Emily R Smith1, Lindsey M Locks2, Karim P Manji3, Christine M McDonald4, Roland Kupka5, Rodrick Kisenge3, Said Aboud6, Wafaie W Fawzi7, Christopher P Duggan8. 1. Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA. Electronic address: ers231@mail.harvard.edu. 2. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA. 3. Department of Pediatrics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 4. Nutrition and Metabolism Center, Children's Hospital Oakland Research Institute, Oakland, CA. 5. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Nutrition Section, United Nations Children's Fund (UNICEF) Headquarters, New York, NY. 6. Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 7. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA. 8. Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Abstract
OBJECTIVE: To assess the relationship between breastfeeding initiation time and postneonatal mortality, morbidity, and growth through 24 months in a cohort of Tanzanian infants. STUDY DESIGN: We included 4203 infants from 2 trials of micronutrient supplementation. We used Cox proportional hazards models or general estimating equations to estimate relative risks. RESULTS: A total of 13% of infants initiated breastfeeding >1 hour after birth (n = 536). There was no association between breastfeeding initiation time and risk of all-cause or cause-specific mortality, nor infant growth failure, from 6 weeks to 2 years of age. However, delayed breastfeeding was associated with an increased risk of several common infectious morbidities in early infancy, including upper respiratory infection symptoms and vomiting. Compared with those who initiated breastfeeding within the first hour of birth, delayed breastfeeding initiation was associated with an 11% increased risk of cough (relative risk 1.11, 95% CI 1.02-1.21) and a 48% increased risk of difficulty breathing (relative risk 1.48, 95% CI 1.09-2.01) during the first 6 months. Delayed initiation was associated with a greater risk of difficulty breathing from 6 to 12 months of age, but it was not associated with risk of any other morbidity during this time, nor any morbidity between 12 and 24 months. CONCLUSION: Delayed breastfeeding initiation is associated with an increased risk of infant morbidity during the first 6 months of life. Early breastfeeding initiation, along with exclusive and prolonged breastfeeding, should be prioritized and promoted in efforts to improve child health.
OBJECTIVE: To assess the relationship between breastfeeding initiation time and postneonatal mortality, morbidity, and growth through 24 months in a cohort of Tanzanian infants. STUDY DESIGN: We included 4203 infants from 2 trials of micronutrient supplementation. We used Cox proportional hazards models or general estimating equations to estimate relative risks. RESULTS: A total of 13% of infants initiated breastfeeding >1 hour after birth (n = 536). There was no association between breastfeeding initiation time and risk of all-cause or cause-specific mortality, nor infantgrowth failure, from 6 weeks to 2 years of age. However, delayed breastfeeding was associated with an increased risk of several common infectious morbidities in early infancy, including upper respiratory infection symptoms and vomiting. Compared with those who initiated breastfeeding within the first hour of birth, delayed breastfeeding initiation was associated with an 11% increased risk of cough (relative risk 1.11, 95% CI 1.02-1.21) and a 48% increased risk of difficulty breathing (relative risk 1.48, 95% CI 1.09-2.01) during the first 6 months. Delayed initiation was associated with a greater risk of difficulty breathing from 6 to 12 months of age, but it was not associated with risk of any other morbidity during this time, nor any morbidity between 12 and 24 months. CONCLUSION: Delayed breastfeeding initiation is associated with an increased risk of infant morbidity during the first 6 months of life. Early breastfeeding initiation, along with exclusive and prolonged breastfeeding, should be prioritized and promoted in efforts to improve child health.
Authors: Cesar G Victora; Rajiv Bahl; Aluísio J D Barros; Giovanny V A França; Susan Horton; Julia Krasevec; Simon Murch; Mari Jeeva Sankar; Neff Walker; Nigel C Rollins Journal: Lancet Date: 2016-01-30 Impact factor: 79.321
Authors: Karen M Edmond; Betty R Kirkwood; Seeba Amenga-Etego; Seth Owusu-Agyei; Lisa S Hurt Journal: Am J Clin Nutr Date: 2007-10 Impact factor: 7.045
Authors: Christopher Duggan; Karim P Manji; Roland Kupka; Ronald J Bosch; Said Aboud; Rodrick Kisenge; James Okuma; Wafaie W Fawzi Journal: Am J Clin Nutr Date: 2012-11-07 Impact factor: 7.045