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Does Exclusive Breastfeeding Increase Risk of Anemia During the First 6 Months of Life?

พรสุดา กฤติกาเมษ; Pornsuda Krittigamas; วิรดา ศักดิ์อมรชัย; Wirada Sakamornchai; ชิดชนก เรือนก้อน; Chidchanok Ruengorn;
Date: 2564-03
Abstract
Background: The World Health Organization recommends exclusively breastfeeding (EBF) for the first 6 months of life. However, infants undergo WHO EBF for 6 months may have an increased risk of anemia. Evidences regarding anemia associated with EBF are limited in the Northern part of Thailand. Objective: To investigate the incidence of anemia at 6 months of age among EBF infants and non-EBF infants, and risk factors of anemia at 6 months of age. Materials and Methods: The retrospective cohort study was conducted in term-healthy infants at a well-baby clinic, Nakornping Hospital in 2019. Mothers answered a questionnaire regarding history of breastfeeding. Hematocrit (Hct) level of infants was retrospectively recorded at birth and 6 months of age. Infants with Hct less than 40% at birth were excluded. Anemia was defined as Hct less than 33%. Data were analyzed comparing Hct between 2 groups of infants: the EBF in the first 6 months of age and the non-EBF. Multivariable linear regression and exponential risk regression were performed to investigate an effect of EBF. Results: Of 259 infants, 137 cases (52.9%) were male, the overall incidence of anemia was 61 cases (23.6%). Prevalence of 6-month EBF infants was 45.9%. Incidence of anemia in the EBF and non-EBF infants was 24.4 and 22.9%, respectively. When compared to the non-EBF group, no statistically significant differences were revealed, adjusted RR 0.98(0.61-1.58), p = 0.934. The mean of Hct in EBF and non-EBF infants were 34.18±3.23 and 34.57±3.38, respectively. There was no statistically significant between mean of Hct of the two groups with adjusted beta coefficient equals to -0.21(-1.09, 0.66), p = 0.631. Factors predicted anemia in infants at 6 months of age included maternal age <20 years (adj. OR 3.88, 95%CI 2.68-5.60), >35 years (adj. OR 2.26, 95%CI 1.44-3.53), mothers with HbE positive (adj. OR 3.01, 95%CI 1.62-5.60). Conclusion: Overall incidence of anemia in infants at 6 months of age was 23.6% classified as a moderate public health problem that urgent investigation is needed. There was no statistical significance between incidence of anemia in the EBF and non-EBF infants. EBF for the first 6 months of life does not increase the risk of anemia in healthy infants compared with non-EBF.
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
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