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Abstract：
BACKGROUND: Despite growing evidence of the impacts of exclusively breastfeeding infants during the first 6 months of life on preventing childhood infections and ensuring optimal health, only a small number of studies have quantified this association in South Asia.
METHODS: We analyzed data from the Demographic and Health Surveys in Afghanistan (2015; n = 3462), Bangladesh (2017-2018; n = 1084), India (2019-2021; n = 26,101), Nepal (2022; n = 581), and Pakistan (2017-2018; n = 1,306), including babies aged 0-6 months. Multivariate logistic regression models were used to determine the association between exclusive breastfeeding in the last 24 h and diarrhoea, acute respiratory infections, and fever in the two weeks before the survey. We also examined the association between other infant and young feeding indicators and these outcomes.
RESULTS: Infants who were exclusive breastfed had decreased odds of diarrhoea in Afghanistan (AOR: 0.49, 95% CI 0.35, 0.70), India (AOR: 0.80, 95% CI 0.70, 0.91), and Nepal (AOR: 0.42, 95% CI 0.20, 0.89). Compared with infants who were not exclusive breastfed, infants who were exclusively breastfed were less likely to have fever in Afghanistan (AOR: 0.36, 95% CI 0.26, 0.50) and India (AOR: 0.75, 95% CI 0.67, 0.84). Exclusive breastfeeding was associated with lower odds of acute respiratory infections in Afghanistan (AOR: 0.57, 95% CI 0.39, 0.83). Early initiation of breastfeeding was protective against diarrhoea in India. Bottle feeding was a risk factor for diarrhoea in India and for fever in Afghanistan and India. Bottle feeding was also a risk factor for acute respiratory infection in Afghanistan and India.
CONCLUSIONS: Not exclusive breastfeeding is a risk factor for diarrhoea, acute respiratory infections, and fever in some South Asian countries. These findings could have substantial implications for global and national efforts to increase exclusive breastfeeding rates. More support, advocacy, and action are required to boost breastfeeding rates as a crucial public health measure.
METHODS: We analyzed data from the Demographic and Health Surveys in Afghanistan (2015; n = 3462), Bangladesh (2017-2018; n = 1084), India (2019-2021; n = 26,101), Nepal (2022; n = 581), and Pakistan (2017-2018; n = 1,306), including babies aged 0-6 months. Multivariate logistic regression models were used to determine the association between exclusive breastfeeding in the last 24 h and diarrhoea, acute respiratory infections, and fever in the two weeks before the survey. We also examined the association between other infant and young feeding indicators and these outcomes.
RESULTS: Infants who were exclusive breastfed had decreased odds of diarrhoea in Afghanistan (AOR: 0.49, 95% CI 0.35, 0.70), India (AOR: 0.80, 95% CI 0.70, 0.91), and Nepal (AOR: 0.42, 95% CI 0.20, 0.89). Compared with infants who were not exclusive breastfed, infants who were exclusively breastfed were less likely to have fever in Afghanistan (AOR: 0.36, 95% CI 0.26, 0.50) and India (AOR: 0.75, 95% CI 0.67, 0.84). Exclusive breastfeeding was associated with lower odds of acute respiratory infections in Afghanistan (AOR: 0.57, 95% CI 0.39, 0.83). Early initiation of breastfeeding was protective against diarrhoea in India. Bottle feeding was a risk factor for diarrhoea in India and for fever in Afghanistan and India. Bottle feeding was also a risk factor for acute respiratory infection in Afghanistan and India.
CONCLUSIONS: Not exclusive breastfeeding is a risk factor for diarrhoea, acute respiratory infections, and fever in some South Asian countries. These findings could have substantial implications for global and national efforts to increase exclusive breastfeeding rates. More support, advocacy, and action are required to boost breastfeeding rates as a crucial public health measure.
摘要：
背景：尽管越来越多的证据表明婴儿在出生后的头6个月内完全母乳喂养对预防儿童感染和确保最佳健康有影响，在南亚,只有少数研究对这种关联进行了量化.
方法：我们分析了阿富汗人口与健康调查（2015年；n=3462）的数据，孟加拉国（2017-2018；n=1084），印度（2019-2021；n=26,101），尼泊尔（2022；n=581），和巴基斯坦（2017-2018年；n=1,306），包括0-6个月的婴儿。使用多变量逻辑回归模型来确定最后24小时纯母乳喂养与腹泻之间的关系。急性呼吸道感染,调查前两周发烧。我们还研究了其他婴幼儿喂养指标与这些结果之间的关联。
结果：在阿富汗，纯母乳喂养的婴儿腹泻的几率降低（AOR：0.49，95%CI0.35，0.70），印度（AOR：0.80，95%CI0.70，0.91），和尼泊尔（AOR：0.42，95%CI0.20，0.89）。与非独家母乳喂养的婴儿相比，在阿富汗(AOR:0.36,95%CI0.26,0.50)和印度(AOR:0.75,95%CI0.67,0.84),纯母乳喂养的婴儿发热的可能性较小.在阿富汗，纯母乳喂养与急性呼吸道感染的几率较低相关（AOR：0.57，95％CI0.39，0.83）。在印度，早期开始母乳喂养可以预防腹泻。在印度，奶瓶喂养是腹泻和阿富汗和印度发烧的危险因素。在阿富汗和印度，奶瓶喂养也是急性呼吸道感染的危险因素。
结论：非纯母乳喂养是腹泻的危险因素，急性呼吸道感染,和一些南亚国家的发烧。这些发现可能对全球和国家提高纯母乳喂养率的努力产生重大影响。更多支持,倡导，需要采取行动提高母乳喂养率，作为一项关键的公共卫生措施。
方法：我们分析了阿富汗人口与健康调查（2015年；n=3462）的数据，孟加拉国（2017-2018；n=1084），印度（2019-2021；n=26,101），尼泊尔（2022；n=581），和巴基斯坦（2017-2018年；n=1,306），包括0-6个月的婴儿。使用多变量逻辑回归模型来确定最后24小时纯母乳喂养与腹泻之间的关系。急性呼吸道感染,调查前两周发烧。我们还研究了其他婴幼儿喂养指标与这些结果之间的关联。
结果：在阿富汗，纯母乳喂养的婴儿腹泻的几率降低（AOR：0.49，95%CI0.35，0.70），印度（AOR：0.80，95%CI0.70，0.91），和尼泊尔（AOR：0.42，95%CI0.20，0.89）。与非独家母乳喂养的婴儿相比，在阿富汗(AOR:0.36,95%CI0.26,0.50)和印度(AOR:0.75,95%CI0.67,0.84),纯母乳喂养的婴儿发热的可能性较小.在阿富汗，纯母乳喂养与急性呼吸道感染的几率较低相关（AOR：0.57，95％CI0.39，0.83）。在印度，早期开始母乳喂养可以预防腹泻。在印度，奶瓶喂养是腹泻和阿富汗和印度发烧的危险因素。在阿富汗和印度，奶瓶喂养也是急性呼吸道感染的危险因素。
结论：非纯母乳喂养是腹泻的危险因素，急性呼吸道感染,和一些南亚国家的发烧。这些发现可能对全球和国家提高纯母乳喂养率的努力产生重大影响。更多支持,倡导，需要采取行动提高母乳喂养率，作为一项关键的公共卫生措施。
