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Lee JS, Shin JI, Kim S, Choi YS, Shin YH, Hwang J, Shin JU, Koyanagi A, Jacob L, Smith L, Jeong HE, Noh Y, Oh IS, Rhee SY, Min C, Cho SH, Turner S, Fond G, Boyer L, Suh DI, Acharya KP, Shin JY, Lee SW, Yon DK. Breastfeeding and impact on childhood hospital admissions: a nationwide birth cohort in South Korea. Nat Commun 2023; 14:5819. [PMID: 37730734 PMCID: PMC10511528 DOI: 10.1038/s41467-023-41516-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
Benefits of breastfeeding for both the mother and the child are well established, but a comprehensive and robust study to investigate the protective effect of breastfeeding and attenuated time effect stratified by cause of morbidity are lacking. This study is based on the nationwide birth cohort in Korea that includes data on all infants born from 2009 to 2015. Of 1,608,540 children, the median follow-up period was 8.41 years (interquartile range, 6.76-10.06). When compared to children with fully formula feeding, the hospital admission rate was 12% lower in those with partially breastfeeding and 15% lower in those with exclusive breastfeeding. The apparent protective effect of breastfeeding was reduced with increasing age. Our study provides potential evidence of the beneficial association of breastfeeding on subsequent hospital admissions. The protective effect declined over time as the children grew older. Encouraging any breastfeeding for at least the first 6 months among infants is an important public health strategy to improve overall child health.
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Affiliation(s)
- Jeong-Seon Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sunyeup Kim
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Yong-Sung Choi
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Republic of Korea
| | - Jimin Hwang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jung U Shin
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
- Department of Physical Medicine and Rehabilitation, Lariboisière-Fernand Widal Hospital, AP-HP, Université Paris Cité, Paris, France
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Han Eol Jeong
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
| | - Yunha Noh
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
- Deparments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - In-Sun Oh
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
- Deparments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Chanyang Min
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Seong Ho Cho
- Division of Allergy-Immunology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Steve Turner
- Maternity and Child Health Division, NHS Grampian, Aberdeen, UK
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea.
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Republic of Korea.
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
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Belinchón I, Velasco M, Ara-Martín M, Armesto Alonso S, Baniandrés Rodríguez O, Ferrándiz Pulido L, García-Bustinduy M, Martínez-López JA, Martínez Sánchez N, Pérez Ferriols A, Pérez Pascual E, Rivera Díaz R, Ruiz-Villaverde R, Taberner Ferrer R, Vicente Villa A, Carrascosa JM. Management of Psoriasis During Preconception, Pregnancy, Postpartum, and Breastfeeding: A Consensus Statement. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:225-241. [PMID: 33065101 DOI: 10.1016/j.ad.2020.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/02/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To develop evidence- and experience-based recommendations for the management of psoriasis during preconception, pregnancy, postpartum, and breastfeeding. METHODS The nominal group technique and the Delphi method were used. Fifteen experts (12 dermatologists, 2 of whom were appointed coordinators; 1 rheumatologist; and 2 gynecologists) were selected to form an expert panel. Following a systematic review of the literature on fertility, pregnancy, postpartum, and breastfeeding in women with psoriasis, the coordinators drew up a series of preliminary recommendations for discussion by the panel at a nominal group meeting. The experts defined the scope, sections, and intended users of the statement and prepared a final list of recommendations. Consensus was obtained using a Delphi process in which an additional 51 dermatologists rated their level of agreement with each recommendation on a scale of 1 (total disagreement) to 10 (total agreement). Consensus was defined by a score of 7 or higher assigned by at least 70% of participants. Level of evidence and strength of recommendation were reported using the Oxford Center for Evidence-Based Medicine categories. The final statement was approved by the expert panel. RESULTS The resulting consensus statement includes 23 recommendations on preconception (fertility and contraception), pregnancy (planning, pharmacological management, and follow-up), and breastfeeding (management and follow-up). Consensus was achieved for all recommendations generated except one. CONCLUSIONS These recommendations for the better management of psoriasis in women of childbearing age could improve outcomes and prognosis.
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Affiliation(s)
- I Belinchón
- Servicio de Dermatología, Hospital General Universitario de Alicante-ISABIAL-UMH, Alicante, España.
| | - M Velasco
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, España
| | - M Ara-Martín
- Servicio de Dermatología, Hospital Clínico Lozano Blesa, Zaragoza, España
| | - S Armesto Alonso
- Servicio de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | | | - L Ferrándiz Pulido
- Servicio de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - M García-Bustinduy
- Servicio de Dermatología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
| | - J A Martínez-López
- Servicio de Reumatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - N Martínez Sánchez
- Servicio de Ginecología-Obstetricia, Hospital Universitario La Paz, Madrid, España
| | - A Pérez Ferriols
- Servicio de Dermatología, Hospital General de Valencia, Valencia, España
| | - E Pérez Pascual
- Servicio de Ginecología-Obstetricia, Hospital General Universitario de Alicante-ISABIAL, Alicante, España
| | - R Rivera Díaz
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - R Ruiz-Villaverde
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - R Taberner Ferrer
- Servicio de Dermatología, Hospital Son Llàtzer, Palma de Mallorca, España
| | - A Vicente Villa
- Servicio de Dermatología, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
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Belinchón I, Velasco M, Ara-Martín M, Armesto Alonso S, Baniandrés Rodríguez O, Ferrándiz Pulido L, García-Bustinduy M, Martínez-López J, Martínez Sánchez N, Pérez Ferriols A, Pérez Pascual E, Rivera Díaz R, Ruiz-Villaverde R, Taberner Ferrer R, Vicente Villa A, Carrascosa J. Management of Psoriasis During Preconception, Pregnancy, Postpartum, and Breastfeeding: A Consensus Statement. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2020.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Oral Sucrose Versus Breastfeeding in Managing Infants' Immunization-Related Pain: A Randomized Controlled Trial. MCN Am J Matern Child Nurs 2019; 44:108-114. [PMID: 30807328 DOI: 10.1097/nmc.0000000000000512] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Treating pain during immunization should be a part of pediatric primary healthcare around the world, as untreated pain in children has short- and long-term consequences. Few studies of pharmacologic and nonpharmacologic methods of pain relief during immunization have been conducted in low- and middle-income countries. Finding pain-mitigating interventions that are low-cost, effective, and feasible across all settings, including with low-resourced settings could improve primary healthcare. PURPOSE To evaluate the effectiveness of oral sucrose versus breastfeeding as methods of pain management during immunization of infants through 6 months of age. METHODS A randomized controlled experimental design was used; 120 infants were randomly assigned to control, sucrose, or breastfeeding groups. Data were collected in an Egyptian primary health center. Outcome measures including pain (as per the FLACC pain scale), crying time, and heart rate were measured at three time points. RESULTS There were significant differences in pain scores and crying duration during and after immunization (p < .001) for the breastfeeding group compared with the sucrose and control groups. IMPLICATIONS FOR PRACTICE Health staff and parents need education and support in use of breastfeeding for pain management during immunization. More studies are needed to evaluate effectiveness of breastfeeding versus other pain management methods for managing infants' immunization-related pain.
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Li S, Yue A, Abbey C, Medina A, Shi Y. Breastfeeding and the Risk of Illness among Young Children in Rural China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16010136. [PMID: 30621049 PMCID: PMC6339247 DOI: 10.3390/ijerph16010136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/14/2018] [Accepted: 12/26/2018] [Indexed: 11/16/2022]
Abstract
Poor rural areas in China exhibit the country’s highest rates of child mortality, often stemming from preventable health conditions such as diarrhea and respiratory infection. In this study, we investigate the association between breastfeeding and disease among children aged 6–24 months in poor rural counties in China. To do this, we conducted a longitudinal, quantitative analysis of socioeconomic demographics, health outcomes, and breastfeeding practices for 1802 child–caregiver dyads across 11 nationally designated poverty counties in southern Shaanxi Province in 2013–2014. We found low rates of continued breastfeeding that decreased as children developed: from 58.2% at 6–12 months, to 21.6% at 12–18 months, and finally to 5.2% at 18–24 months. These suboptimal rates are lower than all but one other country in the Asia-Pacific region. We further found that only 18.3% of children 6–12 months old met the World Health Organization (WHO)-recommended threshold for minimum dietary diversity, defined as consuming four or more of seven specific food groups. Breastfeeding was strongly associated with lower rates of both diarrhea and cough in bivariate and multivariate analyses. As the first analysis to use longitudinal data to examine the relationship between continued breastfeeding and child illness in China, our study confirms the need for programmatic interventions that promote continued breastfeeding in order to improve toddler health in the region.
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Affiliation(s)
- Shanshan Li
- Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Xi'an 710119, China.
| | - Ai Yue
- Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Xi'an 710119, China.
| | - Cody Abbey
- Rural Education Action Program, Freeman Spogli Institute for International Studies, Stanford University, Palo Alto, CA 94305, USA.
| | - Alexis Medina
- Rural Education Action Program, Freeman Spogli Institute for International Studies, Stanford University, Palo Alto, CA 94305, USA.
| | - Yaojiang Shi
- Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Xi'an 710119, China.
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Suleiman N, Shamsuddin SH, Mohd Rus R, Drahman S, Taib MNAM. The Relevancy of paracetamol and Breastfeeding Post Infant Vaccination: A Systematic Review. PHARMACY 2018; 6:E27. [PMID: 29597245 PMCID: PMC6025262 DOI: 10.3390/pharmacy6020027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/18/2018] [Accepted: 03/20/2018] [Indexed: 11/22/2022] Open
Abstract
Background: Paracetamol may be used as an antipyretic agent for the treatment of fever, as well as an analgesic in the treatment of mild to moderate pain post-vaccination in infants. The use of paracetamol during fever may be or may not be recommended since it may alter the natural human body immune response, although it may reduce pain. Objectives: The aims of this study are to describe the effectiveness of breastfeeding in reducing pain and paracetamol in reducing fever and pain post infant vaccination. Methods: Data sources and study selection was conducted by electronic searching of six databases. Manual reference checks of all articles on paracetamol and breastfeeding post infant vaccination published in the English language between 1978 and 2017. Two levels of screening were used on 9614 citations, which include screening of abstracts and titles followed by full text screening. The data synthesis were tabulated into study characteristics, quality, and effects. Results: Systematic review of breastfeeding included three studies from 9614 database searches found significant benefit from breastfeeding in pain scores and the duration of crying, as well as behavioural changes. None of the studies stated the detriment of breastfeeding before, during, and after immunization. Systematic review of paracetamol effectiveness included four studies from 1177 database searches found significant benefit from prophylaxis paracetamol in fever, one study found significant benefit from prophylaxis paracetamol in fussiness, and one study's results were found to be not significant. Two studies on evaluating the safety of prophylactic paracetamol in 2009 found that antibody responses to several antigens were significantly reduced, and the other study in 1988 found that antibody titres to DTP bacteria of placebo and PCM did not differ significantly. Conclusions: The relevancy of giving paracetamol post all types of vaccination may be questionable. Breastfeeding before, during, and after immunization are recommended for pain reduction and are proven effective. Further research is required in deciding if paracetamol is to be of rational use following infant immunization.
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Affiliation(s)
- Nurain Suleiman
- Johor Pharmaceutical Services Division, Ministry of Health of Malaysia, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25710, Pahang, Malaysia.
| | - Siti Hadijah Shamsuddin
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25710, Pahang, Malaysia.
| | - Razman Mohd Rus
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan 25710, Pahang, Malaysia.
| | - Shamsul Drahman
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan 25710, Pahang, Malaysia.
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Martínez López JA, García Vivar ML, Cáliz R, Freire M, Galindo M, Hernández MV, López Longo FJ, Martínez Taboada V, Pego Reigosa JM, Rubio E, Trujillo E, Vela-Casasempere P. Recommendations for the evaluation and management of patients with rheumatic autoimmune and inflammatory diseases during the reproductive age, pregnancy, postpartum and breastfeeding. ACTA ACUST UNITED AC 2016; 13:264-281. [PMID: 27321859 DOI: 10.1016/j.reuma.2016.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/02/2016] [Accepted: 05/07/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To develop recommendations on the evaluation and management of patients with rheumatic autoimmune and inflammatory diseases during the reproductive age, pregnancy, post-partum and breastfeeding based on the best evidence and experience. METHODS Recommendations were generated using nominal group and Delphi techniques. An expert panel of 12 rheumatologists was established. A systematic literature review and a narrative review (websites, clinical guidelines and other relevant documentation) were performed and presented to the panel in its 1st meeting to be discussed and to help define recommendations. A first draft of recommendations was generated and circulated for comments and wording refinement. A national survey analyzing different aspects of this topic was undertaken separately, followed by a Delphi process (2 rounds). Agreement with each recommendation was ranked on a scale of 1 (total disagreement) to 10 (total agreement), and was considered to be achieved if at least 70% voted≥7. The level of evidence and grade of recommendation were assessed using the Oxford Centre for Evidence-based Medicine Levels of Evidence. RESULTS A total of 14 recommendations were generated for the preconception period (oral and hormonal contraception, reproductive techniques), pregnancy (planning, treatment and follow-up), and breastfeeding (treatment and follow-up). High-risk situations such as lupus or antiphospholipid syndrome were included. A consensus>90% was reached for all but one recommendation. CONCLUSIONS These recommendations are intended to provide rheumatologists, patients, families and other stakeholders with a consensus on the evaluation and management of patients with autoimmune and inflammatory diseases during the reproductive age, pregnancy, postpartum and breastfeeding.
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Affiliation(s)
| | - M Luz García Vivar
- Servicio de Reumatología, Hospital Universitario Basurto, Bilbao, España
| | - Rafael Cáliz
- Unidad de Gestión de Reumatología, Complejo Hospitalario Universitario de Granada, Granada, España
| | - Mercedes Freire
- Servicio de Reumatología, Complexo hospitalario Universitario A Coruña (CHUAC), A Coruña, España
| | - María Galindo
- Servicio de Reumatología, Hospital Universitario 12 de Octubre, Madrid, España
| | | | | | - Víctor Martínez Taboada
- Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla, Santander, España; Facultad de Medicina, Universidad de Cantabria, Santander, España
| | - Jose María Pego Reigosa
- Servicio de Reumatología, Hospital Meixoeiro-Complexo Hospitalario Universitario de Vigo, Vigo, España
| | - Esteban Rubio
- Servicio de Reumatología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Elisa Trujillo
- Servicio de Reumatología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
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Ajetunmobi OM, Whyte B, Chalmers J, Tappin DM, Wolfson L, Fleming M, MacDonald A, Wood R, Stockton DL. Breastfeeding is associated with reduced childhood hospitalization: evidence from a Scottish Birth Cohort (1997-2009). J Pediatr 2015; 166:620-5.e4. [PMID: 25556021 PMCID: PMC4344374 DOI: 10.1016/j.jpeds.2014.11.013] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 09/16/2014] [Accepted: 11/05/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate the risk of childhood hospitalization associated with infant feeding patterns at 6-8 weeks of age in Scotland. STUDY DESIGN A retrospective population level study based on the linkage of birth, death, maternity, infant health, child health surveillance, and admission records for children born as single births in Scotland between 1997 and 2009 (n = 502 948) followed up to March 2012. Descriptive analyses, Kaplan Meier tests, and Cox regression were used to quantify the association between the mode of infant feeding and risk of childhood hospitalization for respiratory, gastrointestinal, and urinary tract infections, and other common childhood ailments during the study period. RESULTS Within the first 6 months of life, there was a greater hazard ratio (HR) of hospitalization for common childhood illnesses among formula-fed infants (HR 1.40; 95% CI 1.35-1.45) and mixed-fed infants (HR 1.18; 95% CI 1.11-1.25) compared with infants exclusively breastfed after adjustment for parental, maternal, and infant health characteristics. Within the first year of life and beyond, a greater relative risk of hospitalization was observed among formula-fed infants for a range of individual illnesses reported in childhood including gastrointestinal, respiratory, and urinary tract infections, otitis media, fever, asthma, diabetes, and dental caries. CONCLUSIONS Using linked administrative data, we found greater risks of hospitalization in early childhood for a range of common childhood illnesses among Scottish infants who were not exclusively breastfed at 6-8 weeks of age.
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Affiliation(s)
- Omotomilola M Ajetunmobi
- Information Services Division, National Health Service, National Services Scotland, Glasgow, Scotland.
| | - Bruce Whyte
- Glasgow Centre for Population Health, Glasgow, Scotland
| | - James Chalmers
- Information Services Division, National Health Service, National Services Scotland, Glasgow, Scotland; National Education Scotland, National Health Service, National Services Scotland, Edinburgh, Scotland
| | - David M Tappin
- Pediatric Epidemiology and Community Health (PEACH) Unit, Glasgow University, Glasgow, Scotland
| | - Linda Wolfson
- National Health Service (NHS), Greater Glasgow and Clyde, Glasgow, Scotland
| | - Michael Fleming
- Information Services Division, National Health Service, National Services Scotland, Glasgow, Scotland
| | | | - Rachael Wood
- Information Services Division, National Health Service, National Services Scotland, Glasgow, Scotland
| | - Diane L Stockton
- Information Services Division, National Health Service, National Services Scotland, Glasgow, Scotland
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Lin H, Sun L, Lin J, He J, Deng A, Kang M, Zeng H, Ma W, Zhang Y. Protective effect of exclusive breastfeeding against hand, foot and mouth disease. BMC Infect Dis 2014; 14:645. [PMID: 25471294 PMCID: PMC4273484 DOI: 10.1186/s12879-014-0645-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 11/20/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Infants who are exclusively breastfed receive natural protection against some infectious agents. This study examined whether there was protective effect of exclusive breastfeeding on the occurrence of hand, foot and mouth disease, which was an emerging infectious disease among children in China. METHODS A community-based case-control study was carried out among children age 4 years or younger in Guangdong Province, China. Cases were newly diagnosed hand, foot and mouth disease. Controls were randomly sampled from healthy children from the nearby village. Unconditional logistic regression model was used to estimate the odds ratio (OR) for exclusive breastfeeding after adjusting for potential confounding factors. RESULTS A total of 316 cases and 566 controls were included in the analysis. Significantly beneficial effect of exclusive breastfeeding during the first 6 months was observed for hand, foot and mouth disease occurrence. The overall OR was 0.63 (95% CI: 0.47-0.85) for exclusive breastfeeding compared with mixed feeding type. The age-specific analyses indicated that the protective effect persisted till the age of 28 months. CONCLUSIONS This study suggests that exclusive breastfeeding might have protective effect against HFMD infection among the children within 28 months of age.
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Affiliation(s)
- Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
| | - Limei Sun
- Guangdong Provincial Center for Disease Control and Prevention, 160, Qunxian Road, Panyu, Guangzhou, 511430, China.
| | - Jinyan Lin
- Guangdong Provincial Center for Disease Control and Prevention, 160, Qunxian Road, Panyu, Guangzhou, 511430, China.
| | - Jianfeng He
- Guangdong Provincial Center for Disease Control and Prevention, 160, Qunxian Road, Panyu, Guangzhou, 511430, China.
| | - Aiping Deng
- Guangdong Provincial Center for Disease Control and Prevention, 160, Qunxian Road, Panyu, Guangzhou, 511430, China.
| | - Min Kang
- Guangdong Provincial Center for Disease Control and Prevention, 160, Qunxian Road, Panyu, Guangzhou, 511430, China.
| | - Hanri Zeng
- Guangdong Provincial Center for Disease Control and Prevention, 160, Qunxian Road, Panyu, Guangzhou, 511430, China.
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, 160, Qunxian Road, Panyu, Guangzhou, 511430, China.
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Abstract
Many mothers are inappropriately advised to discontinue breastfeeding or avoid taking essential medications because of fears of adverse effects on their infants. This cautious approach may be unnecessary in many cases, because only a small proportion of medications are contraindicated in breastfeeding mothers or associated with adverse effects on their infants. Information to inform physicians about the extent of excretion for a particular drug into human milk is needed but may not be available. Previous statements on this topic from the American Academy of Pediatrics provided physicians with data concerning the known excretion of specific medications into breast milk. More current and comprehensive information is now available on the Internet, as well as an application for mobile devices, at LactMed (http://toxnet.nlm.nih.gov). Therefore, with the exception of radioactive compounds requiring temporary cessation of breastfeeding, the reader will be referred to LactMed to obtain the most current data on an individual medication. This report discusses several topics of interest surrounding lactation, such as the use of psychotropic therapies, drugs to treat substance abuse, narcotics, galactagogues, and herbal products, as well as immunization of breastfeeding women. A discussion regarding the global implications of maternal medications and lactation in the developing world is beyond the scope of this report. The World Health Organization offers several programs and resources that address the importance of breastfeeding (see http://www.who.int/topics/breastfeeding/en/).
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Zhu Q, Li Y, Li N, Han Q, Liu Z, Li Z, Qiu J, Zhang G, Li F, Tian N. Prolonged exclusive breastfeeding, autumn birth and increased gestational age are associated with lower risk of fever in children with hand, foot, and mouth disease. Eur J Clin Microbiol Infect Dis 2012; 31:2197-202. [PMID: 22278296 DOI: 10.1007/s10096-012-1555-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Accepted: 01/07/2012] [Indexed: 11/26/2022]
Abstract
Epidemics of hand, foot, and mouth disease (HFMD) have been emerging and reemerging in recent years. This study aims to investigate whether breastfeeding and other factors may affect the profile of fever and disease course in children with HFMD. Three hundred seventy-two preschool children with HFMD were included. The demographics, environmental factors, and delivery- and feeding-associated factors in the children were obtained and their effects on the profile of fever and disease course were analyzed. Of the 372 children, 139 (37.37%) had fever during the disease course. Gender, breastfeeding pattern, birth season and gestational age were significantly different between the children with and without fever (p = 0.034, p < 0.0001, p = 0.035 and p = 0.013, respectively). After multivariate-adjusted analysis, prolonged exclusive breastfeeding (p = 0.001, OR 0.401, 95% CI 0.229-0.704), autumn birth (p = 0.007, OR 0.409, 95% CI 0.214-0.784) and higher gestational age (p = 0.029, OR 0.089, 95% CI 0.010-0.781) were protective factors for the incidence of fever.
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Affiliation(s)
- Q Zhu
- Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
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Chockalingam P, Rammeloo LA, Postema PG, Hruda J, Clur SAB, Blom NA, Wilde AA. Fever-induced life-threatening arrhythmias in children harboring an SCN5A mutation. Pediatrics 2011; 127:e239-44. [PMID: 21135007 DOI: 10.1542/peds.2010-1688] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Cardiac channelopathies caused by SCN5A mutation are well tolerated by most patients. However, the dramatic presentation of a previously healthy 4-month-old girl with life-threatening arrhythmias and the subsequent findings in the child and her family provide evidence that loss-of-function sodium channel mutations can present very early in life. An SCN5A mutation was detected in the infant, her brother, and their father. Both the siblings manifested recurrent serious arrhythmias during febrile episodes, which followed immunization, as well as fever of nonspecific origin. Management consisted of prompt antipyretic measures, hospitalization with vigorous monitoring during immunization and febrile episodes, and prevention of tachycardia-induced conduction disturbance with β-blockers.
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Affiliation(s)
- Priya Chockalingam
- Department of Cardiology, Heart Failure Research Centre, Academic Medical Centre, Meibergdreef 9, 1105AZ Amsterdam, Netherlands.
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