Infant Feeding Type of Children Who Qualify For SARS-CoV-2 Testing: An Observational Study

Background: It has been demonstrated that children who had been breastfed remain better protected against various infections, and notably respiratory tract infections, well beyond infancy. Since the role of breastfeeding to explain why children are less affected by COVID-19 has not been studied until now, the aim of this study was to determine whether any history of breastfeeding reduces the incidence rate of COVID-19 in children.Methods: This was a secondary analysis of an observational study on clinical and epidemiological characteristics of pediatric COVID-19 in Majorca. A total of 691 children were recruited. Eligible participants were children under 14 who were tested for SARS-CoV-2 in pediatric emergency services. The independent explanatory variable was initial breastfeeding. Bivariate analyses were conducted through the Chi-square test, the Fisher's Exact test or the Student’s T test. All children had the same demographic, epidemiological and clinical data collected through a study team member interview and via the participants medical records. Aspredicted Trials Registry number is #62721. Results: Within the sample of children who visited emergency services with symptoms of potential COVID-19, we found higher prevalence of positive SARS-CoV-2 RT-PCR test results among those who were exclusively formula fed compared with those who were ever breastfed (OR, 2.48; 95%CI, 1.45-3.51; P=0.036). Conclusions: Since approximately 1 in 60 ever breastfed symptomatic children had tested positive for SARS-CoV-2 versus 1 in 25 never breastfed symptomatic children, this study shows that initially breastfed children remain at lower risk of COVID-19.