Infant Feeding in Leicester City - East Midlands Public Health ...

28A number of studies have shown that breastfeeding has a protective effect against RTI inchildhood(26)(21)(27). In the most recent Infant Feeding Survey(1), the highest rates of chest infectionswere reported in those infants that had been formula-fed from birth (31%) but only 24% of those that hadbeen breastfed experienced chest infections. The duration of breastfeeding was also important. After twoweeks of breastfeeding, the longer an infant had been breastfed the less likely they were to experienceillness. It was reported that 29% of infants that had been breastfed for two weeks experienced chestinfections compared to 24% of those that had been breastfed for four-six months and 20% of thosebreastfed for longer than six months.Bacharach et al(27) analysed the results of nine studies to examine the link between lower respiratory tractdisease in infancy and breastfeeding (both exclusivity and duration). They reported a consistent protectiveeffect of breastfeeding against lower respiratory tract disease. Exclusive breastfeeding for longer than fourmonths was seen to significantly reduce the risk of respiratory hospitalisation in infancy by 72% comparedwith formula-fed infants. This still remained even after accounting for differences in parental smoking statusand socioeconomic status. They found that formula-fed infants were more than 3 ½ times more likely to beadmitted to hospital for respiratory illness than those that had been exclusively breastfed for over fourmonths. The authors also reported that 26 more infants would need to be breastfed exclusively for longerthan four months to prevent one lower respiratory tract disease admission.Quigley et al(20) also found breastfeeding to have a protective effect on hospitalisation for respiratory tractillness. Infants who were exclusively breastfed were 34% less likely to be admitted to hospital for lowerrespiratory tract infection than those who were never breastfed. A similar pattern was seen for partialbreastfeeding but the relationship was not significant. The authors suggest that 27% of hospitalisations forlower respiratory tract infections could be prevented by exclusive breastfeeding and 25% by partialbreastfeeding. The time since breastfeeding cessation was also important and the protective effect seemedto weaken almost immediately once breastfeeding was stopped.A study undertaken in Rotterdam, Netherlands(21) also examined the effect of breastfeeding (exclusivityand duration) on respiratory illness in infants. This study also reported that breastfeeding had a protectiveeffect against both upper and lower respiratory tract infections in infants. Infants that had been breastfedexclusively for four months and partially thereafter were less likely to experience either lower respiratorytract illness (50% less likely) or upper respiratory tract illness (35% less likely) until the age of six months,compared to those infants that had never been breastfed. This group were also less likely to experiencelower respiratory tract illness between seven and twelve months. A similar pattern was reported for those