Exclusive breastfeeding for 6 months is associated with reduced risk of febrile seizure
Abstract
Background Febrile seizure (FS) is the most common convulsion disorder without an intracranial abnormality in children aged 6 months to 5 years. Risk factors for FS vary from maternal illness during pregnancy to pediatric nutritional factors, such as micronutrient deficiency or history of exclusive breastfeeding (EBF). The WHO recommends breastfeeding for up to 6 months because breastmilk contains numerous protective factors that may influence immune system development.
Objective To analyze the relationship between FS and EBF and other potential risk factors in children aged 6-60 months.
Methods This paired case-control study used patient medical record data from Wangaya Hospital, Denpasar from 2019-2020. Subjects were included by a purposive sampling technique, matched by age group. Children aged 6 to 60 months with fever >38oC and seizures were allocated to the case group; those with fever but without seizures were allocated to the control group. Patients with intracranial disorders, born prematurely, or with incomplete medical record data were excluded. Data were analyzed using McNemar test, with P values <0.05 deemed to be statistically significant.
Results Of 92 participants, 46 children were allocated into each group. There were no significant differences of gender, delivery method, or birth weight between the case and control groups. Febrile seizure was significantly greater in subjects with a family history of all seizures, overweight nutritional status, and who were non-EBF. McNemar analysis showed that EBF children had significantly lower risk of FS compared to non-EBF children (OR 0.74; 95%CI 0.15 to 3.55; P=0.017). Additionally, positive family history of FS was also a significant factor (OR 4.33; 95% CI 0.25 to 76.04; P=0.021), but not with the overweight nutritional status.
Conclusion Exclusive breastfeeding are associated with reduced risk of FS in children aged 6 months to 5 years.
References
2. IDAI. Rekomendasi penatalaksanaan kejang demam. Edisi 1. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2016. p. 1-16.
3. Yousif AB, Hafez LM, Benkhaial FS. Risk factors for febrile seizures in Benghazi, Libya: a case control study. Alex J Pediatr. 2017;30:68–73. DOI: https://doi.org/10.4103/AJOP.AJOP_21_17
4. Laino D, Mencaroni E, Esposito S. Management of pediatric febrile seizures. International J Environ Res Public Health. 2018;15:2232. DOI: https://doi.org/10.3390/ijerph15102232
5. Mohsenipour R, Saidi M, Rahmani P. Assessment of causative factors of febrile seizure related to a group of children in Iran. Biomedical Research. 2017;28:1548-52. Corpus ID: 42095320.
6. Paul SP, Rogers E, Wilkinson R, Paul B. Management of febrile convulsion in children. Emerg Nurse. 2015;23:18-25. DOI: https://doi.org/10.7748/en.23.2.18.e1431
7. Nishiyama M, Yamaguchi H, Ishida Y, Tomioka K, Takeda H, Nishimura N, et al. Seizure prevalence in children aged up to 3 years: a longitudinal population-based cohort study in Japan. BMJ Open. 2020;10:e035977. DOI: https://doi.org/10.1136/bmjopen-2019-035977
8. Mitsuda N, Hosokawa T, Eitoku M, Fujieda M, Suganuma N. Japan Environment and Children Study Group. Breastfeeding and risk of febrile seizures in infants: The Japan Environment and Children’s Study. Brain Dev. 2019;41:839-47. DOI: https://doi.org/10.1016/j.braindev.2019.07.001
9. Sajadi M, Khosravi S. Mothers’ experiences about febrile convulsions in their children: a qualitative study. Int J Community Based Nurs Midwifery. 2017;5:284-91. PMID: 28670589.
10. Kantamalee W, Katanyuwong K, Louthrenoo O. Clinical characteristics of febrile seizures and risk factors of its recurrence in Chiang Mai University Hospital. Neurology Asia. 2017;22:203-8.
11. Kementrian Kesehatan RI. Infodatin: Menyusui sebagai dasar kehidupan, dukung ibu menyusui untuk cegah stunting. anak sehat, bangsa kuat. [cited 2023 Nov 5]. Available from: https://p2ptm.kemkes.go.id/kota/menkes-menyusui-sebagai-dasar-kehidupan-dukung-ibu-menyusui-untuk-cegah-stunting-anak-sehat-bangsa-kuat
12. Sayres S, Visentin L. Breastfeeding: uncovering barriers and offering solutions. Curr Opin Pediatr. 2018;30:591-6. DOI: https://doi.org/10.1097/MOP.0000000000000647
13. Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD003517. DOI: https://doi.org/10.1002/14651858.CD003517.pub2
14. Peng X, Yao BZ, Wang S, Yu SQ, Fang CC, Xu YM, et al. The protective effect of breastfeeding on febrile seizures: a case control study. Breastfeed Med. 2020;15:709-14. DOI: https://doi.org/10.1089/bfm.2020.0105
15. Yahyaoui S, Lammouchi M, Yahyaoui O, Olfa B, Sonia M, Samir B. Risk factor of febrile seizures in Tunisian children: a case-control study. J Med Surg Pathol. 2019;4:176. DOI: https://doi.org/10.35248/2472-4971.19.176
16. Kakalang JP, Masloman N, Manoppo JIC. Profil kejang demam di bagian ilmu kesehatan anak RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2014 – Juni 2016. E-Clinic. 2016;4:1-6. DOI: https://doi.org/10.35790/ecl.4.2.2016.14396
17. Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD003517. DOI: https://doi.org/10.1002/14651858.CD003517
18. Aswin A, Muhyi A, Hasanah N. Hubungan kadar hemoglobin dengan kejang demam pada anak yang disebabkan infeksi saluran pernapasan akut: studi kasus kontrol. Sari Pediatri. 2019;20:270-5. DOI: https://doi.org/10.14238/sp20.5.2019.270-5
19. Amitay EL, Raz GD, Keinan-Boker, L. Breastfeeding, other early life exposures and childhood leukemia and lymphoma. Nutr Cancer. 2016;68:968–77. DOI: https://doi.org/10.1080/01635581.2016.1190020
Copyright (c) 2024 Jessica Gosal
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2024-11-04
Published 2024-11-04
