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2009 Southern Regional Meeting Abstracts
Session: Joint Plenary Poster Session and Reception
Breast feeding does not protect against urinary tract infection in the first 3 months of life, but vitamin D supplementation of formula fed infants doubles the risk
Katikaneni R, Ponnapakkam T, Ponnapakkam A, Gensure R. Ochsner Clinic Foundation, New Orleans, LA.
Purpose of Study: To determine if breast feeding or vitamin D supplementation protects against UTI
Methods Used: Retrospective chart review
Summary of Results: It has been reported that breast feeding protects infants against urinary tract infection (UTI). To investigate this further, we performed a chart review of infants who had urine cultures obtained within the first 3 months of life at Ochsner Hospital, New Orleans, LA, between the years 2001-2006. 40% of these children were breast fed (18.7% exclusively breast fed), similar to previously reported breast feeding rates at our hospital. 20% of all of the urine cultures tested positive. As expected, a greater percentage of urine cultures in females were positive (22.5%) vs. males (18.1%, p<0.05). We next compared the rates of positive urine cultures in exclusively breast fed children (22%) with those of formula fed infants (21%). The relative risk of UTI with breast feeding versus formula feeding was 1.03 (0.58-1.82) and the relative risk of UTI with any breast feeding versus no breast feeding was 0.92 (0.58-1.45). We thus found no evidence that breast feeding protects against UTI. We were concerned that a greater percentage of breast fed infants may be receiving vitamin D supplementation, increasing rates of UTI in this group and confound our analysis. We found that vitamin D supplementation significantly increased the risk of UTI, with a relative risk of 1.76 (1.07-2.91, p<0.05). However, only the formula-fed infants showed an increased UTI risk (RR=2.24 (1.29-3.90), p<0.05); neither exclusively breast fed infants (RR=1.61(0.46-5.59)) nor infants receiving any breast milk (RR=1.12(0.38-3.28)) showed any increased risk. This finding may have confounded earlier studies and led to the conclusion that breast feeding protects infants from UTI. Importantly, the rates of vitamin D supplementation in our population were very low (5 percent), minimizing their effect on our study’s results.
Conclusions: Our data indicate that breast feeding does not protect from UTI, but supplementing formula fed infants with vitamin D increases their risk of UTI by 125%. We would therefore recommend that parents whose children are formula fed be advised against providing vitamin D supplements to their children.
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