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Isr J Med Sci. 1984 May;20(5):395-9.

Episodes of illness in breast-fed and bottle-fed infants in Jerusalem.


In a prospective study on breast-feeding in Jerusalem, 274 middle-class Jewish women were interviewed about their breast-feeding practices, and symptoms and signs of disease, episodes of illness and hospitalization of the infant. Women of a higher education level breast-fed more often and for a longer period than did women with less education. Infants exclusively breast-fed had significantly fewer symptoms of disease than did those not breast-fed or partially breast-fed. The odds ratios for cough, respiratory difficulty, and diarrhea by breast-feeding practice were 3.66, 2.14 and 2.72 (P = 0.04). Significant differences in the number of illness episodes were found between breast-fed and bottle-fed infants at 20 weeks; infants exclusively breast-fed had the least number of illness episodes. A positive association was found between number of illness episodes and duration of breast-feeding. Infants who were breast-fed for 20 weeks had the least number of illness episodes; 52% of them had no episode compared with only 15% who were not breast-fed. Comparison of the numbers of illness episodes among non-breast-fed infants of mothers with low and high education levels indicated that the infants of better educated mothers had a significantly lower percentage of illness episodes (P less than 0.05). Even infants of a middle-class and well-educated population benefit from the breast-feeding practice and its protective effect, more so if they are exclusively breast-fed and for a longer period.


The frequency of illness episodes in bottlefed, partially breastfed, and exclusively breastfed infants was compared through the 19th postpartum week for 274 infants born at the Hadassah University Hospital between January and July 1979. 402 infants were selected for inclusion in the study from the 1000 consecutive births, which occurred at the hospital during that time period, on the basis of residential proximity to the hospital and single birth status. Mothers of the infants were interviewed after delivery, just prior to discharge, at 6-7 weeks postpartum, and at 20 weeks postpartum. 69% of the mothers were interviewed at all 4 stages, and 274 were interviewed at the 4th stage. At each stage the women were questioned about infant feeding practices and at the 3rd and 4th stage about illness episodes among their infants. 50% of the mothers were Israeli born, 31% were of European or American origin, and the remaining 19% were either from Ais or North Africa. 52% had more than 12 years of schooling, and 48% had less. 89% of the women started breastfeeding in the hospital, 41% still breastfed at 13 weeks, and 27% still breastfed at the 20th week. Prolonged breastfeeding was more common among the more educated mothers than among the less educated mothers. At 20 weeks postpartum the mothers were asked whether their infants experienced any of 10 symptoms during the previous week. Infants exclusively breastfed at 20 weeks had significantly fewer symptoms than partially breastfed and bottlefed infants. For example the proportion of infants who had more than 1 symptom was 8% for the exclusively breastfed, 43% for the partially breastfed, and 43% for the bottlefed infants. Odds ratios for the bottlefed infants compared to the breastfed infants for respiratory difficulties, cough, diarrhea, and vomiting were respectively 3.66, 2.14, 2.72, and 2.14. When educational level was controlled, the corresponding values were 3.33, 1.96, 2.27, and 1.49. An analysis of the number of illness episodes which occurred between the 6th and 20th postpartum weeks revealed that excusivley breastfed infants had significantly fewer episodes than the other 2 groups of infants. For example, the proportion of infants who had 3 or more illness episodes was 16% for bottlfed infants, 4% for partially breastfed infants, and 0% for exclusively breastfed infants; and the proportion reporting no episodes of illness was 62% for the exclusively breastfed, 47% for the partially breastfed, and 29% for the bottlefed. The pattern held for all educational groups and was strongest for infants whose mothers had the least education. Furthermore, 11% of the bottlefed, 8.1% of the partially breastfed, and 2.7% of the exclusively breastfed infants required hospitalization at some point between the 1st and 20th postpartum week. These findings demonstrate that even in predominantly middle class populations, breastfeeding provides health advantages for infants.

[Indexed for MEDLINE]

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