History of breastfeeding and Helicobacter pylori infection in pre-school children: results of a population-based study from Germany.

Background: Helicobacter pylori infection is predominantly acquired in early childhood. Therefore, childhood nutrition may be related to acquisition of infection. However, there are few current data from developed countries to elucidate this association. We investigated the relation between history of breastfeeding and H. pylori infection in a large population-based sample.

Methods: Study subjects were all pre-school children in the city of Ulm, located in southern Germany and two nearby communities who were screened for school fitness between January and July 1997. The infection status of the children and of the accompanying mother was determined by the 13C-urea breath test. The parents provided additional information through a standardized questionnaire.

Results: In all, 946 children (mean age 5.9 years) and their mothers were included in the final analysis (response in study population 80.2%). Overall, H. pylori prevalence was 9.8% in children and 34.7% in their mothers; there was a strong association between children's and mother's infection. Of the children, 82.5% had ever been breastfed. Prevalence of H. pylori infection was higher in children breastfed compared to never breastfed children (10.1% versus 8.4%) and showed a positive relationship with duration of breastfeeding. After controlling for covariates, including mother's H. pylori status, by means of multivariable analysis, the odds ratio (OR) for children's H. pylori infection was 1.56 (95% CI: 0.79-3.11) for any versus never breastfeeding and 2.57 (95% CI: 1.19-5.55) given the child was breastfed > or =6 months.

Conclusions: These data suggest that breastfeeding in infancy does not protect against H. pylori infection among pre-school children in industrialized countries.