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Clinical Pediatrics
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Breastfeeding Does Not Protect Against Urinary Tract Infection in the First 3 Months of Life, but Vitamin D Supplementation Increases the Risk by 76%

Ranjitha Katikaneni, MD

Pediatric Endocrinology Research Laboratory, Ochsner Clinic Foundation, New Orleans, Louisiana

Tulasi Ponnapakkam, PhD

Pediatric Endocrinology Research Laboratory, Ochsner Clinic Foundation, New Orleans, Louisiana, tponnapakkam{at}ochsner.org

Adharsh Ponnapakkam

Pediatric Endocrinology Research Laboratory, Ochsner Clinic Foundation, New Orleans, Louisiana

Robert Gensure, MD, PhD

Pediatric Endocrinology Research Laboratory, Ochsner Clinic Foundation, New Orleans, Louisiana

Our goal was to determine if breastfeeding provides any protection against urinary tract infection (UTI) and if vitamin D supplementation imposes any additional risks for UTI in infants < 3 months of age. In this study, 40% of the children who had urine cultures were breastfed, and 18.7% of the children were exclusively breastfed. Twenty percent of all of the urine cultures tested positive, and this number was greater in females (22.5%) than in males (18.1%, P < .05). There was no significant difference between the rates of positive urine cultures in exclusively breastfed (22% vs 21%, nonsignificant [NS]) formula-fed infants. The relative risk of UTI with breastfeeding versus formula feeding was 1.03 (0.58-1.82), and any breastfeeding versus no breastfeeding was 0.92 (0.58-1.45). Vitamin D supplementation increased the UTI risk, with a relative risk of 1.76 (1.07-2.91, P < .05). However, only formula-fed infants showed an increased risk of UTI after vitamin D supplementation.

Key Words: American Academy of Pediatrics (AAP) • vitamin D recommendation • urinary tract infection

This version was published on September 1, 2009

Clinical Pediatrics, Vol. 48, No. 7, 750-755 (2009)
DOI: 10.1177/0009922809332588
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