Abstract

MACIAS-CARRILLO, Claudia et al. Breast feeding and the incidence of acute diarrhea during the first three months of life. Salud pública Méx [online]. 2005, vol.47, n.1, pp.49-57. ISSN 0036-3634.

OBJECTIVE: To assess the effect of exclusive breastfeeding and its interactions with selected socioeconomic factors, on the incidence of acute infantile diarrhea during the first three months of life. MATERIAL AND METHODS: A prospective cohort study with a follow up of three months was conducted in 327 mother and child pairs, living in the city of Durango, Mexico, between April and June 1994. Data analyses included simple univariate and bivariate cross-tabulations, as well as multivariate logistic regression models with random effects. RESULTS: Infants who were not exclusively breastfed were at a significantly increased risk of having acute diarrhea during early infancy (OR_{combined breastfeeding}= 3.23; 95% CI 1.84-5.68 and OR_{artificial breastfeeding}=4.36; 95% CI 2.32-8.19). Moreover, the protective effect of breastfeeding was independent from the effects of the following factors: poor maternal education, lack of social support for baby care, and being an adolescent mother. However, lack of potable water and lack of sewerage were potential effect modifiers of type of lactation DG=9.26; p=0.09; OR_{no water/no sewerage}= 2.58; 95% CI 1.10-6.03 in the final multivariate model), for simultaneous lack of potable water and sewerage, which is greater than the sum of the individual OR for each variable. CONCLUSIONS: Similar to previous studies, exclusive breastfeeding was found to have great importance, since this practice protects the child's health and allows for a better development, despite unfavorable social and economic conditions. In particular, it seems that the protection conferred by breastfeeding is stronger when home conditions are poor, but this same condition presents an intervention opportunity, particularly the assurance of potable water provision for the infant when breastfeeding is not an option.

Keywords : breast feeding; infant morbidity; acute diarrhea; sanitation epidemiology; Mexico.

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