BREAST-FEEDING PROTECTS INFANTS IN INDONESIA AGAINST ILLNESS AND WEIGHT-LOSS DUE TO ILLNESS

The authors tested the hypothesis that breast feeding modifies the effect of morbidity on growth by examining, at different levels of breast feeding: 1) number of days ill; and 2) the relation between morbidity and weight change. A total of 200 observations made at 3-weekly intervals between 1983 and 1984 on 33 breast-fed infants from a rural village on the island of Madura, Indonesia were used. Levels of breast feeding were defined as quartiles (Q1-Q4) of proportion of household visit time spent breast feeding. Regression analysis and analysis of variance were used and within child effects examined. Number of days ill from respiratory tract illness decreased significantly (p = 0.01) as quartile of breast feeding increased. Weight change was not affected by respiratory tract illness in Q2-Q4 but was significantly and negatively affected by such illness in the lowest quartile, Q1 (β = -22.5 ± 4.8 g/day ill). The slopes of Q2-Q4 were not significantly different from each other but were significantly different (p = 0.0094) from the Q1 slope. The authors examined whether measurement, reverse causality, or confounding bias changed the interpretation of findings; they did not. The authors conclude that breast feeding protects infants against the nutritional consequences of illness by decreasing the number of days with respiratory tract illness and protecting against weight loss due to this form of illness. However, this protective effect of breast feeding is attained only when levels of breast feeding are adequate, because at the lowest level of breast feeding, illness had a negative Impact on weight performance. © 1990 by The Johns Hopkins University School of Hygiene and Public Health.