Breastfeeding status and duration and infections, hospitalizations for infections, and antibiotic use in the first two years of life in the ELFE cohort

Abstract

In low- and middle-income countries, the protective effect of breastfeeding against infections is well established, but in high-income countries, the effect could be weakened by higher hygienic conditions. We aimed to examine the association between breastfeeding and infections in the first2 years of life, in a high-income country with relatively short breastfeeding duration. Among 10,349 young children from the nationwide Etude Longitudinale Francaise depuis lífEnfance (ELFE) birth cohort, breastfeeding and parent-reported hospitalizations, bronchiolitis and otitis events, and antibiotic use were prospectively collected up to 2 years. Never-breastfed infants were used as reference group. Any breastfeeding for ≥3 months was associated with higher risks of hospitalizations from gastrointestinal infctions or fever. Predominant breastfeeding for 1 month was associated with higher risk of a single hospital admission while predominant breastfeeding for.3 months was associated with a lower risk of long duration ≥4 nights)of hospitalization. Ever breastfeeding was associated with lower risk of antibiotic use. This study confirmed the well-known associations between breastfeeding and hospitalizations but also highlighted a strong inverse association between breastfeeding and antibiotic use. Although we cannot infer causality from this observational study, this finding is worth highlighting in a context of rising concern regarding antibiotic resistance.