Early initiation of breastfeeding and the risk of infant diarrhea in ruralEgypt

Background. Initiation of breastfeeding shortly after delivery may enhance breastfeeding's protective effect against diarrhea because of the protectiv e properties of human colostrum contained in early breast milk. Objective. To evaluate whether initiation of breast-feeding within the firs t 3 days of life, when breast milk contains colostrum, was associated with a lower rate of diarrhea in rural Egyptian infants during the first 6 month s of life. Methods. Infants initially breastfed (n = 198) were monitored prospectively with twice-weekly home visits to ascertain dietary practices and diarrheal illnesses. Results. The burden of diarrhea during the first 6 months of life in the co hort was high: seven episodes per child-year of follow-up. Only 151 (76%) i nfants initiated breastfeeding during the first 3 days of life ("early init iation"). Infants in whom breastfeeding was initiated early had a 26% (95% CI: 2%,44%) lower rate of diarrhea than those initiated late. The protectiv e association between early initiation and diarrhea was independent of the pattern of postinitiation dietary practices and was evident throughout the first 6 months of life. Conclusions. Early initiation of breastfeeding was associated with a marked reduction of the rate of diarrhea throughout the first 6 months of life, p ossibly because of the salutary effects of human colostrum. These data high light the need for interventions to encourage early initiation of breastfee ding in less developed settings.