Full breastfeeding and hospitalization as a result of infections in the first year of life

OBJECTIVE

Our objective was to assess the effect of breastfeeding on the probability of hospitalization as a result of infectious processes during the first year of life

METHODS

We followed 1385 infants from birth to age 1 year between 1996 and 1999. Recruitment and data collection were done at the 6-month well-infant visit under the National Child Health Program. Full breastfeeding, hospital admission, and other relevant variables related to the delivery, infant, mother, health services system, and sociologic aspects were recorded. The statistical analysis included Kaplan-Meier test, Cox regression to obtain the hazard ratio, and the adjusted attributable risk.

RESULTS

Full breastfeeding at discharge after delivery and at 3, 4, and 6 months of age were 85%, 52%, 41%, and 15%, respectively; 78 hospital admissions as a result of infections were recorded (38 respiratory tract, 16 gastrointestinal tract). Mean age at admission was 4.1 months. After estimating the attributable risk, it was found that 30% of hospital admissions would have been avoided for each additional month of full breastfeeding. Seemingly, 100% of full breastfeeding among 4-month-old infants would avoid 56% of hospital admissions in infants who are younger than 1 year.

CONCLUSIONS

On the basis of the present data, we conclude that full breastfeeding would lower the risk for hospital admission as a result of infections among infants who are younger than 1 year within an industrialized country.

A breastfeeding e-learning project based on a web forum

OBJECTIVE

The Internet has introduced new ways of learning that may complement medical training during the residency period. We describe the experience with a new method of e-learning for training in human lactation and breastfeeding counselling. Pediatric residents participated in the Human Lactation Forum maintained by the Spanish Pediatric Association Breastfeeding Committee, a site on the Internet where parents may write in for pediatric advice on breastfeeding.

METHODS

From April 2005 to May 2006, 42 pediatric residents from four hospitals in Spain received a month of intensive theoretical training on breastfeeding, and afterward, they took weekly turns answering parents' questions in the forum. Before and after the experience, they completed a pre-post knowledge test and an opinion postexperience questionnaire with open questions. A t-test was used to analyze the differences pre- and posttest; the opinion questionnaire was analyzed qualitatively.

RESULTS

The mean age of participants was 28.3 years; 88% were women, and 80% were in their third or fourth year of residency. The percentage of correct answers was higher after participation in the program, and the difference had statistic significance. The residents estimated that nearly a half of their patients needed breastfeeding advice, and they thought that the program improved their knowledge of breastfeeding and their communication skills with mothers. On average, they spent 2.9 hours daily to answer the questions.

CONCLUSIONS

The learning experience was positively evaluated by the participants and contributed to increase their knowledge and skills in breastfeeding issues. We think it is a good method for training future pediatricians on breastfeeding management. In addition, the instrument may contribute to improve lactation knowledge among pediatricians.