Mother's Own Milk Feeding and Severity of Respiratory Illness in Acutely Ill Children: An Integrative Review

J Pediatr Nurs. 2020 Jan-Feb:50:5-13. doi: 10.1016/j.pedn.2019.09.020. Epub 2019 Oct 26.


Problem: Breastfed infants experience less severe infections while actively breastfeeding. However, little is known about whether a history of prior breastfeeding affects severity of illness. Therefore, the purpose of this integrative review was to examine the relationship between previous exposure to mother's own milk (MOM) feeding and severity of respiratory infectious illness in infants and children.

Eligibility criteria: Studies meeting the following criteria were included: human subjects, term birth, ages 0-35 months at time of study, diagnosis of pneumonia, bronchiolitis or croup, MOM feeding, and statistical analyses reporting separate respiratory infectious illness outcomes when combined with other infections.

Sample: Twelve articles met eligibility criteria.

Results: Major findings were inconsistent definitions of both dose and exposure period of breastfeeding and the severity of illness. In particular, the severity of illness measure was limited by the use of proxy variables such as emergency room visits or hospitalizations that lacked reliability and validity. However, given this limitation, the data suggested that exclusive breastfeeding for four to six months was associated with reduced severity of illness as measured by frequency of visits to the primary care provider office, emergency department or hospitalization.

Conclusions: Future research in this area should incorporate reliable and valid measures of MOM dose and exposure period and severity of illness outcomes in the critically ill child.

Implications: Among many positive outcomes associated with breastfeeding, an additional talking point for encouragement of exclusive breastfeeding for four to six months may be protective against severe respiratory infectious illness after cessation of breastfeeding.

Keywords: Acute respiratory infectious illness; Breastfeeding; Human milk; Severity of illness.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Breast Feeding*
  • Child, Preschool
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Milk, Human*
  • Respiratory Tract Infections / epidemiology*
  • Severity of Illness Index