Breastmilk Feeding during the First 4 to 6 Months of Age and Childhood Disease Burden until 10 Years of Age.

BACKGROUND: Breastfeeding is recommended due to its beneficial effects on human health. However, the effect of breastfeeding on health differs, resulting in various childhood diseases. OBJECTIVE: Our purpose was to investigate the association between breastfeeding at least in the first 4 months and the subsequent development of 15 certainly defined childhood diseases until 10 years of age, the all-cause hospitalization rate and growth at 6-7 years of age. METHODS: Participants included propensity-score matched 188,052 children born between January 2008 and December 2009, who were followed up till 10 years of age. Data were taken from the National Investigation of birth Cohort in Korea study 2008 database. Risk ratios were obtained using a modified Poisson regression and weighted risk differences using binomial regression. RESULTS: Compared to formula feeding, breastfeeding was associated with decreased risks of febrile convulsion, attention deficit hyperactivity disorder and autism spectrum disorder, pneumonia, acute bronchiolitis, hypertrophic pyloric stenosis, asthma, all-cause hospitalization, overweight/obesity and short stature. Exclusive breastfeeding at 4 to 6 months of age had similar results to exclusive breastfeeding over 6 months of age. CONCLUSIONS: Breastfeeding in early infancy reduces the risk for various childhood diseases, all-cause hospitalization rate, obesity, and short stature during childhood.

Does Maternal Omega 3 Supplementation Protect Against Infantile Hypertrophic Pyloric Stenosis?

OBJECTIVES: Infantile hypertrophic pyloric stenosis (IHPS) is potentially life threatening. The etiology of IHPS remains unknown and many risk factors have been reported. We aimed to assess the prevalence of known risk factors and investigate maternal nutrition and habits as possible additional risk factors for IHPS. METHODS: This case-control study includes mothers of infants diagnosed with IHPS and control mothers of infants, age 2 to 11 months, hospitalized in the pediatric department due to other conditions. Cases of IHPS were identified by review of all infants diagnosed with IHPS and operated upon in 2010 to 2016 at 2 major hospitals in central Israel. Data regarding potential risk factors were collected via questionnaires in both study groups. RESULTS: Sixty-six cases and 67 controls were included in the study. Maternal omega 3 supplement consumption during pregnancy was significantly less common among cases of IHPS as compared with controls (P = 0.031). Consumption of omega 3 supplement was defined as consumption of at least 1 to 2 per week during the pregnancy period. Following adjustment for known risk factors, including male sex and maternal smoking, maternal omega 3 supplement consumption remained associated with a significantly lower risk of developing IHPS (odds ratio = 0.303, 95% confidence interval 0.111-0.828, P = 0.02). CONCLUSIONS: Maternal omega 3 supplement consumption during pregnancy was associated with a significantly reduced risk of IHPS. Further studies are needed to support these results and investigate possible mechanisms of the effect of omega 3.

Perinatal risk factors for infantile hypertrophic pyloric stenosis: A meta-analysis.

BACKGROUND: Infantile hypertrophic pyloric stenosis (IHPS) is the most common surgical cause of nonbilious vomiting in infancy. The etiology of IHPS is not completely understood. Hence, we performed a meta-analysis to investigate the association between perinatal factors and IHPS onset. METHODS: The MEDLINE, EMBASE, PubMed and Cochrane Library databases were searched for studies published in English before December 2016. The combined odd ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models. RESULTS: Fifteen studies were included. Several perinatal factors, including first-born (OR 1.19, 95% CI: 1.07-1.33), cesarean section delivery (OR 1.63, 95% CI: 1.53-1.73), preterm birth (OR 1.37, 95% CI: 1.12-1.67), and bottle-feed (OR 2.46, 95% CI: 1.76-3.43), were significantly associated with the IHPS onset. Among these, bottle-feed was the most significantly risk factor for IHPS onset. Although few studies have evaluated the relationship between perinatal factors and IHPS, they have major limitations including retrospective collection of data on perinatal events and testing of multiple hypotheses without appropriate statistical corrections. CONCLUSIONS: First-born, cesarean section delivery, preterm birth, and bottle-feed are associated with the development of IHPS. Well-designed future studies are needed to help understand the etiology of IHPS. TYPE OF STUDY: Systematic reviews and meta-analyses. LEVEL OF EVIDENCE: Level III.

Cambios epidemiológicos y diagnósticos en la estenosis hipertrófica de píloro / Changes in epidemiology and diagnosis of hypertrophic pyloric stenosis

Introducción: La estenosis hipertrófica de píloro es una de las causas más frecuentes de vómitos en los lactantes, con una importante repercusión clínica y metabólica, y más acentuados según progresa el tiempo de evolución. El objetivo de este estudio es detectar los cambios en su evolución epidemiológica y diagnóstica a lo largo de una década. Pacientes y métodos: Estudio descriptivo y retrospectivo de 141 pacientes tratados en nuestro hospital entre 2000 y 2009, ambos años inclusive. Se recogieron diversas variables epidemiológicas, clínicas y analíticas, y se compararon dos periodos elegidos de forma aleatoria, 2000-2004 y 2005-2009, para detectar posibles cambios. Resultados: La incidencia del 1,92‰ de recién nacidos vivos se mantuvo estable en el tiempo, con una relación entre varones y mujeres de 6:1. No se observaron cambios en el porcentaje de pérdida de peso de los pacientes. Sin embargo, se detectó un descenso del 33% en la edad en el momento del diagnóstico, así como un aumento de los pacientes diagnosticados con menos de 5 días de evolución. La disminución de las medidas ecográficas correspondientes a la longitud y el espesor de la pared indican un descenso en el diagnóstico de píloros de gran tamaño y, por tanto, más evolucionados. En cuanto a los parámetros analíticos estudiados, sólo la creatinina presenta una disminución de sus valores. Conclusiones: El diagnóstico de la estenosis hipertrófica de píloro ha experimentado una cierta anticipación. Los pacientes se diagnostican a una edad y con un tiempo de evolución menores y, por tanto, presentan una menor alteración clínica y analítica. El diagnóstico ecográfico ha desplazado de forma significativa al diagnóstico clínico (AU)

Introduction: Hypertrophic pyloric stenosis is one of the most common causes of vomiting in infants with significant clinical and metabolic impact, more pronounced as time progresses. The objective of this study is to detect epidemiological changes and diagnostic development of hypertrophic pyloric stenosis, over a decade. Patients and methods: Retrospective descriptive study of 141 patients treated in our hospital between 2000 and 2009, inclusive. Several epidemiological, clinical and laboratory variables were collected and compared between two periods of time chosen at random to detect changes: 2000-2004 and 2005-2009. Results: The incidence of 1.92 ‰ live births, remained stable over time, with a male: female ratio of 6:1. There were also no changes in the porcentage of patient weight loss. However, we detected a decrease of 33% in the age of infants at the time of diagnosis as well as an increase of patients with less than 5 days lasting symptoms. The decrease of ultrasound measurements, lenght and wall thickness lead to a decline in the diagnosis of large and therefore more evolved pylori. As for the analytical parameters studied, we only appreciated a decrease in creatinine values. Conclusions: The diagnosis of hypertrophic pyloric stenosis has experienced an anticipation. Patients are diagnosed younger with less hypertrophied pylorus and therefore less clinical and laboratory alteration. Diagnosis has shifted significantly from clinical to the ultrasound one (AU)

Does exclusive breastfeeding confer protection against infantile hypertrophic pyloric stenosis? A 30-year experience in Benin City, Nigeria.

The incidence of infantile hypertrophic pyloric stenosis has steadily decreased in developing countries, and this study was designed to confirm this and establish any protection conferred by exclusive breastfeeding. A retrospective study was done between July 1978 and June 2008, at the University of Benin Teaching Hospital, Benin City, Nigeria. A total of 57 children aged between 2 and 6 weeks (mean 3.5 +/- 1.2 weeks) comprising of 49 males and 8 females with male female ratio 6.1 : 1 were treated. Following the introduction of exclusive breastfeeding in late 1980s and early 1990 s in Nigeria, a steady drop in incidence was noticed, with only five cases seen in the last decade and just one case seen in the past 5 years. All were babies who had artificial feeds, with none recorded among babies exclusively breastfed. This decrease in the incidence of infantile hypertrophic pyloric stenosis may have been due to exclusive breastfeeding.