Breastfeeding Does Not Protect Against Urinary Tract Infection in the First 3 Months of Life,but Vitamin D Supplementation Increases the Risk by 76%

Abstract

Our goal was to determine if breastfeeding provides any protection against urinary tract infection (UTI) and if vitamin D supplementation imposes any additional risks for UTI in infants < 3 months of age. In this study, 40% of the children who had urine cultures were breastfed, and 18.7% of the children were exclusively breastfed. Twenty percent of all of the urine cultures tested positive, and this number was greater in females (22.5%) than in males (18.1%, P < .05). There was no significant difference between the rates of positive urine cultures in exclusively breastfed (22% vs 21%, nonsignificant [NS]) formula-fed infants. The relative risk of UTI with breastfeeding versus formula feeding was 1.03 (0.58-1.82), and any breastfeeding versus no breastfeeding was 0.92 (0.58-1.45). Vitamin D supplementation increased the UTI risk, with a relative risk of 1.76 (1.07-2.91, P < .05). However, only formula-fed infants showed an increased risk of UTI after vitamin D supplementation.

Keywords

American Academy of Pediatrics (AAP)vitamin D recommendation urinary tract infection

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References

Wang SF , Huang FY , Chiu NC , et al. Urinary tract infection in infants less than 2 months of age . Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1994;35:294-300.

Hoberman A. , Wald ER Urinary tract infections in young febrile children. Pediatr Infect Dis J, 1997;16: 11-17.

Wold AE , Adlerberth I. Breast feeding and the intestinal microflora of the infant--implications for protection against infectious diseases. Adv Exp Med Biol , 2000;478: 77-93.

Bauchner H. , Leventhal JM , Shapiro ED

Studies of breast-feeding and infections. How good is the evidence?

JAMA, 1986;256:887-892.

Gartner LM , Morton J. , Lawrence RA , et al. Breastfeeding and the use of human milk. Pediatrics . 2005;115:496-506.

Newberry RE The Infant Formula Act of 1980. J Assoc Off Anal Chem , 1982;65:1472-1473.

Kremer R. , Campbell PP , Reinhardt T. , Gilsanz V. Vitamin D status and its relationship to body fat, final height, and peak bone mass in young women. J Clin Endocrinol Metab. 2009;94:67-73.

Holick MF , Chen TC Vitamin D. deficiency: a worl dwide problem with health consequences. Am J Clin Nutr. 2008;87:1080S-1086S.

Gartner LM , Greer FR Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics. 2003;111:908-910.

10.

Holick MF Vitamin D deficiency. N Engl J Med. 2007;357:266-281.

11.

Wagner CL , Greer FR Prevention of rickets and vitamin d deficiency in infants, children, and adolescents . Pediatrics. 2008;122:1142-1152.

12.

O’Regan S. , Robitaille P. , Mongeau JG , Homsy Y. Cystine calcium bladder calculus in a 2-year-old child. J Urol. 1980;123:770.

13.

Garcia Nieto V. , Rodrigo MD , Barrios Y. , Torres A. Vitamin D receptor polymorphisms and susceptibility to urinary infection in children diagnosed with idiopathic hypercalciuria . Nefrologia. 2002;22:390-391.

14.

Baysoy G. , Gürel S. , Cakici H. , Uyan AP Concurrent septic arthritis and urinary tract infection in a patient with nephrocalcinosis and vesicoureteral reflux. Turk J Pediatr . 2006;48:275-278.

15.

Ronnefarth G. , Misselwitz J. Nephrocalcinosis in children: a retrospective survey. Members of the Arbeitsgemeinschaft für pädiatrische Nephrologie. Pediatr Nephrol. 2000;14:1016-1021.

16.

Chambellan-Tison CH , Horen B. , Plat-Wilson G. , Moulin P. , Claudet I. Severe hypercalcemia due to vitamin D intoxication [in French]. Arch Pediatr. 2007;14:1328-1332.

17.

Ponnapakkam T. , Ravichandran A. , Bradford E. , Tobin G. , Gensure R. Breast-feeding and Vitamin D Supplementation Rates in the Ochsner Health System. The Ochsner Journal. 2008;8:146-150.

18.

Hanson LA Protective effects of breastfeeding against urinary tract infection . Acta Paediatr. 2004;93:154-156.

19.

Oddy WH Breastfeeding protects against illness and infection in infants and children: a review of the evidence. Breastfeed Rev. 2001;9:11-18.

20.

Ghaemi S. , Fesharaki RJ , Kelishadi R. Late onset jaundice and urinary tract infection in neonates. Indian J Pediatr. 2007;74:139-141.

21.

Pisacane A. , Graziano L. , Mazzarella G. , Scarpellino B. , Zona G. Breast-feeding and urinary tract infection . J Pediatr. 1992;120:87-89.