Background: Passive smoking and different types of feeding have an important and crucial effect on physical, mental, and over-all health and future productivity of infants.
Aim of the Work: To detect the impact of passive smoking and suboptimal infant feeding (partially breastfed or artificially fed) on the growth and health of infants.
Patients and Methods: This prospective study has been conducted at Al-Azhar Assiut University Hospital from 1st of May 2020 to 30th of November 2020 on 200 full-term infants, 150 of them exposed to passive smoking from a closed family member and all infant are free from any chronic disease. Preterm infants, infants aged more than 1 year, infants with major congenital anomalies and infants with chronic disease or receiving any chronic medication were excluded from our study. The 200 full-term infants included in this study were further subdivided into 4 groups: group (1) 50 infant fed by exclusive breast feeding and exposed to passive smoking, group (2) 50 infant fed by artificial feeding and exposed to passive smoking, group (3) 50 infant fed by complementary feeding and exposed to passive smoking and group (4) 50 infant fed by exclusive breast feeding and not exposed to passive smoking. Infant anthropometry was performed at first visit and months 1, 2, 4, and 6 after the first visit. Modeling and linear regression were used to calculate growth rates over 6 months. The association between environmental tobacco smoke (ETS) exposure with growth rate was assessed using multivariate linear regression adjusted for confounders, with ETS.
Results: It was found that the mean±SD for age of studied infants was 7.27±3.82 months with male predominance. The predominant effect on physical and mental health was pronounced and statistically significant in group (2) in which their anthropometric measurement (weight, length, head circumference and mid-arm circumference) and Bayley-IV scale (cognitive,language, motor, social-emotional and adaptive behavior) were significantly decreased. And the least affected group was group (4) in which the infants not exposed to environmental tobacco smoke and were on exclusive breast feeding. A categorical analysis using multi nominal logistic regression test taking into consideration Group (4) as reference group, Group (2), Group (3), Group (1) were respectively had a statistically significant lower weight, height, head circumference, and Weight gain rate adjusted for length gain rate (WLG) compared to this reference group, (P<0.05).
Conclusion: The concordance of passive smoking with artificial feeding had dramatic bad effects on physical health of infants in form of marked decrease in their weight, length, head circumference, mid-arm circumference, and also mental health in form of decrease in Bayley scale reflecting impaired cognitive, language, social-emotional and adaptive behavior. Breast feeding in association with no exposure to passive smoking was found to be protective from hazardous effects of passive smoking.
Recommendation: We should encourage breast feeding and avoid exposure of infants to passive smoking during this critical period of life.