Pei-Lin Chen1, Nelís Soto-Ramírez2, Hongmei Zhang1, Wilfried Karmaus1. 1. 1 Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA. 2. 2 College of Social Work, University of South Carolina, Columbia, SC, USA.
Abstract
BACKGROUND: Gastroesophageal reflux in neonates is frequently reported by parents, potentially motivating changes in infant feeding mode and/or addition of solid food. OBJECTIVE: The authors prospectively analyzed associations between repeated measurement of feeding modes and reflux in infancy. METHODS: The Infant Feeding Practices Study II, conducted between 2005 and 2007 (2,841 infants), provides data on reflux and feeding modes at nine time points from months 1 to 12. Feeding modes were defined based on direct breastfeeding, feeding of bottled human milk, formula feeding, their combinations, and use of solid food. Repeated measurements were investigated using 1-month delayed models to estimate risk ratios (RRs) and their 95% confidence intervals (CIs). Risk ratios of different feeding modes were estimated for reflux; addressing a reverse association, RRs for feeding mode were estimated as responses to prior reflux. RESULTS: Compared to direct breastfeeding, combinations with formula feeding showed a statistically significant risk for reflux (bottled human milk plus formula feeding: RR = 2.19, 95% CI [1.11, 4.33]; formula feeding: RR = 1.95, 95% CI [1.39, 2.74]; and mixed breastfeeding plus formula feeding: RR = 1.59, 95% CI [1.40, 2.42]). Addition of solid food was not protective (RR = 1.21, 95% CI [0.86, 1.70]). Analyses of reverse association (reflux → feeding) showed fewer breastfed infants among those with reflux in the prior month. CONCLUSION: Any combination of infant feeding with formula seems to be a risk for reflux. Although breastfeeding was protective, mothers with a child with reflux were more likely to wean their child.
BACKGROUND: Gastroesophageal reflux in neonates is frequently reported by parents, potentially motivating changes in infant feeding mode and/or addition of solid food. OBJECTIVE: The authors prospectively analyzed associations between repeated measurement of feeding modes and reflux in infancy. METHODS: The Infant Feeding Practices Study II, conducted between 2005 and 2007 (2,841 infants), provides data on reflux and feeding modes at nine time points from months 1 to 12. Feeding modes were defined based on direct breastfeeding, feeding of bottled human milk, formula feeding, their combinations, and use of solid food. Repeated measurements were investigated using 1-month delayed models to estimate risk ratios (RRs) and their 95% confidence intervals (CIs). Risk ratios of different feeding modes were estimated for reflux; addressing a reverse association, RRs for feeding mode were estimated as responses to prior reflux. RESULTS: Compared to direct breastfeeding, combinations with formula feeding showed a statistically significant risk for reflux (bottled human milk plus formula feeding: RR = 2.19, 95% CI [1.11, 4.33]; formula feeding: RR = 1.95, 95% CI [1.39, 2.74]; and mixed breastfeeding plus formula feeding: RR = 1.59, 95% CI [1.40, 2.42]). Addition of solid food was not protective (RR = 1.21, 95% CI [0.86, 1.70]). Analyses of reverse association (reflux → feeding) showed fewer breastfed infants among those with reflux in the prior month. CONCLUSION: Any combination of infant feeding with formula seems to be a risk for reflux. Although breastfeeding was protective, mothers with a child with reflux were more likely to wean their child.
Authors: Yamini Mallisetty; Nandini Mukherjee; Yu Jiang; Su Chen; Susan Ewart; S Hasan Arshad; John W Holloway; Hongmei Zhang; Wilfried Karmaus Journal: Nutrients Date: 2020-12-30 Impact factor: 5.717