Breastfeeding and Risk of Late-Onset Group B Streptococcal Disease

Author:

Ching Natasha S.123,Buttery Jim P.1245,Lai Emily16,Steer Andrew C.567,Standish Jane578,Ziffer Joel9,Daley Andrew J.61011,Doherty Richard12

Affiliation:

1. Departments of Infection and Immunity

2. Department of Paediatrics, Monash University, Clayton, Victoria, Australia

3. General Paediatrics, Monash Children’s Hospital, Monash Health, Clayton, Victoria, Australia

4. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine

5. Infection and Immunity, Murdoch Children’s Research Institute, Parkville, Victoria, Australia

6. Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia

7. Department of General Medicine, The Royal Children’s Hospital, Melbourne, Victoria, Australia

8. Department of Children’s Services, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia

9. Department of Paediatrics, Bendigo Health, Bendigo, Victoria, Australia

10. Laboratory Services

11. Department of Microbiology and Infectious Diseases, The Royal Women’s Hospital, Melbourne, Victoria, Australia

Abstract

BACKGROUND Group B Streptococcus (GBS) is a major contributor to neonatal sepsis worldwide. Late-onset group B Streptococcus disease (LOGBS) and its risk factors remain poorly understood. The isolation of GBS from breast milk has been described in cases of LOGBS. This potential association has raised concerns for mothers and clinicians regarding the safety of ongoing breastfeeding. In this study, we aimed to investigate whether exposure to breast milk is associated with increased risk of LOGBS. METHODS A case-control study of LOGBS was conducted across 4 hospital networks in Victoria, Australia, including the 2 major tertiary pediatric centers in the state, to evaluate 11 years of data (2007–2017). Cases were captured initially from microbiology databases and recaptured with International Classification of Diseases discharge coding. Each case patient was matched with 4 controls to assess feeding status. Patients were matched for chronological age, gestation, discharge status, recruitment site, and calendar year. RESULTS We identified 92 cases of LOGBS: 73 cases on initial capture and 76 cases on the recapture analysis. Case patients were matched with 368 controls: 4 controls to each patient. Seventy-two patients were exposed to breast milk at the time of LOGBS (78.3%), compared with 274 controls (74.5%; odds ratio 1.2 [95% confidence interval 0.7–2.3]). CONCLUSIONS Breastfeeding was not associated with increased risk of LOGBS. Breast milk should not be tested for GBS during a first episode of LOGBS.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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