Clinical Sciences Division, International Centre for Diarrhoeal Disease Research Bangladesh, Mohakhali, Dhaka, Bangladesh.
PLoS One. 2011;6(10):e25817. doi: 10.1371/journal.pone.0025817. Epub 2011 Oct 3.
Hypoxemia is a grave sequel of pneumonia, and an important predictor of a fatal outcome. Pneumonia in the neonatal period is often associated with lack of breast feeding. However, there is no published report on the impact of the cessation of breast feeding in the neonatal period on the development of pneumonia and hypoxemia. The purpose of our study was to assess the impact of non-breast feeding or stopping breast feeding during the neonatal period (henceforth to be referred to as non-breast fed) on clinical features of pneumonia and hypoxemia in 0-6-month-old infants with diarrhea admitted to an urban hospital in Bangladesh.
We prospectively enrolled all infants (n = 107) aged 0 to 6 months who were admitted to the Special Care Ward (SCW) of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR,B) with diarrhea and pneumonia from September 2007 through December 2007.We compared the clinical features of pneumonia and hypoxemia of breast fed infants (n = 34) with those who were non-breast fed (n = 73).
The median (inter-quartile range) duration of hypoxemia (hours) in non-breast-feds was longer than breast-fed infants [0.0 (0.0, 12.0) vs. 12.0 (0.0, 21.75); p = 0.021]. After adjusting for potential confounders such as inability to drink, fever, head nodding, cyanosis, grunting respiration, and lower chest wall in drawing, the non-breast-fed infants with pneumonia along with diarrhea had a higher probability of cough (OR 9.09; CI 1.34-61.71; p = 0.024), hypoxemia (OR 3.32; CI 1.23-8.93; p = 0.017), and severe undernutrition (OR 3.42; CI 1.29-9.12; p = 0.014).
Non-breast feeding or cessation of breast feeding during the neonatal period may substantially increase the incidence of severe malnutrition, incidence of cough, and both the incidence and duration of hypoxemia in young infants presenting with pneumonia and diarrhea. The findings emphasize the paramount importance of the continuation of breast feeding in the neonatal period and early infancy.
低氧血症是肺炎的严重后果，也是致命结局的重要预测指标。新生儿肺炎常与缺乏母乳喂养有关。然而，目前尚无关于新生儿期停止母乳喂养对肺炎和低氧血症发展影响的报道。我们的研究目的是评估孟加拉国城市医院收治的腹泻 0-6 个月婴儿中非母乳喂养（以下简称未母乳喂养）对肺炎和低氧血症临床特征的影响。
我们前瞻性纳入了 2007 年 9 月至 2007 年 12 月期间因腹泻和肺炎入住孟加拉国国际腹泻病研究中心（ICDDR,B）达卡医院特殊护理病房（SCW）的 0-6 个月龄婴儿（n=107）。我们比较了母乳喂养婴儿（n=34）和未母乳喂养婴儿（n=73）的肺炎和低氧血症的临床特征。
未母乳喂养婴儿的低氧血症（小时）中位数（四分位距）长于母乳喂养婴儿[0.0（0.0，12.0）比 12.0（0.0，21.75）；p=0.021]。在调整了无法饮水、发热、点头、发绀、呼噜呼吸和吸气时胸壁下部凹陷等潜在混杂因素后，患有肺炎和腹泻的未母乳喂养婴儿咳嗽的可能性更高（OR 9.09；95%CI 1.34-61.71；p=0.024），发生低氧血症的可能性更高（OR 3.32；95%CI 1.23-8.93；p=0.017），且严重营养不良的可能性更高（OR 3.42；95%CI 1.29-9.12；p=0.014）。
新生儿期非母乳喂养或停止母乳喂养可能会大大增加患有肺炎和腹泻的年轻婴儿发生严重营养不良、咳嗽以及低氧血症的发生率和持续时间。这些发现强调了新生儿期和婴儿早期持续母乳喂养的至关重要性。
