Comparison of late neonatal sepsis in breast fed and bottle fed infants admitted to Khyber Teaching Hospital, Peshawar, Pakistan

Abstract

BACKGROUND:Infections are frequent and important causes of morbidity and mortality in the neonatal period. Late-onset infections, occurring after one week of life, are acquired in the normal newborn nursery,neonatal intensive care unit (NICU), or the community. The associated factor of late-onset sepsis causing deaths includes lack of breastfeeding among others. Feeding colostrum and breast feeding, especially exclusive breast feeding, protects against such deaths. The objective of this study was to compare the frequency of late neonatal sepsis in breastfed and bottle fed infants.
METHODS: This cross sectional study was conducted over a period of six months, from April 8, 2009 to Oct 7, 2009. Receiving patients from both outpatient department and emergency. 246 cases of full term infants aged 7-28 days with suspected late neonatal sepsis were selected from Neonatology unit of Pediatric department, Khyber Teaching Hospital,
Peshawar through non probability purposive sampling. Cultures from blood, urine, CSF and umbilicus in all cases and pleural fluid in selective cases were taken or confirmation of sepsis. Feeding practices of neonates were noted. Mean ,standard deviation, frequencies and percentages, odd ratios with 95% Confidence Intervals were calculated for selective variables while Chi square test was applied using SPSS version 14.
RESULTS:Out of 246 infants with late neonatal sepsis, 140 (57%) were males and106 (43%) females. Mean age was 16.75 days (SD ±5.93);222(90%) were bottle fed while 24(10%) were exclusively breast fed. Among bottle fed 128(57.6%) were confirmed as having neonatal sepsis while in breast fed, 17(70.8%) were found to have sepsis. Odd Ratio was
0.56 ( 95% CI=0.22 to 1.40) and p-value equal to 0.212 rendering the result as non-significant.
CONCLUSION:Though no significant association is found between feeding pattern and late neonatal sepsis, It is therefore concluded that bottle feeding is a major contributor in the causation of late onset neonatal sepsis.

KEY WORDS: Neonate, sepsis, breast feeding, bottle feeding.