Article

King George's Medical University

Breastfeeding pattern and the risk of neonatal illnesses among urban poor in Lucknow, northern India: a prospective follow-up study

N.M. Srivastava, S. Awasthi

Clinical Epidemiology and Global Health

Abstract

Background: Exclusive breastfeeding has been shown to be protective against infants’ illnesses. Evidence is sparse about the association of different breastfeeding patterns on neonatal illnesses.
Methods: The study was conducted at two urban public-hospitals at Lucknow. Neonates were enrolled within 48 hours of birth and followed-up once at six weeks at the outpatients’ clinic or home to assess neonatal illnesses and voluntary breastfeeding pattern. Association of established breastfeeding patterns with neonatal illnesses was studied using multivariate logistic regression, adjusting for potential confounders. Results: 1020 neonates were enrolled from March 2007-April 2008. Among those followed-up (n=937), 46% presented with any illness, with 20.2% reported with at least one Integrated Management of Neonatal and Childhood Illnesses (IMNCI) danger sign of severe illness. Partially breastfed neonates were significantly more likely to develop any illness (Adj. OR= 7.3; 95% CI= 4.4 to 12.0, p< 0.001) as well as IMNCI illnesses (Adj. OR = 6.4; 95% CI= 3.1 to 13.1, p< 0.001) as compared to exclusively breastfed. Similarly, predominantly breastfed neonates were significantly more likely to develop any illness (Adj. OR= 3.4; 95% CI: 2.0 to 5.9, p< 0.001) as well as IMNCI illnesses (Adj. OR= 2.7; 95% CI= 1.1 to 6.2, p=0.02) as compared to exclusively breastfed. The strength and consistency of these associations remained similar on refitting the model with term, singleton, and normal birth weight neonates.
Conclusion: Exclusive breastfeeding during neonatal period was significantly protective against any illness as well as illnesses mentioned in the IMNCI program, as compared to predominant or partial breastfeeding.

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