOR .92 [95% CI .45-1.85]. Discussion: In households experiencing epidemic gastroenteritis, breastfeeding appeared to be protective against secondary illness in children with symptomatic mothers. Further studies are needed to corroborate these findings with respect to increasing age, duration and frequency of breastfeeding, and chronic gastrointestinal infection.

Learning Objectives:

Attendees will learn to
• recognize the methods of a major comunity-based cohort study
• evaluate factors associated with household episodes of gastroenteritis
• Evaluate modifiers of the effect of breastfeeding on risk of symptomatic gastroenteritis in young children

Keywords: Breast Feeding, Diarrhea

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.