The impact of infant feeding patterns on infection and diarrheal disease due to enterotoxigenic Escherichia coli

Objective. Determine the impact of dietary risk factorson patterns of infection by heat labile toxin-producingEscherichia coli (LT-ETEC). Materials and methods.Ninety-eight infants were followed from birth for one yearin Guadalajara, Mexico, beginning in august of 1986. Stooland breast milk samples were collected weekly from infantsand their mothers, respectively. Mothers were alsointerviewed on a weekly basis regarding the health of theinfants. Parametric hazard models were fit to durations ofdifferent LT-ETEC disease states determined through theanalysis of stools. The child’s consumption of supplementalfoods and liquids as well as specific levels of LT-ETEC-specificbreast milk antibodies were included in each model as timevaryingcovariates. Results. The hazard of LT-ETECasymptomatic infection increased 400 percent amongchildren who received oats gruel (hazard rate= 4.01; 95%CI 2.77-5.24). The duration of infection was reduced if thechild had had a previous LT-ETEC diarrheal episode (2.12;95% CI 1.74-2.49) but was prolonged if the child consumedherbal teas (0.53; 95% CI 0.27-0.7). Herbal teas and highLT-ETEC-specific breast milk antibody levels each reducedthe hazard of symptomatic infection by ninety percent.Symptomatic episodes became asymptomatic more rapidlyif a child was given rice water. Conclusions. Specific weaningfoods increase the risk of infection. Breastmilk antibodiesand liquid infusions reduce diarrheal disease and infectionduration.