Respiratory tract and diarrheal infections of breast-fed infants from birth to 6 months of age in household contexts of an Egyptian village.

OBJECTIVE

To investigate the pattern of respiratory tract infections (RTI) and diarrhea among brest-fed infants and the impact of birth weight, maternal diet during lactation, and household socioenvironmental conditions on these illnesses.

DESIGN

A longitudinal household-based study of infant morbidity from birth to 6 months of age.

SETTING

Kalama village, Egypt.

SUBJECTS

Morbidity information was obtained for 119 infants; 80 had longitudinal records over the first 6 months of age.

RESULTS

Birth weights were normally distributed and the mean was comparable to the National Center for Health Statistics reference median. Most infants experienced growth faltering and increased illness episodes during 3 to 6 months of age. Infants with RTI during the first 3-month period were at a significantly higher risk of developing subsequent RTI compared with infants without earlier infections (OR = 5.0, chi-square 10.4, P < (0.0001). Similar associations were not observed for diarrhea. Controlling for earlier RTI, lower maternal intakes of vitamin A or C and animal source energy, protein, riboflavin, zinc or calcium were associated with more days sick with RTI in infants during 3-6 months whereas lower birth weight was associated with a longer duration. Among the variables examined poor household sanitation was the only significant predictor of diarrheal illnesses in this population.

CONCLUSIONS

Infants living in unsanitary households were the main victims of diarrhea. Duration of RTI was shorter for infants of higher birth weight and sick days were fewer for infants whose mothers consumed more animal source foods, vitamin A or vitamin C.