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Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/kjp.2019.00402    [Accepted]
Published online November 12, 2019.
Positive Association of Breastfeeding on Respiratory Syncytial Virus Infection in Hospitalized Infants: A Multicenter Retrospective Study
Min Jeong Jang1, Yong Joo Kim2, Shinhye Hong2, Jaeyoon Na2, Jong Hee Hwang3, Son Moon Shin4, Young Min Ahn1 
1Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
2Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea
3Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea
4Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea
Correspondence: 
Young Min Ahn, Tel: +82-2-970-8221, Fax: +82-2-972-0068, Email: aym3216@eulji.ac.kr
Received: 30 April 2019   • Revised: 4 November 2019   • Accepted: 11 November 2019
Abstract
Background
Breastfeeding is reported to reduce the overall frequency of infections. Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and associated with recurrent wheezing which pathogenic mechanism is related to the airway structural damage.
Purpose
The aim of this study is to investigate whether breastfeeding has a beneficial effect against RSV-induced respiratory infection compared to formula feeding among infants in Korea.
Methods
We retrospectively reviewed the medical records of infants under 1 year of age who were admitted due to RSV infection between January 2016 and February 2018 at the department of pediatrics of four hospitals. We investigated the differences in clinical parameters such as cyanosis, chest retraction, and combined infection, duration of fever, oxygen use, duration of oxygen therapy, intensive care unit (ICU) admission, and corticosteroid treatment according to three groups of feeding patterns: exclusive breast milk feeding (BMF), artificial milk formula fed (AMF) and mixed feeding infants (MF).
Results
Among 411 infants included in our study, BMF, MF and AMF group were 94, 161 and 156 infants respectively. The rate of infants underwent oxygen therapy was significantly different among BMF (4.3%), MF (8.1%), and AMF (13.5%) groups (P = 0.042). The odds ratios (ORs) for oxygen therapy is significantly higher in AMF group than BMF group (adjusted OR: 3.807 with 95% CI (1.22, 11.90), P = 0.021). The ICU admission rate in the BMF group (1.1%) was observed to be lower than that in the MF group (3.5%) and AMF group (4.5%); however, the dissimilarity was not statistically significant (P = 0.338).
Conclusion
The severity of RSV infection required for oxygen therapy is less in BMF than in AMF group. This protective role of human milk on RSV infection might decrease the risk of oxygen application.
Key Words: Breast feeding, Respiratory Syncytial Virus infection, Infant




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