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  • Title: Protection against infection with Giardia lamblia by breast-feeding in a cohort of Mexican infants.
    Author: Morrow AL, Reves RR, West MS, Guerrero ML, Ruiz-Palacios GM, Pickering LK.
    Journal: J Pediatr; 1992 Sep; 121(3):363-70. PubMed ID: 1517909.
    Abstract:
    To determine whether breast-feeding protects infants against symptomatic and asymptomatic infection by Giardia lamblia, we followed 197 infants in a poor area of Mexico City from birth to 18 months of age; symptoms and feeding status were recorded weekly. Stool specimens were collected every 1 to 2 weeks and tested for Giardia by enzyme-linked immunosorbent assay. A mean of 1.0 Giardia infection per child-year was detected; 94 infants had a total of 139 infections; 17% of infections were symptomatic. Ninety-one percent of infants were breast fed from birth and 38% were breast fed at 1 year of age. Lack of breast-feeding was a significant risk factor for first Giardia infection at all ages. The adjusted incidence rate ratio for first Giardia infection for none versus complete breast-feeding was 5.0 (confidence interval (CI) 1.5 to 16.9; p = 0.009), and for none versus any breast-feeding, 1.8 (CI 1.1 to 2.8; p = 0.013). Symptomatic Giardia infection was also associated with lack of breast-feeding (none vs any: incidence rate ratio = 2.5; CI 0.9 to 6.8; p = 0.077), but breast-feeding did not protect against chronic carriage of Giardia. Other significant risk factors for Giardia infection were presence of animals in the household (p = 0.005) and the use of water or nonmilk liquid for infant feedings (p = 0.035). We conclude that breast-feeding protects infants against Giardia by mechanisms that include preventing the establishment of infection. To determine whether breast feeding protects infants against symptomatic and asymptomatic infection by Giardia lamblia, the authors followed 197 infants in a poor area of Mexico City from birth to 18 months of age. Symptoms and feeding status were recorded weekly. Stool specimens were collected every 1-2 weeks and tested for Giardia by an enzyme-linked immunosorbent assay. A mean of 1.0 Giardia infection/child-year was detected; 94 infants had a total of 139 infections and 17% were symptomatic. 91% of the infants were breast fed from birth and 38% were breast fed at 1 year of age. Lack of breast feeding was a significant risk factor for 1st Giardia infection across all ages. The adjusted incidence rate ratio for 1st Giardia infection for none vs. complete breast feeding was 5.0 (confidence interval [CI] 1.5-16.9; p=0.009), and for none vs. any breast feeding, 1.8 (CI 1.1-2.8; p=0.013). Symptomatic Giardia infection was also associated with a lack of breast feeding (none vs. any; incidence rate ratio=2.5; CI 0.9-6.8; p=0.077), but breast feeding did not protect against chronic carrying of the infection. Other significant risk factors for Giardia infection were: presence of animals in household (p=0.005) and the use of water or nonmilk liquid for infant feedings (p-0.035). The authors conclude that breast feeding feeding helps protect infants against Giarda by mechanisms which include the prevention of infection invasion at the outset.
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