Mothers’ Knowledge of Breastfeeding and Infant Feeding Types Affect Acute Respiratory Infections
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Keywords

Acute Respiratory Infections
Exclusive Breastfeeding
Feeding Practice
Mothers’ Knowledge

Abstract

Introduction: World Health Organization (WHO) recommends exclusive breastfeeding for new-borns until 6 months of age. However, exclusive breastfeeding in Indonesia only reached 52.3% in 2014 and 65.16% in 2018. It is known that administration of infant formula and non-formula supplements to infants aged less than 6 months increases the risk of Acute Respiratory Infections (ARIs). In addition, the high prevalence of ARIs in infants in Sleman Regency, Indonesia indicates the need of optimal early prevention. Therefore, we conducted this study to confirm that mothers’ knowledge of breastfeeding and infant feeding types affect the prevalence of Acute Respiratory Infections (ARIs).

Methods: Data were collected through questionnaires from 50 mothers with infants aged 7-12 months who had experienced ARIs in the last 3 months (case group) and 50 mothers with healthy infants (control group). Collected data were then analysed using Chi-Square, Logistic Regression, Lambda, and Somers’ D tests.

Results: The results showed that types of infant feeding are associated with the prevalence of ARIs. Non-breastfed infants were 14 times riskier to contract ARIs. Mothers’ knowledge of exclusive breastfeeding influence their preferences of feeding practice. However, their attitude towards breastfeeding did not appear to significantly affect their choices of feeding practice.

Conclusion: Exclusive breastfeeding during the first 6 months of an infant’s life can lower the prevalence of ARIs for when they are older. Mothers’ good knowledge of breastfeeding is associated with its practice.

https://doi.org/10.15167/2421-4248/jpmh2020.61.3.1499
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References

1. Departemen Kesehatan RI. Pedoman pemberantasan penyakit infeksi saluran pernafasan akut untuk penanggulangan pneumonia pada balita. Dirjen P2M dan PLP; 2004.
2. Bulla A, Hitze KL. Acute respiratory infections: a review. Bull World Health Organ. 1978;56(3):481-98. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2395579/.
3. World Health Organization (WHO). Infection prevention and control of epidemic-and pandemic-prone acute respiratory disease in health care. Geneva: WHO; 2017.
4. Hengsterman S, Mantaring JBV, Sobel HL, Borja VE, Basilio MD, Iellamo AD, Nyunt-U S. Formula feeding is associated with increased hospital admissions due to infections among infants younger than 6 months in Manila, Philippines. J Hum Lact. 2010;26(1):19-25. doi: 10.1177/0890334409344078.
5. Oyejide CD. Review of epidemiological risk factors affecting the pathogenesis of acute respiratory infections. Niger J Paediatr. 1988;15:1–9.
6. Kementerian Kesehatan RI. Riset Kesehatan Dasar: Riskesdas Dalam Angka Daerah Istimewa Yogyakarta Tahun 2013. Yogyakarta: Kementerian Kesehatan RI; 2013.
7. Islam F, Sarma R, Debroy A, Kar S, Pal R. Profiling acute respiratory tract infections in children from assam, India. J Glob Infect Dis. 2013;5(1):8-14. doi: 10.4103/0974-777X.107167.
8. Chen Y, Williams E, Kirk M. Risk factors for acute respiratory infections in the Australian community. PLoS One. 2014;9(7):1-8. doi: 10.1371/journal.pone.0101440.
9. Benediktsdóttir B. Upper airway infections in preschool children - frequency and risk factors. Scand J Prim Health Care. 1993;11(3):197–201. doi: 10.3109/02813439308994830.
10. Kementerian Kesehatan RI. Profil Kesehatan Indonesia Tahun 2014. Kementerian Kesehatan RI; 2014.
11. Ikatan Dokter Anak Indonesia. Makanan Terbaik untuk Bayi. Ikatan Dokter Anak Indonesia; 2006.
12. World Health Organization (WHO). Infant and Young Child Feeding. WHO International Nutrition. Geneva: WHO; 2009.
13. Wong DL, Hockenberry-Eaton M, Wilson D. Wong’s Essentials of Pediatric Nursing (6th ed.). St. Louis, Missouri: Mosby Year Book; 2000.
14. Berg RD. The indigenous gastrointestinal microflora. Trends Microbiol. 1996;4(11):430–5. doi: 10.1016/0966-842x(96)10057-3.
15. Gill N, Wlodarska M, Finlay BB. The future of mucosal immunology: studying an integrated system-wide organ. Nat Immunol. 2010;11(7):558–60. doi: 10.1038/ni0710-558.
16. Jakaitis BM, Denning PW. Human breast milk and the gastrointestinal innate immune system. Clin Perinatol. 2014;41(2):423-35. doi: 10.1016/j.clp.2014.02.011.
17. Garofalo R. Cytokines in human milk. J Pediatr. 2010;156(Suppl 2):S36–40. doi: 10.1016/j.jpeds.2009.11.019.
18. Goldman AS. The immune system of human milk: antimicrobial, antiinflammatory and immunomodulating properties. Pediatr Infect Dis J. 1993;12(8):664–71. doi: 10.1097/00006454-199308000-00008.
19. Lemeshow S, David J. Besar Sampel dalam Penelitian. Yogyakarta: Gadjah Mada University Press; 1997.
20. Mihrshahi S, Oddy WH, Peat JK, Kabir I. Association between infant feeding patterns and diarrhoeal an respiratory illness: A cohort study in Chittagong, Bangladesh. Int Breastfeed Jl. 2008; 3:28. doi: 10.1186/1746-4358-3-28.
21. Gorlanova O, Thalman S, Proietti E, Stern G, Latzin P, Kuhni C, Röösli M, Frey U. Effects of breastfeeding on respiratory symptoms in infancy. J Pediatr. 2016;174:111-7. doi: 10.1016/j.jpeds.2016.03.041.
22. Quigley MA, Carson C, Sacker A, Kelly Y. Exclusive breastfeeding duration and infant infection. Eur J Clin Nutr. 2016;70(12):1420-7. doi: 10.1038/ejcn.2016.135.
23. Bartick MC, Jegier BJ, Green BD, Schwarz EB, Reinhold AG, Stuebe AM. Disparities in breastfeeding: Impact on maternal and child health outcomes and costs. J Pediatr. 2017;181:49-55. doi: 10.1016/j.jpeds.2016.10.028.
24. Tromp I, Kiefte-de Jong J, Raat H, Jaddoe V, Franco O, Hofman A, de Jongste J, Moll H. Breastfeeding and the risk of respiratory tract infections after infancy: The Generation R Study. PloS One. 2017;12(2):e0172763. doi: 10.1371/journal.pone.0172763.
25. Wang J, Ramette A, Jurca M, Goutaki M, Beardsmore CS, Kuehni CE. Breastfeeding and respiratory tract infections during the first 2 years of life. ERJ Open Res. 2017;3(2):00143-2016. doi: 10.1183/23120541.00143-2016.
26. Al-Sharbatti SS, Aljumaa LI. Infant feeding patterns and risk of acute respiratory infections in Baghdad/Iraq. Ital J Public Health. 2012;9(3):1-9. doi: 10.2427/7534.
27. Ladomenou F, Moschandreas J, Kafatos A, Tselentis Y, Galanakis E. Protective effect of exclusive breastfeeding against infections during infancy: A prospective study. Arch Dis Child. 2010;95(12):04-08. doi: 10.1136/adc.2009.169912.
28. Lawrence RA, Lawrence RM. Breastfeeding: a guide for the medical professional (7th ed.). Philadelphia, Pennsylvania: Saunders; 2010.
29. Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am. 2013;60(1):49-74. doi: 10.1016/j.pcl.2012.10.002.
30. Gregory KE, Walker WA. Immunologic factors in human milk and disease prevention in the preterm infant. Curr Pediatr Rep. 2013;1(4). doi: 10.1007/s40124-013-0028-2.
31. Cacho NT, Lawrence RM. Innate Immunity and Breast Milk. Front Immunol. 2017;8:584. doi: 10.3389/fimmu.2017.00584.
32. Jarvinen KM, Suomalainen H. Leucocytes in human milk and lymphocyte subsets in cow’s milk-allergic infants. Pediatr Allergy Immunol. 2002;13(4):243–54. doi: 10.1034/j.1399-3038.2002.00087.x.
33. Ichikawa M, Sugita M, Takahashi M, Satomi M, Takeshita T, Araki T, Takahashi H. Breast milk macrophages spontaneously produce granulocyte-macrophage colony-stimulating factor and differentiate into dendritic cells in the presence of exogenous interleukin-4 alone. Immunol. 2003;108(2):189–95. doi: 10.1046/j.1365-2567.2003.01572.x.
34. Yagi Y, Watanabe E, Watari E, Shinya E, Satomi M, Takeshita T, Takahashi H. Inhibition of DC-SIGN-mediated transmission of human immunodeficiency virus type 1 by Toll-like receptor 3 signalling in breast milk macrophages. Immunol. 2010;130(4):597–607. doi: 10.1111/j.1365-2567.2010.03264.x.
35. Van de Perre P. Transfer of antibody via mother’s milk. Vaccine. 2003;21(24):3374–6. doi: 10.1016/s0264-410x(03)00336-0.
36. Agarwal S, Karmaus W, Davis S, Gangur V. Immune markers in breast milk and fetal and maternal body fluids: a systematic review of perinatal concentrations. J Hum Lact. 2011;27(2):171–186. doi: 10.1177/0890334410395761.
37. Castellote C, Casillas R, Ramirez-Santana C, Perez-Cano FJ, Castell M, Moretones MG, Lopez-Sabater MC, Franch A. Premature delivery influences the immunological composition of colostrum and transitional and mature human milk. J Nutr. 2011;141(6):1181–87. doi: 10.3945/jn.110.133652.
38. Peterson JA, Hamosh M, Scallan CD, Ceriani RL, Henderson TR, Mehta NR, Armand M, Hamosh P. Milk fat globule glycoproteins in human milk and in gastric aspirates of mother’s milk-fed preterm infants. Pediatr Res. 1998;44(4):499–506. doi: 10.1203/00006450-199810000-00006.
39. Sherman MP, Bennett SH, Hwang FF, Yu C. Neonatal small bowel epithelia: enhancing anti-bacterial defense with lactoferrin and Lactobacillus GG. Biometals. 2004;17(3):285–9. doi: 10.1023/b:biom.0000027706.51112.62.
40. Adamkin DH. Mother’s milk, feeding strategies, and lactoferrin to prevent necrotizing enterocolitis. J Parenter Enteral Nutr. 2012;36(1):25S-9S. doi: 10.1177/0148607111420158.
41. Loss G, Depner M, Ulfman LH, Neerven JV, Jose AJ, Genuneit J, Karvonen AM, Hyvärinen A, Kaulek V, Roduit C, Weber J, Lauener R, Pfefferle PI, Pekkanen J, Vaarala O, Dalphin JC, Riedler J, Braun-Fahrländer C, von Mutius E, Ege MJ; PASTURE study group. Consumption of unprocessed cow’s milk protects in from common respiratory infections. J Allergy Clin Immunol. 2015; 135(1): 56-62. doi: 10.1016/j.jaci.2014.08.044.
42. Institute of Medicine (US). Infant Formula: Evaluating the Safety of New Ingredients. Washington DC: National Academic Press; 2004.
43. Jackson AA. Feeding the normal infant, child and adolescent. Paed Nutr. 2014;43(2):127-31. doi: 10.1016/j.mpmed.2014.11.005.
44. Drewett R, Amatayakul K, Wongsawasdii L, Mangklabruks A, Ruckpaopunt S, Ruangyuttikarn C, Baum D, Imong S, Jackson D, Woolridge M. Nursing frequency and the energy intake from breast milk and supplementary food in a rural Thai population: a longitudinal study. Eur J Clin Nutr. 1993;47(12):880–91.
45. Altmann AE, Ozanne-Smith J. Non-fatal asphyxiation and foreign body ingestion in children 0-14 years. Inj Prev. 1997;3(3):176-82. doi: 10.1136/ip.3.3.176.
46. American Academy of Pediatrics. Committee on Nutrition Hypoallergenic infant formulas. Pediatr. 2000;106(2 Pt 1):346–9. doi: 10.1542/peds.106.2.346.
47. UNICEF. Complementary foods and feeding: nutritional companion to breastfeeding after 6 months. https://www.unicef.org/programme/breastfeeding/food.htm. Accessed February 5 2019.
48. Karmaus W, Soto-Ramírez N, Zhang H. Infant feeding pattern in the first six months of age in USA: a follow-up study. Int Breastfeed J. 2017;12:48. doi: 10.1186/s13006-017-0139-4.
49. World Health Organization (WHO). Complementary feeding: report of the global consultation. Summary of guiding principles. Geneva: WHO; 2003.
50. Rachmaniah N. Hubungan tingkat pengetahuan ibu tentang ASI dengan tindakan ASI eksklusif. Universitas Muhammadiyah Surakarta Repository; 2014.
51. Yuliarti ID. Hubungan pengetahuan dan sikap ibu dengan perilaku pemberian ASI eksklusif. Universitas Sebelas Maret Thesis Repository; 2008.
52. Zeller CL. Effect of education on breastfeeding knowledge and attitudes among middle school students. Health Educ J. 2016;75(4):501-510. doi: 10.1177/0017896915597531.
53. Essien NC, Samson-Akpan PE, Ndebbio TJ, John ME. Mothers' knowledge, attitudes, beliefs and practices concerning exclusive breastfeeding in Calabar, Nigeria. Afr J Nurs Midwifery. 2009;11(1):65–75. https://journals.co.za/content/ajnm/11/1/EJC19316.
54. Ayed A. Knowledge, attitude and practice regarding exclusive breastfeeding among mothers attending primary health care centers in Abha city. Int J Med Sci Public Health. 2014;3(11):1355. doi: 10.5455/ijmsph.2014.140820141.
55. Mengesha MG. Knowledge, attitude, and practice of mothers towards EBF and mixed feeding, Gubalafto Wereda, Amhara regional state of Ethiopia: a descriptive cross sectional study. Addis Ababa University Thesis Repository; 2014.
56. Wolde T, Diriba G, Wakjira A, Misganu G, Negesse G, Debela H, Tadesse, Ejeta E. Knowledge, attitude and practice amongst lactating mothers in Bedele town, southwestern Ethiopia: descriptive cross sectional study. Researcher. 2014;6(1):91–7. https://www.semanticscholar.org/paper/Knowledge%2C-Attitude-and-Practice-of-Exclusive-Among-Wolde-Diriba/f7c4df4634f094f2b2fefedd2b49a79df97564ff.
57. Alamirew MW, Bayu NH, Birhan Tebeje N, Kassa SF. Knowledge and attitude towards exclusive breast feeding among mothers attending antenatal and immunization clinic at Dabat Health Center, Northwest Ethiopia: A cross-sectional institution based study. Nurs Res Pract. 2017:6561028. doi:10.1155/2017/6561028.
58. Mbada CE, Olowookere AE, Faronbi JO, Oyinlol-Aromoralan FC, Faremi FA, Ogundele A, Awotidebe TO, Ojo AA, Augustine OA. Knowledge, attitude and techniques of breastfeeding among Nigerian mothers from a semi-urban community. BMC Res Notes. 2013;6:552. doi: 10.1186/1756-0500-6-552.
59. Pound CM, Williams K, Grenon R, Aglipay M, Plint AC. Breastfeeding knowledge, confidence, beliefs, and attitudes of Canadian physicians. J Hum Lact. 2014;30(3):298-309. doi: 10.1177/0890334414535507.
60. Notoatmodjo S. Pendidikan dan perilaku kesehatan. Jakarta: Rineka Cipta; 2007.
61. Astari N. Hubungan pemberian susu formula dengan kejadian diare pada bayi usia 0–6 bulan. Repository Universitas Diponegoro; 2013.