George A, Bonne S, Ekpenyong E N, Edem E N, Ajayi S
The Oxford Vaccine Group, Department of Paediatrics, University of Oxford, England.
Faculty of Medicine, McGill University, Canada.
Ann Ib Postgrad Med. 2024 Dec 31;22(3):39-47.
Acute Respiratory Infections (ARIs) significantly contribute to infant morbidity and mortality worldwide, especially in developing countries like Nigeria, where factors such as inadequate nutrition, poor environmental conditions, and partial immunization increase their incidence, while exclusive breastfeeding (EBF) offers immune protection that can reduce their incidence and severity. Therefore this review assessed the role of breastfeeding, especially exclusive breastfeeding, in reducing the risk and severity of ARIs in Nigerian infants, while also evaluating factors influencing breastfeeding practices.
A systematic review was conducted following PRISMA guidelines, involving a comprehensive search of databases such as PubMed, Scopus, ScienceDirect, Google Scholar, and African Journals Online. Twelve studies conducted between 2004 and 2024 focusing on breastfeeding practices and their impact on ARIs in Nigerian infants aged 0-6 months were selected. The review focused on primary studies with observational and cohort designs.
The review found that exclusive breastfeeding significantly reduces the risk of ARIs in infants, with non-exclusively breastfed infants facing a fourfold increase in ARI risk. Breast milk contains immunologically active components like secretory IgA, lactoferrin, and lysozyme, which enhance immune defenses and reduce the severity of ARIs such as pneumonia. However, only 25-40% of infants in Nigeria are exclusively breastfed for six months due to cultural beliefs, maternal employment, lack of education etc.
Exclusive breastfeeding significantly protects Nigerian infants against ARIs, but cultural misconceptions, socioeconomic barriers, insufficient maternal education etc hinder optimal practices, necessitating targeted public health initiatives and policy interventions to improve infant health outcomes.
急性呼吸道感染(ARIs)在全球范围内对婴儿的发病率和死亡率有重大影响,特别是在尼日利亚等发展中国家,营养不良、恶劣的环境条件和部分免疫等因素会增加其发病率,而纯母乳喂养(EBF)提供的免疫保护可以降低其发病率和严重程度。因此,本综述评估了母乳喂养,特别是纯母乳喂养,在降低尼日利亚婴儿患急性呼吸道感染的风险和严重程度方面的作用,同时还评估了影响母乳喂养行为的因素。
按照PRISMA指南进行了一项系统综述,全面检索了PubMed、Scopus、ScienceDirect、谷歌学术和非洲期刊在线等数据库。选取了2004年至2024年期间进行的12项研究,这些研究聚焦于0至6个月大的尼日利亚婴儿的母乳喂养行为及其对急性呼吸道感染的影响。该综述侧重于观察性和队列设计的原发性研究。
该综述发现,纯母乳喂养显著降低了婴儿患急性呼吸道感染的风险,非纯母乳喂养的婴儿患急性呼吸道感染的风险增加了四倍。母乳含有分泌型IgA、乳铁蛋白和溶菌酶等具有免疫活性的成分,这些成分可增强免疫防御并降低肺炎等急性呼吸道感染的严重程度。然而,由于文化观念、母亲就业、缺乏教育等原因,尼日利亚只有25%至40%的婴儿纯母乳喂养六个月。
纯母乳喂养显著保护尼日利亚婴儿免受急性呼吸道感染,但文化误解、社会经济障碍、母亲教育不足等阻碍了最佳实践,因此需要有针对性的公共卫生举措和政策干预措施来改善婴儿健康状况。