Placing young children in day care exposes them to sharply increased risk of infection. Breastfeeding young children sharply reduces that risk - even when those children are in day care. But only keeping young children out of the day-care center and in the arms of a breastfeeding mother provides optimal health protection.
To investigate the way breastfeeding and day care affect children's health, a team of epidemiologists at the University of Ottawa recently examined statistical data collected for a representative sample of 1,841 young children living in the province of Quebec. Much as they expected, day-care attendance drove up the frequency with which these children contracted infections and therefore the frequency with which they had to receive antibiotics to combat these infections. "Day care attendance," write the Ottawa scholars, "not only increased the number of antibiotic treatments at each of the studied ages, but it also had a negative effect on the number of antibiotic treatments between birth and five years." The researchers were hardly puzzled by this, given that "day care puts children in contact with other children and creates a milieu suitable for the development of infections."
Also much as expected, breastfeeding drove down the frequency with which the children in the study contracted infections and therefore the frequency with which they had to receive antibiotics to fight these infections. Indeed, breastfeeding conferred protective effects on children long after they had been weaned. The Ottawa researchers find that even in multivariable analyses that control for maternal smoking, maternal education, and family income, breastfeeding for at least four months confers a statistically significant "protective effect" against antibiotic treatments at 1.5 years and at 2.5 years.
If breastfeeding delivers a "protective effect," it only stands to reason that not breastfeeding yields a health risk. The researchers indeed document such a risk. However, the researchers calculate that "day-care attendance had a stronger effect on antibiotic treatments than not being breast-fed." More specifically, "day-care attendance was related to the prescription of 1 or more antibiotic treatments at all ages." In fact, "day-care attendance raised by 30% the odds of having one antibiotic treatment between 2.5 and 4-5 years of age, and it doubled the odds of having three antibiotic treatments between 2.5 and 4-5 years of age."
Breastfeeding delivers its "protective effect" in all of the family circumstances examined in this study, but the researchers were particularly interested in its effects on young children in day care. Their parsing of the data indicates that "breast-feeding reduced the number of antibiotic treatments given to children entering day care before 2.5 years of age." For day-care children two- and-a-half years old, the researchers calculate that "the odds of receiving three or more antibiotic treatments was 2.9 for children breast-fed at least 4 months, 3.4 for children breast-fed less than 4 months, and 4.7 for children never breast-fed."
Stating the obvious, the researchers suggest that "the more-at-risk children could be protected by breast-feeding and by being taken care of in a familial setting, especially before 2.5 years of age."
This new study does show that breast-feeding helps to mitigate the bad health outcomes of day care, but only a relatively small percentage of the young children who end up in day-care centers receive even this partial protection. In our mixed-up, contemporary world, the lucky children are the ones born into less affluent families where they are cared for and breast-fed at home and not into the wealthier families where their careerist mothers drop them off at the sources of contagion we call day-care centers.
