Relation of breast versus bottle feeding to hospitalization for gastroenteritis in a middle-class U.S. population

Abstract

In an effort to determine the relation of breast versus bottle feeding to hospitalization for gastroenteritis, children hospitalized for gastroenteritis at the Kaiser-Permanente Medical Center in California were compared with a larger normal population of children discharged from the Center's nursery, for incidence of breast feeding. All infants under 12 months of age admitted to the hospital with acute gastroenteritis between January 1, 1973 and December 31, 1975 were identified. All infants had an acute onset of diarrhea and weight loss, some with vomiting. Variable degrees of clinical dehydration also occurred. 107 infants were admitted during the period of study. The type of feeding--breast or bottle--was obtained from the patients' admission history, nursery records, outpatient clinic charts, or by direct contact with parents. Of the 197 patients admitted with acute gastroenteritis during the study period, only 1 was being breast fed at the time of admission. 40 infants were under 6 months of age. Breast feeding accounted for 28 percent of the infant-months in the 0-6 month age group. The lower than predicted incidence of acute gastroenteritis in the breast fed infants was statistically significant. Although about 1/3 of the bottle fed infants had started breast feeding at birth, all had been switched to the bottle at least 1 month prior to hospitalization. The study data strongly indicate that breast feeding plays a major role in protection against intestinal infections.