Infant Feeding, Lower Respiratory Infection and Child Physical Growth:
Comparative Study
Nuhad Mohammed Aldoori
1,Mahdi Saleh hadi
2, Ehsan F. Hussein
3, Bassam Ibraheem
4, Hatem.K Mansour
5, Hashem Yassin Jawad
6, P. Saranraj
71. Ph.D. in nursing, assistant Prof., Pediatric Health Nursing, College of Nursing, University of Babylon. Email: [email protected]
2. Nursing Department, Al-Mustaqbal Uneversity College.
Email: [email protected]
3. University of Sumer, College of Science, Department of Pathological Analyses, Iraq.
Email address: [email protected]
4. Pediatrician( C.A.B.P) in Ministry of Health and Environment at Babylon health directorate, Province Babylon, Iraq Email: [email protected] 5. MSC in Nursing, Clinical nurse specialist in Ministry of Health and Environment at
Babylon health directorate, Province Babylon, Iraq Email:
6. Register nurse in Ministry of Health and Environment at Babylon health directorate, Province Babylon, Iraq Email: [email protected]
7. Department of Microbiology, Sacred Heart College (Autonomous), Tirupattur, Tamil Nadu, India, [email protected]
Abstract
Background: Breast milk contains factors such as lymphocytes, neutrophils, cytokines, and antibodies that actively promote and activate the infant's immune system while also facilitating growth, immunity, and the proper immune response.
Aims: To compare between types of feeding during infancy in relation to lower respiratory infection, and physical growth during first year.
Method : This study was conducted through a convenience sampling on (50) hospitalized child with lower chest infection.
Results: There is about 74% of children with lower respiratory infection take artificial feeding and about 90.3% of them infected with pneumonia and fifth 20% of sample’s BMI with in 85th percentile. The result show that a significant differences between type of feeding in relation to lower respiratory infection, while there is no significant differences between type of feeding in relation to physical growth..
Conclusion: Children who take breast feeding have less incidence of lower respiratory infection in relation to those who take artificial feeding (bottle feeding) as they having a large incidence of lower respiratory infection , and there is a significance differences between them. In addition, the large percentage of those who take bottle feeding with in normal range of MBI percentile and there is no significance differences between groups in relation to physical growth.
Recommendations: There is a need to increase and development of educational training
Keyword: type of feeding, infancy, physical growth, lower respiratory infection
Introduction
The World Health Organization (WHO) advises that babies be breastfed completely before they reach the age of six months, and then supplemented with breast milk for up to two years or longer.(Frank et al., 2019).
Breastfeeding is definitely a significant public health concern because it offers important immunity from diseases in newborns and children. Breast feeding has been used to safeguard from infections so effectively in developed countries that it is estimated that increasing breast feeding by 40percent globally would decrease respiratory infection deaths by 50percent in children under the age of two years. In the developed world, breast feeding is associated with reduced rates of morbidity and mortality. (Rubin et al., 2019).
Breast milk contains factors such as lymphocytes, neutrophils, cytokines, and antibodies that actively promote and activate the infant's immune system while also facilitating growth, immunity, and the proper immune response.(Fisk et al., 2011).
Infections of the respiratory tract are a leading cause of morbidity in infants. In the first year of childhood, research in developed countries indicate a prevalence of respiratory tract infections ranging from 3.4 to 32.1 percent. In children under the age of five, respiratory tract infections are a frequent cause of hospitalization. Breastfeeding has been shown to safeguard children living in developed countries from respiratory infections on several instances. Most research find that breastfeeding protects against respiratory infections over time, as effects are mostly assessed at six months , or even at 1, 2, or six years, suggesting that the preventive effect continues even after breastfeeding is discontinued. (Pandolfi et al., 2019).
Formula-fed infants are more likely than breastfed infants to gain excess or rapid weight, and this increased risk in formula-fed infant populations could be due to a variety of mechanisms. Excess or rapid weight gain within the first two years of life is linked to a higher risk of childhood and adult overweight and obesity later in life. The nutritional content of the formula, as well as the way it is prepared and given to babies, are examples of these processes. There are several possible best practice formula feeding tips that can minimize excess or rapid weight gain, such as using reduced protein formula, not adding cereals to bottle, not placing a baby to bed with a bottle, and not over feeding formula. (Appleton et al., 2018).
Despite the reported short- and long-term health benefits of breastfeeding, only 37percent of children under the age of six months are breastfed in low- and middle-income countries, and much less regularly or for a shorter period of time in high-income countries. (Zaqout et al., 2016).
2. Methodology
2.1Ethical considerations
Permission has been obtained from Babylon health directorate.
Design ,setting, sampling of study and data collection
A Descriptive-comparative study which conducted to compare between types of feeding during infancy in relation to lower respiratory infection, and physical growth during first year.
The study Initiated from (3rd November , 2020 –10th February, 2021). The study carried out in the Babylon province, held on 50 hospitalized children infected with lower respiratory infection selected by convenience sampling from two hospital randomly by convenience sampling in order to collecting data by using a modified tool.
Instrument of study
The researchers were developing a questionnaire that consist of demographical data, head circumference, chest circumference height, weight, type of feeding during infancy, types of antibiotics.
Statistical Analysis
The data analysis of this study is analyzed through using the Statistical Package of Social Sciences (SPSS) version (24). The following statistical data analysis approaches were used in order to analyze data and assess the results of the study. The researchers used descriptive and inferential data analysis to obtain results.
3. Result and discussion
Table 1:Distribution of the Study Sample by their demographic data (N =50)
Demographical data
Ranking And Intervals Frequency Percentage %
Age/ month 1-3 18 35.5
4-6 15 29.0
7-9 6 12.9
10-12 11 22.6
Total 50 100
Gender Male 26 52
Female 24 48
Total 50 100
Mother’s age / year 17-22 23 45.2
23-27 16 32.3
28-32 11 22.6
Total 50 100
Occupation Employee 2 3.2
Housewife 48 96.8
Total 50 100
3.20%
6.50%
Pneumonia Bronchitis Bronchiolitis
90.30%
Moderate 21 42
Good 6 12
Total 50 100
Type of feeding Breast feeding 3 6
Bottle feeding 37 74
Mix feeding 10 20
Total 50 100
Table 1 showed that most of sample 35.5 % were between (1-3) month, this result disagree with the study conducted in Southampton by (Fisk et al., 2011), which indicate that most child age were > 6month and agree with the same study result regarding child gender which indicate that most 53 %study sample were male. Regarding mother’s age, higher percentage 45.2% were between (17-22), this result disagree with study that carried out in Bangladesh by (Mihrshahi et al., 2018), to study the Association between infant feeding patterns and diarrhea and respiratory illness
Table 1 revealed that 74% of child were bottle feeding, this result disagree with the study conducted in Copenhagen by (Munir et al., 2016), which show that higher percentage 70% of child in second month were breast feeding.
Figure1. medical diagnosis of sample
Figure.1 show that 90.3% of hospitalized child were diagnosed with pneumonia, this due to the severity of this disease and the need for hospitalization.
Antibiotic
54.80%
22.60%
12.90% 16.10% 19.40%
3.20%
Table 2. Distribution of sample’s physical growth
Physical growth measurements
Ranking And Intervals Frequency Percentage %
MBI percentile less than 3rd percentile 9 18
3rd percentile 3 6
15th percentile 8 16
50th percentile 9 18
85th percentile 10 20
97th percentile 5 10
More than 97th percentile 6 12
Total 50 100
Head circumference percentile
Under normal height 13 25.8
2-10 percentile 14 29
25-75 percentile 21 41.9
Over normal 2 3.2
Total 50 100
Chest circumference Under normal 11 22.6
Normal 32 64.5
Over normal 7 12.9
Total 50 100
Table 2 explore that one fifth of child MBI percentile were 85th percentile, this result agree with the study conducted in United States between May 2005 and June 2007 by (Ruowei Li et al., 2014), to study (Risk of Bottle-feeding for Rapid Weight Gain During the First Year of Life) which revealed that 45.97 % with in normal BMI.
64.50%
Pneumonia Bronchitis
19.40%
Bronchiolitis 6.50%
0% 0% 3.20% 6.50%
0% 0%
Figure.2 showed that 54.8% of antibiotic that used in the treatment of lower respiratory infection was ceftriaxone, this due to the wide spread of antimicrobial coverage of this drug.
Table 3. differences between type of feeding in relation to lower respiratory infection(N=50).
Type of feeding Diagnosis p-value*
Pneumonia Bronchitis Bronchiolitis
Breast feeding 7.1% 0% 0% 0.042
Bottle feeding 71.4% 100% 100%
Mix feeding 21.4% 0% 0%
Total 100% 100% 100%
*ANOVA
Table 4 show that more than two 71.4% of hospitalized children with pneumonia were bottle feeding, while all children who infected with bronchitis and bronchiolitis take artificial feeding (bottle feeding) and there is a significant differences between type of feeding in relation to lower respiratory infection at p-value <= 0.05.
Mixing Bottle feeding Breast feeding
Pneumonia 19.40% 64.50% 6.50%
Bronchitis 0% 3.20% 0%
Bronchiolitis 0% 6.50% 0%
Figure3. Distribution of type of feeding in relation to lower respiratory infection.
Figure 3 show that two third 65.5% of children with bottle feeding infected with pneumonia and just 6.5% of children with breast feeding infected with pneumonia, this due to weak immunity of children who take artificial feeding compared with breast feeding, and this result agree with the study that carried out in Bangladesh by (Mihrshahi et al., 2018) to study (Association between infant feeding patterns and diarrhoeal and respiratory illness) which find that about 75% of non- exclusively breastfed children infected with acute respiratory infection.
Table 4. differences between type of feeding in relation to physical growth(N=50).
MBI percentile Type of feeding p-value*
Breast feeding Bottle feeding Mix feeding
Less than 3rd percentile 0% 24.4% 0% 0.627
3rd- 97th percentile 100% 58.6% 100%
More than 97th percentile 0% 16.2% 0%
Total 100% 100% 100%
*ANOVA
Table 5 explore that all children who take breast feeding mix feeding with in normal weight (3rd- 97th percentile) and more than fifth of children who take bottle feeding with in normal weight, related to significancy, there is no differences between type of feeding in relation to physical growth, this result agree with the result of study that carried out by (Zasada et al., 2019) under title of (Does type of feeding affect body composition in very low birth weight infants) which state that no difference in body weight or length between any of the three studied groups.
4. Conclusion
The researchers conclude that children who take breast feeding have less incidence of lower respiratory infection in relation to those who take artificial feeding (bottle feeding) as they having a large incidence of lower respiratory infection , and there is a significance differences between them. In addition, the large percentage of those who take bottle feeding with in normal range of MBI percentile and there is no significance differences between groups in relation to physical growth.
5- Recommendations:
According to the conclusion of the current study, the researchers recommended the following 1- The results of the study point toward the important of breast feeding during the first 6
months of life, so there is a need to increase and development of educational training courses, seminars and workshop that held by governmental and non-governmental agencies.
2- Due to the lack in such researches in Iraq, further studies will be required to improve breast feeding through the infancy period.
6- References
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