Breast-feeding and infant illness: A dose-response relationship?

Objectives. The purpose of this study was to determine whether breastfeeding has a dose-related protective effect against illness and whether it confers special health benefits to poor infants. Methods. The association between breast-feeding dose and illnesses in the first 6 months of life was analyzed with generalized estimating equations regression for 7092 infants from the National Maternal and Infant Health Survey. Breast-feeding dose (ratio of breast-feedings to other feedings) was categorized as full, most, equal, less, or no breast-feeding. Results. Compared with no breastfeeding, full breast-feeding infants had lower odds ratios of diarrhea, cough or wheeze, and vomiting and lower mean ratios of illness months and sick baby medical visits. Most breast-feeding infants had lower odds ratios of diarrhea and cough or wheeze, and equal breast-feeding infants had lower odds ratios of cough or wheeze. Full, most, and equal breast-feeding infants without siblings had lower odds ratios of ear infections and certain other illnesses, but those with siblings did not. Less breast-feeding infants had no reduced odds ratios of illness. Findings did not vary by income. Conclusions. Full breast-feeding was associated with the lowest illness rates. Minimal (less) breast-feeding was not protective. Breast-feeding conferred similar health benefits in all economic groups.