Full breastfeeding protection against common enteric bacteria and viruses: results from the MAL-ED cohort study.
MAL-ED
breastfeeding
enteropathogens
enteropathy
infant feeding
Journal
The American journal of clinical nutrition
ISSN: 1938-3207
Titre abrégé: Am J Clin Nutr
Pays: United States
ID NLM: 0376027
Informations de publication
Date de publication:
04 03 2022
04 03 2022
Historique:
received:
29
07
2021
accepted:
19
11
2021
pubmed:
2
12
2021
medline:
28
4
2022
entrez:
1
12
2021
Statut:
ppublish
Résumé
Breastfeeding is known to reduce the risk of enteropathogen infections, but protection from specific enteropathogens is not well characterized. The aim was to estimate the association between full breastfeeding (days fed breast milk exclusively or with nonnutritive liquids) and enteropathogen detection. A total of 2145 newborns were enrolled at 8 sites, of whom 1712 had breastfeeding and key enteropathogen data through 6 mo. We focused on 11 enteropathogens: adenovirus 40/41, norovirus, sapovirus, astrovirus, and rotavirus, enterotoxigenic Escherichia coli (ETEC), Campylobacter spp., and typical enteropathogenic E. coli as well as entero-aggregative E. coli, Shigella and Cryptosporidium. Logistic regression was used to estimate the risk of enteropathogen detection in stools and survival analysis was used to estimate the timing of first detection of an enteropathogen. Infants with 10% more days of full breastfeeding within the preceding 30 d of a stool sample were less likely to have the 3 E. coli and Campylobacter spp. detected in their stool (mean odds: 0.92-0.99) but equally likely (0.99-1.02) to have the viral pathogens detected in their stool. A 10% longer period of full breastfeeding from birth was associated with later first detection of the 3 E. coli, Campylobacter, adenovirus, astrovirus, and rotavirus (mean HRs of 0.52-0.75). The hazards declined and point estimates were not statistically significant at 3 mo. In this large multicenter cohort study, full breastfeeding was associated with lower likelihood of detecting 4 important enteric pathogens in the first 6 mo of life. These results also show that full breastfeeding is related to delays in the first detection of some bacterial and viral pathogens in the stool. As several of these pathogens are risk factors for poor growth during childhood, this work underscores the importance of exclusive or full breastfeeding during the first 6 mo of life to optimize early health.
Sections du résumé
BACKGROUND
Breastfeeding is known to reduce the risk of enteropathogen infections, but protection from specific enteropathogens is not well characterized.
OBJECTIVE
The aim was to estimate the association between full breastfeeding (days fed breast milk exclusively or with nonnutritive liquids) and enteropathogen detection.
METHODS
A total of 2145 newborns were enrolled at 8 sites, of whom 1712 had breastfeeding and key enteropathogen data through 6 mo. We focused on 11 enteropathogens: adenovirus 40/41, norovirus, sapovirus, astrovirus, and rotavirus, enterotoxigenic Escherichia coli (ETEC), Campylobacter spp., and typical enteropathogenic E. coli as well as entero-aggregative E. coli, Shigella and Cryptosporidium. Logistic regression was used to estimate the risk of enteropathogen detection in stools and survival analysis was used to estimate the timing of first detection of an enteropathogen.
RESULTS
Infants with 10% more days of full breastfeeding within the preceding 30 d of a stool sample were less likely to have the 3 E. coli and Campylobacter spp. detected in their stool (mean odds: 0.92-0.99) but equally likely (0.99-1.02) to have the viral pathogens detected in their stool. A 10% longer period of full breastfeeding from birth was associated with later first detection of the 3 E. coli, Campylobacter, adenovirus, astrovirus, and rotavirus (mean HRs of 0.52-0.75). The hazards declined and point estimates were not statistically significant at 3 mo.
CONCLUSIONS
In this large multicenter cohort study, full breastfeeding was associated with lower likelihood of detecting 4 important enteric pathogens in the first 6 mo of life. These results also show that full breastfeeding is related to delays in the first detection of some bacterial and viral pathogens in the stool. As several of these pathogens are risk factors for poor growth during childhood, this work underscores the importance of exclusive or full breastfeeding during the first 6 mo of life to optimize early health.
Identifiants
pubmed: 34849524
pii: S0002-9165(22)00193-9
doi: 10.1093/ajcn/nqab391
pmc: PMC8895209
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
759-769Investigateurs
Angel Mendez Acosta
(AM)
Rosa Rios de Burga
(RR)
Cesar Banda Chavez
(CB)
Julian Torres Flores
(JT)
Maribel Paredes Olotegui
(MP)
Silvia Rengifo Pinedo
(SR)
Mery Siguas Salas
(MS)
Dixner Rengifo Trigoso
(DR)
Angel Orbe Vasquez
(AO)
Imran Ahmed
(I)
Didar Alam
(D)
Asad Ali
(A)
Zulfiqar A Bhutta
(ZA)
Shahida Qureshi
(S)
Muneera Rasheed
(M)
Sajid Soofi
(S)
Ali Turab
(A)
Aisha Yousafzai
(A)
Anita K M Zaidi
(AKM)
Ladaporn Bodhidatta
(L)
Geetha Ammu
(G)
Sudhir Babji
(S)
Anuradha Bose
(A)
Ajila T George
(AT)
Dinesh Hariraju
(D)
M Steffi Jennifer
(MS)
Sushil John
(S)
Shiny Kaki
(S)
Gagandeep Kang
(G)
Priyadarshani Karunakaran
(P)
Beena Koshy
(B)
Robin P Lazarus
(RP)
Jayaprakash Muliyil
(J)
Preethi Ragasudha
(P)
Mohan Venkata Raghava
(MV)
Sophy Raju
(S)
Anup Ramachandran
(A)
Rakhi Ramadas
(R)
Karthikeyan Ramanujam
(K)
Anuradha Rose
(A)
Reeba Roshan
(R)
Srujan L Sharma
(SL)
Shanmuga Sundaram E
(SS)
Rahul J Thomas
(RJ)
William K Pan
(WK)
Ramya Ambikapathi
(R)
J Daniel Carreon
(JD)
Viyada Doan
(V)
Christel Hoest
(C)
Stacey Knobler
(S)
Benjamin J J McCormick
(BJJ)
Monica McGrath
(M)
Mark A Miller
(MA)
Stephanie Psaki
(S)
Zeba Rasmussen
(Z)
Stephanie A Richard
(SA)
Jessica C Seidman
(JC)
Michael Gottlieb
(M)
Dennis R Lang
(DR)
Karen H Tountas
(KH)
Erling Svensen
(E)
Caroline Amour
(C)
Eliwaza Bayyo
(E)
Estomih R Mduma
(ER)
Regisiana Mvungi
(R)
Rosemary Nshama
(R)
John Pascal
(J)
Buliga Mujaga Swema
(BM)
Ladislaus Yarrot
(L)
Carl J Mason
(CJ)
Tahmeed Ahmed
(T)
A M Shamsir Ahmed
(AMS)
Md Ashraful Alam
(MA)
Rashidul Haque
(R)
Umma Haque
(U)
Md Iqbal Hossain
(MI)
Munirul Islam
(M)
Mustafa Mahfuz
(M)
Dinesh Mondal
(D)
Baitun Nahar
(B)
Fahmida Tofail
(F)
Ram Krishna Chandyo
(RK)
Prakash Sunder Shrestha
(PS)
Rita Shrestha
(R)
Manjeswori Ulak
(M)
Aubrey Bauck
(A)
Robert E Black
(RE)
Laura E Caulfield
(LE)
William Checkley
(W)
Margaret N Kosek
(MN)
Gwenyth O Lee
(GO)
Kerry Schulze
(K)
Pablo Peñataro Yori
(PP)
Laura E Murray-Kolb
(LE)
A Catharine Ross
(AC)
Barbara Schaefer
(B)
Suzanne Simons
(S)
Laura Pendergast
(L)
Cláudia B Abreu
(CB)
Hilda Costa
(H)
Alessandra Di Moura
(AD)
José Quirino Filho
(JQ)
Alexandre Havt
(A)
Álvaro M Leite
(ÁM)
Aldo A M Lima
(AAM)
Noélia L Lima
(NL)
Ila F Lima
(IF)
Bruna L L Maciel
(BLL)
Pedro H Q S Medeiros
(PHQS)
Milena Moraes
(M)
Francisco S Mota
(FS)
Reinaldo B Oriá
(RB)
Josiane Quetz
(J)
Alberto M Soares
(AM)
Rosa M S Mota
(RMS)
Crystal L Patil
(CL)
Pascal Bessong
(P)
Cloupas Mahopo
(C)
Angelina Maphula
(A)
Emanuel Nyathi
(E)
Amidou Samie
(A)
Leah Barrett
(L)
Rebecca Dillingham
(R)
Jean Gratz
(J)
Richard L Guerrant
(RL)
Eric Houpt
(E)
William A Petri
(WA)
James Platts-Mills
(J)
Elizabeth Rogawski
(E)
Rebecca Scharf
(R)
Elizabeth T Rogawski
(ET)
Binob Shrestha
(B)
Bishnu Bahadur Rayamajhi
(BB)
Sanjaya Kumar Shrestha
(SK)
Tor Strand
(T)
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.
Références
Br Med J. 1972 Jan 8;1(5792):69-75
pubmed: 4550126
Pediatrics. 2010 Jul;126(1):e18-25
pubmed: 20566605
J Infect Dis. 2017 Aug 1;216(3):305-316
pubmed: 28472348
Clin Infect Dis. 2014 Nov 1;59 Suppl 4:S255-60
pubmed: 25305295
Lancet Glob Health. 2018 Dec;6(12):e1309-e1318
pubmed: 30287127
PLoS Negl Trop Dis. 2017 Jul 24;11(7):e0005798
pubmed: 28742106
Proc Natl Acad Sci U S A. 2014 Feb 25;111(8):3074-9
pubmed: 24569806
BMJ Glob Health. 2017 Dec 28;2(4):e000370
pubmed: 29333282
Clin Infect Dis. 2016 Nov 1;63(9):1171-1179
pubmed: 27501842
Int J Environ Res Public Health. 2020 Nov 02;17(21):
pubmed: 33147841
N Engl J Med. 1983 Jun 9;308(23):1389-92
pubmed: 6843632
Br J Nutr. 2013 Jan;109 Suppl 2:S63-9
pubmed: 23360882
Clin Infect Dis. 2014 Nov 1;59 Suppl 4:S248-54
pubmed: 25305294
Stud Fam Plann. 1990 Jul-Aug;21(4):226-30
pubmed: 2219227
Clin Infect Dis. 2020 Aug 14;71(4):989-999
pubmed: 31773127
Am J Trop Med Hyg. 2018 Mar;98(3):904-912
pubmed: 29380724
Clin Infect Dis. 2014 Nov 1;59 Suppl 4:S220-4
pubmed: 25305290
J Clin Microbiol. 2016 Jun;54(6):1598-1604
pubmed: 27076657
Matern Child Nutr. 2016 Oct;12(4):740-56
pubmed: 27500709
BMC Public Health. 2011 Apr 13;11 Suppl 3:S15
pubmed: 21501432
PLoS One. 2016 Jun 23;11(6):e0158199
pubmed: 27336160
Clin Infect Dis. 2013 Apr;56(7):988-92
pubmed: 23243179
Breastfeed Med. 2013 Aug;8(4):354-62
pubmed: 23697737
Popul Health Metr. 2014 Mar 21;12(1):8
pubmed: 24656134
Acta Paediatr. 2015 Dec;104(467):3-13
pubmed: 26249674
J Pediatr. 1990 May;116(5):707-13
pubmed: 2329419
J Health Popul Nutr. 2015 May 01;34:10
pubmed: 26825923
Clin Infect Dis. 2014 Feb;58(4):483-91
pubmed: 24300042
BMJ Glob Health. 2018 Jul 23;3(4):e000752
pubmed: 30058645
J Nutr. 2005 May;135(5):1304-7
pubmed: 15867329
Nature. 2020 May;581(7809):470-474
pubmed: 32461640
Clin Infect Dis. 2018 Nov 13;67(11):1660-1669
pubmed: 29701852
Pediatrics. 1993 Nov;92(5):680-5
pubmed: 8414854
Nestle Nutr Inst Workshop Ser. 2020;94:86-93
pubmed: 32200373
Lancet. 2016 Jan 30;387(10017):475-90
pubmed: 26869575
JAMA Pediatr. 2017 Jul 1;171(7):647-654
pubmed: 28492938
Nutrients. 2020 Mar 20;12(3):
pubmed: 32244880
Lancet Glob Health. 2015 Sep;3(9):e564-75
pubmed: 26202075
BMC Med. 2020 Dec 15;18(1):392
pubmed: 33317529
J Pediatr Gastroenterol Nutr. 2014 Feb;58(2):165-8
pubmed: 24048169
Br J Nutr. 2012 Nov 28;108(10):1839-46
pubmed: 22264879
J Pediatric Infect Dis Soc. 2017 Jun 1;6(2):153-160
pubmed: 28204556
Lancet. 1998 Apr 18;351(9110):1160-4
pubmed: 9643686
J Infect Dis. 2020 Nov 9;222(11):1858-1868
pubmed: 31984416
Pediatr Clin North Am. 2013 Feb;60(1):49-74
pubmed: 23178060
Gut. 2002 Nov;51(5):748-54
pubmed: 12377819
Clin Lab. 2007;53(3-4):125-8
pubmed: 17447646
Lancet Infect Dis. 2014 Aug;14(8):716-724
pubmed: 25022434