Bottle-feeding Risk Factor for Hypertrophic Pyloric Stenosis (Hps) in Infants

Bottle-feeding Risk Factor for Hypertrophic Pyloric Stenosis (Hps) in Infants

The power of mother’s milk, when directly fed to infants, whether premies or term infants, is indescribable and the health benefits produced by its continued use only makes the case stronger. According to the latest CDC report, the moms that breastfeed has risen to 77% in 2010, and those that continue breastfeeding upto atleast 6 months has increased to 49%. This is in good part due to the increased services provided at the hospitals, where they now better encourage rooming-in and skin-to-skin time.

Breastfeeding: Secret to good health of infants

Everyday, there are a multitude of reports attesting to the power of mother’s milk and its benefits to infants, in providing them not only with nourishment, but also improving their chances to fight infections, and preventing prolonged hospital stays in premies.

The latest study, published today by Dr. Goldin’s group, demonstrated an inverse correlation in the decreased incidence of hypertrophic pyloric stenosis (HPS) in infants over the years, to an increased prevalence of breastfeeding.

Causes of HPS

HPS is a thickening of the muscle layer of the pylorus (lower part of stomach) that occurs in the crucial first weeks of life. When the muscles in pylorus become enlarged, the channel to empty food from stomach to intestine narrows and prevents gastric emptying. This condition occurs in 2 per 1000 births and manifests as forceful vomiting in the infant. The obstruction of gastric outlet necessitates surgery in most cases. The proposed causes are many: male, firstborns and seen in white individuals.

In order to understand the association between increased breastfeeding and decreased incidence of HPS, the authors studied 715 infants, to assess the effects of maternal age, smoking status of mother, bottle-feeding, infant sex and maternal parity. This study demonstrated that in mothers with increased maternal age, there was a significant risk association with bottle-feeding and HPS.

Bottle-feeding as a risk factor for HPS

It is interesting to note that while breastmilk contains a peptide hormone to relax the pylorus and aid in emptying the gastric contents, formula possesses higher osmolarity and decreases gastric emptying. It has also been shown in previous studies that infants drink larger volumes when fed by bottle, so that could also account for the condition.

There was an increased risk in the causation of HPS due to bottle-feeding in mothers of increased maternal age. That possibly could add another factor to consider: the increased estrogen present in older mothers also slows gastric emptying. It is also suspected that the fetus’ pyloric muscle could be primed, in utero, to the high estrogen levels in the older mother’s uterus, thereby making the infant more susceptible to the effects of bottle feeding, after birth.

The authors caution that the design of this study was based on observation and more detailed analyses, taking into consideration, the multiple factors of mother and infant needs to be performed.

As for the breastfeeding advocates, this study adds a feather in their cap, and they can continue to push for this noble cause.

Written By: Dheepa Balasubramanian

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