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. 2019 Jul;15(3):e12756.
doi: 10.1111/mcn.12756. Epub 2019 Jan 13.

Infant growth faltering linked to subclinical mastitis, maternal faecal-oral contamination, and breastfeeding

Hilary M Wren-Atilola  1 , Noel W Solomons  2 , Marilyn E Scott  3 , Kristine G Koski  1
Affiliations

Infant growth faltering linked to subclinical mastitis, maternal faecal-oral contamination, and breastfeeding

Hilary M Wren-Atilola et al. Matern Child Nutr. 2019 Jul.

Abstract

Infant growth faltering occurs in breastfed infants <6 months of age. The possibility that maternal health status contributes to this growth faltering is underexplored. We investigated whether (a) subclinical mastitis (SCM), an asymptomatic inflammation of the breast, (b) maternal intestinal nematode and protozoan infections, indicators of faecal-oral contamination, or (c) poor breastfeeding practices increased the odds of stunting (length-for-age z-score < -2SD), underweight (weight-for-age z-score < -2SD), or low head circumference (head circumference-for-age z-score < -2SD) in breastfed infants in rural indigenous communities in Guatemala. Mother-infant dyads (n = 105) were subdivided into those with and without SCM (milk Na:K ratio > 0.6). Maternal and infant anthropometry were measured at the time of breast milk collection. Maternal stool samples were examined for the presence of intestinal nematodes and protozoa. Questionnaires were used to characterize breastfeeding practices (exclusivity and frequency) and support, hygiene (latrine use and household faucet), and infant diarrhoea. SCM occurred in 14% of women and was associated with increased odds of infant stunting (odds ratio [OR] = 4.3; confidence interval [CI] [1.1, 15.8]), underweight (OR = 9.2; CI [1.8, 48.0]), and low head circumference (OR = 15.9; CI [2.6, 96.9]). Maternal pathogenic protozoa and nematodes were uncommon (<4%), but nonpathogenic protozoa were common (e.g., Entamoeba coli [39%]). Entamoeba coli increased the likelihood (OR = 3.3; CI [1.02, 10.6]) of low head circumference, whereas higher breastfeeding frequency lowered its odds (OR = 0.74, CI [0.56, 0.97]). Prevention of SCM may improve early infant growth, but public health measures that increase breastfeeding frequency and reduce faecal-oral contamination may be required to minimize low head circumference.

Keywords: Entamoeba coli; Guatemala; breastfeeding frequency; infant growth; low head circumference; subclinical mastitis.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

References

    1. Adenusi, A. A. , & Adewoga, T. O. (2013). Human intestinal parasites in non‐biting synanthropic flies in Ogun State, Nigeria. Travel Medicine and Infectious Diseases, 11, 181–189. 10.1016/j.tmaid.2012.11.003 - DOI - PubMed
    1. Aryeetey, R. N. O. , Marquis, G. S. , Brakohiapa, L. , Timms, L. , & Lartey, A. (2009). Subclinical mastitis may not reduce breastmilk intake during established lactation. Breastfeeding Medicine, 4, 161–166. 10.1089/bfm.2008.0131 - DOI - PMC - PubMed
    1. Chomat, A. M. , Solomons, N. W. , Koski, K. G. , Wren, H. M. , Vossenaar, M. , & Scott, M. E. (2015). Quantitative methodologies reveal a diversity of nutrition, infection/illness, and psychosocial stressors during pregnancy and lactation in rural Mam‐Mayan mother‐infant dyads from the Western Highlands of Guatemala. Food and Nutrition Bulletin, 36, 415–440. 10.1177/0379572115610944 - DOI - PubMed
    1. Contreras, G. A. , & Rodríguez, J. M. (2011). Mastitis: comparative etiology and epidemiology. Journal of Mammary Gland Biology and Neoplasia, 16, 339–356. 10.1007/s10911-011-9234-0 - DOI - PubMed
    1. Cumming, O. , & Cairncross, S. (2016). Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications. Maternal and Child Nutrition, 12(S1), 91–105. 10.1111/mcn.12258 - DOI - PMC - PubMed

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