breastfeeding babyome babies just seem to be more fussy than others. The case could be more physical disorder than disposition, though, and a recent study suggests bottle-feeding may be the culprit in some cases.

Dr. Jarod P. McAteer and his colleagues at the Seattle Children’s Hospital explored Washington state medical records and birth certificates from 2003 through 2009 to identify babies diagnosed with hypertrophic pyloric stenosis (HPS). This form of stomach obstruction usually strikes infants less than two months old. The disorder is considered medically common since two children out of every 1,000 gets it but little is known about what causes it.

Surgical correction - pyloromyotomy - is sometimes used to clear the HPS. The pylorus is the “gateway” marking the end of the stomach and the beginning of the small intestines. When HPS occurs, the smooth muscle layer of the pylorus thickens and blocks further digestion. Symptoms include frequent vomiting that is severe and projectile.

The McAteer team combed records to identify 714 children during the study period who were both diagnosed with HPS and who had pyloromyotomy to correct it. Each HPS case was matched with a baby of similar age, weight, gender, and other characteristics to create a control group for comparative contrast. They then matched each child with the form of feeding the child got - bottle or breast.

Breastfeeding grew in favor during the 1980s, about the same time the number of HPS diagnoses declined. The researchers wanted to know if the numbers represented cause or coincidence.

Study findings include:

  • 2003: 14 HPS cases per 10,000 births
  • 2009: 9 HPS cases per 10,000 births
  • 2003: 80 percent of mothers were breastfeeding
  • 2009: 94 percent were breastfeeding
  • Bottle-fed babies were 19.5 percent more likely to develop HPS.
  • Breast-fed babies were 9.1 percent likely to develop it.
  • Male children were more likely to develop HPS.
  • Mothers age 35 and older were more likely to have children diagnosed with HPS.
  • Mothers who already had children were more likely to have HPS babies.

The research team concludes that bottle-feeding is indeed associated with an increased risk of HPS although the exact physiological mechanism remains unknown. The need for further study is suggested.

Source:  McAteer, Jarod P. MD, MPH, et al. “Role of Bottle Feeding in the Etiology of Hypertrophic Pyloric Stenosis (abstract).” JAMA Pediatrics. The American Medical Association. Oct. 21, 2013. Web. Nov. 21, 2013.

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