Clemens J D, Rao M R, Chakraborty J, Yunus M, Ali M, Kay B, Naficy A, Sack D A
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Pediatrics. 1997 Dec;100(6):E2. doi: 10.1542/peds.100.6.e2.
To assess the relationship between breastfeeding and the risk of life-threatening enterotoxigenic Escherichia coli (ETEC) diarrhea among Bangladeshi infants and young children <36 months of age.
Case-control study.
A rural Bangladesh community.
A total of 168 cases with clinically severe ETEC diarrhea detected in a treatment center-based surveillance system during 1985 to 1986 and 3679 controls selected in three surveys of the same community during the same calendar interval.
Cases and controls were compared for the frequency of antecedent breastfeeding patterns.
Compared with other feeding modes, exclusive breastfeeding of infants was associated with significant protection against severe ETEC diarrhea (relative risk [RR] = 0.51; 95% confidence interval [CI]: 0.28,0.96). However, during the second and third years of life, the risk of this outcome was similar in both breastfed and nonbreastfed children (RR = 0.98; 95% CI: 0.45,2.12), and no significant overall protective association between breastfeeding and severe ETEC diarrhea was evident during the first 3 years of life (RR = 0.86; 95% CI: 0.43,1. 74).
Exclusive breastfeeding appeared to protect infants against severe ETEC diarrhea, but breastfeeding was not associated with protection after infancy, nor was it associated with a major overall reduction of severe ETEC disease during the first 3 years of life. Although not diminishing the importance of breastfeeding, our findings suggest that other interventions, such as immunization and education about proper food hygiene, may also be required in efforts to prevent this major pediatric disease.
评估孟加拉国36个月龄以下婴幼儿母乳喂养与危及生命的产肠毒素大肠杆菌（ETEC）腹泻风险之间的关系。
病例对照研究。
孟加拉国一个农村社区。
1985年至1986年期间在一个基于治疗中心的监测系统中检测到的168例临床严重ETEC腹泻病例，以及在同一日历区间内对同一社区进行的三次调查中选取的3679名对照。
比较病例组和对照组之前母乳喂养模式的频率。
与其他喂养方式相比，纯母乳喂养婴儿可显著预防严重ETEC腹泻（相对风险[RR]=0.51；95%置信区间[CI]：0.28，0.96）。然而，在生命的第二年和第三年，母乳喂养和非母乳喂养儿童发生这种情况的风险相似（RR=0.98；95%CI：0.45，2.12），并且在生命的前3年中，母乳喂养与严重ETEC腹泻之间没有明显的总体保护关联（RR=0.86；95%CI：0.43，1.74）。
纯母乳喂养似乎可以保护婴儿免受严重ETEC腹泻的影响，但母乳喂养在婴儿期之后没有保护作用，在生命的前3年中也与严重ETEC疾病的总体大幅减少无关。虽然没有削弱母乳喂养的重要性，但我们的研究结果表明，在预防这种主要儿科疾病的努力中，可能还需要其他干预措施，如免疫接种和关于适当食品卫生的教育。
