Breastfeeding pattern and the risk of neonatal illnesses among urban poor in Lucknow, Northern India: A prospective follow-up study

Abstract

Background: Exclusive breastfeeding has been shown to be protective against infants’ illnesses. Evidence is sparse about the association of different breastfeeding patterns on neonatal illnesses. Methods The study was conducted at two urban public hospitals at Lucknow. Neonates who did not have any morbidity or congenital malformation and were residents of Lucknow were enrolled within 48 h of birth and followed up once at 6 weeks of age, at the outpatients clinic or home to assess neonatal illnesses and established (voluntary) breastfeeding pattern (exclusive, predominant, partial, never breastfed). Association of established breastfeeding patterns with neonatal illnesses was studied using multivariate logistic regression, adjusting for potential confounders. Results A total of 1020 neonates were enrolled. Follow-up information on occurrence of neonatal illnesses (if any) as well as established breastfeeding pattern was available for 937 (91.8%) enrolled neonates. Among these, 46% (431/937) presented with any illness, with 20.2% (189/937) reported with at least one danger sign of severe illnesses as mentioned in Integrated Management of Neonatal and Childhood Illnesses (IMNCI). Partially breastfed neonates were significantly more likely to develop any illness (Adj. OR = 6.6; 95% CI: 4.0–10.8, p < 0.001) as well as IMNCI illnesses (Adj. OR = 5.8; 95% CI: 2.9–11.8, p < 0.001) as compared to exclusively breastfed neonates. Similarly, predominantly breastfed neonates were also significantly more likely to develop any illness (Adj. OR = 3.4; 95% CI: 2.0–5.8, p < 0.001) as well as IMNCI illnesses (Adj. OR = 2.9; 95% CI: 1.3–6.4, p < 0.01) as compared to exclusively breastfed neonates. The strength and consistency of these associations remained similar on refitting the model with term, singleton, and normal birth weight neonates. Conclusions: Exclusive breastfeeding during the neonatal period was significantly protective against the occurrence of any illness as well as illnesses mentioned in the IMNCI program, as compared to predominant or partial breastfeeding.