Breastfeeding and risk of hospitalisation from respiratory or gastrointestinal illness in children from birth to two-years in Northern Ireland

IntroductionBreastfeeding can reduce infectious-disease related morbidity and mortality. This study sought to assess the association between hospitalisation from the most common childhood infections and breastfeeding in N.Ireland; having some of the lowest breastfeeding rates worldwide.MethodsA population-based retrospective cohort study was performed using aggregate data of live births, 2012 and 2015 in N.Ireland (n=98,979), followed-up for two years. Breastfeeding exposure was defined as ‘total’, ‘partial’ or ‘none’ and analysis at discharge, primary review, six weeks, three, six and 12-months. Outcomes of interest were hospital admission with respiratory-tract or gastrointestinal illness by two-years. Statistical analysis was conducted using R-Studio. Descriptive and univariate analysis reflected variables associated with the outcomes. Multivariable regression was used to assess and quantify the independent association of partial and total breastfeeding. ResultsBreastfeeding was associated with significantly reduced odds of hospitalisation from gastrointestinal or respiratory-tract illness in fully-adjusted models at least until the age of two, compared with not breastfeeding. Greatest reductions were associated with total breastfeeding and breastfeeding of increasing duration. Any breastfeeding at 12-months, was associated with the greatest reduction in odds of hospitalisation from gastrointestinal illness by age two (OR 0.71 (0.60-0.83), p < 0.001). Any breastfeeding at 12-months was similarly associated with significantly reduced odds of hospitalisation from respiratory-tract illness by age two (OR 0.75 (0.69-0.83), p<0.001).Partial breastfeeding of at least six weeks, was significantly associated with reduced odds of hospitalisation from both gastrointestinal (OR 0.79 (0.68-0.92), p = 0.002) and respiratory-tract illness (OR 0.89 (0.81-0.97, p = 0.009) in comparison with not breastfeeding, by the age of two, in fully adjusted models. In this study, younger mothers, more deprived, white ethnicity, unemployed, single-parents and with other children, were less likely to initiate breastfeeding.This study reaffirms the increased risk of harmful effects from suboptimal breastfeeding, even in developed countries.