Breast-feeding, day-care attendance and the frequency of antibiotic treatments from 1.5 to 5 years: a population-based longitudinal study in Canada.

This paper aims to study, at the population level, the protective role of breast-feeding on child health and its relation to day-care attendance during the first 5 years of life. The analysis, done on a national sample of children, uses antibiotic treatments as a general measure of health. It takes into account mother's education level, family poverty level, mother's smoking status during pregnancy and after birth, mother's age, sex, gestation duration, and birth rank. The analyses were performed using data from the Longitudinal Study of Child Development in Quebec (LSCDQ), conducted by Santé Québec, a division of the Institut de la Statistique du Québec (ISQ). The study was based on face-to-face interviews and included a set of questionnaires addressed to the children's mothers and fathers. A total of 1841 were included in the sample analyzed. Detailed information on breast-feeding and complementary feeding was collected at 5 and 17 months through face-to-face interviews with the most knowledgeable person, generally the mother. From this information, it has been possible to estimate breast-feeding duration and exclusivity. Our results indicate that the positive effects of breast-feeding on health persist up to the second year of life, even in the presence of day-care attendance. The analyses indicate that breast-feeding reduced the number of antibiotic treatments given to children entering day care before 2.5 years of age. The study also indicates that the more-at-risk children could be protected by breast-feeding and by being taken care of in a familial setting, especially before 2.5 years of age. Mother's education, family poverty level, and other social inequality indicators did not play a role in the frequency of antibiotic treatments. Over the long term, it will be important to continue to monitor the health of children and to implement public health interventions aimed at reducing health problems among children of preschool age.