Antibiotic use among 8-month-old children in Malmö, Sweden – in relation to child characteristics and parental sociodemographic, psychosocial and lifestyle factors

In the county of Scania, Sweden, antibiotic use among small children is among the highest in the country. The aim of this study was to investigate the associations between antibiotic use among 8-month-old children in Malmö and characteristics of the child as well as parental sociodemographic characteristics, lifestyle factors, and psychosocial support. The study was a population-based cross-sectional survey. The study population consisted of children who visited the Child Health Care (CHC) centres in Malmö for their 8-month health checkup during 2003–2006 and whose parents answered a self-administered questionnaire (n = 7266 children). The questionnaire was distributed to parents of children registered with the CHC and invited for an 8-month checkup during the study period. The odds of using antibiotics increased as parental educational level decreased. Using high educational level as a reference group, low maternal educational level was associated with an increased antibiotic use for the child, odds ratio (OR) = 1.61 (95% CI: 1.34–1.93). Furthermore, children whose parents were born outside Sweden showed higher antibiotic use, OR = 1.43 (95% CI: 1.24–1.65), in comparison with children whose parents were born in Sweden. Exposure to environmental smoking, parental experience of economic stress, and a low level of emotional support increased the odds for antibiotic use. Boys had higher odds of use of antibiotics than girls, OR = 1.40 (95% CI: 1.25–1.57). Having a low birth weight, having an allergy and having siblings also increased the odds for early antibiotic use, while breastfeeding seemed to have a protective role. Conclusion There were clear associations between parental factors such as sociodemographic, psychosocial and lifestyle factors and antibiotic use at this early stage of life. Several characteristics of the child also affected the use of antibiotics

Exclusive breastfeeding and infant infection

Objectives: We estimated the risk of infection associated with the duration of exclusive breastfeeding (EBF). Methods: We analysed data on 15,809 term, singleton infants from the UK Millennium Cohort Study. Infants were grouped according to months of EBF: never, <2, 2-4, 4-6, 6 (the latter being WHO policy since 2001: ‘post-2001 WHO policy’). Among those EBF for 4-6 months, we separated those who started solids, but not formula, before 6 months, and were still breastfeeding at 6 months (i.e. WHO policy before 2001: ‘pre-2001 WHO policy’), from other patterns. Outcomes were infection in infancy (chest, diarrhoeal, ear). Results: EBF was not associated with ear infection, but was associated with chest infection and diarrhoea. EBF for <4 months was associated with a significantly increased risk of chest infection (adjusted risk ratios 1.24-1.28) and diarrhoea (adjusted RRs 1.42-1.66) compared with the pre-2001 WHO policy. There was an excess risk of chest infection (adjusted RR 1.19, 95% CI: 0.97-1.46) and diarrhoea (adjusted RR 1.66, 95% CI: 1.11, 2.47) among infants EBF for 4-6 months, but who stopped breastfeeding by 6 months, compared with the pre-2001 WHO policy. There was no significant difference in the risk of chest infection or diarrhoea in those fed according to the pre-2001 versus post-2001 WHO policy. Conclusions: There is an increased risk of infection in infants EBF for <4 months, or EBF for 4-6 months who stop breastfeeding by 6 months. These results support current guidelines of EBF for either 4-6 or 6 months with continued breastfeeding thereafter

Hospital admissions from birth to early adolescence and early-life risk factors: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study

The aim of this prospective analysis was to describe the cumulative incidence of hospital admissions in the first year of life and between 1 and 11 years of age and to explore associated factors. Hospital admissions were collected through regular monitoring in the first year of life, and through maternal report on admissions between 1 and 11 years. Analyses were stratified by sex and adjusted for confounding factors. 18.1% of children were hospitalized in the first year of life, and 30.7% between ages 1 and 11 years. Among boys, hospital admission in the first year was associated with low family income, paternal smoking during pregnancy, preterm delivery, and low birthweight. Among girls, in addition to the variables described for boys, black/mixed skin color was also a risk factor for hospital admission. For admissions between 1 and 11 years of age, low family income and gestational age ≥ 37 weeks were found to be significant risk factors.Com o objetivo de descrever a incidência cumulativa de hospitalizações no primeiro ano de vida e entre 1-11 anos de idade, e identificar fatores de risco precoces, foi realizado um estudo de coorte de nascimento de 1993 a 2004-2005. As hospitalizações foram coletadas por meio de monitoramento hospitalar até 1 ano de idade, e relato das mães sobre internações ocorridas de 1-11 anos. As análises foram estratificadas por sexo e ajustadas para fatores de confusão. Os percentuais de hospitalizações de 0-1 ano e de 1-11 anos foram 18,1% e 30,7%, respectivamente. As variáveis associadas com internações de 0-1 ano em meninos foram: baixa renda familiar, tabagismo paterno na gestação, prematuridade e baixo peso ao nascer. No sexo feminino, além dos fatores de risco descritos entre os meninos, observou-se associação com cor da pele preta/parda. Quanto às hospitalizações de 1-11 anos, no sexo masculino, encontrou-se associação com baixa renda familiar e idade gestacional ≥ 37 semanas