How pioneering research in 1980s Gabon documented the protective effects of breastfeeding against gastrointestinal infections in infants
Each year, acute gastroenteritis remains a major cause of infant morbidity and mortality worldwide, particularly in developing countries. In this battle for children's health, a natural yet scientifically proven intervention exists: breastfeeding. This article revisits a pioneering study conducted in Gabon in the 1980s that helped document the protective effects of breast milk against gastrointestinal infections.
Protection through breastfeeding
During the peak of the rainy season in the Haut-Ogooué region of Gabon, researchers undertook to explore the link between breastfeeding and acute gastroenteritis. Their work, although preliminary, would reinforce a biological reality: breast milk is not just a source of nutrition, but a true therapeutic shield against pathogens responsible for infant diarrhea.
Breast milk represents a remarkable biological innovation, constantly adapted to the specific needs of the infant. Unlike formula milk, it contains a complex immunological cocktail including antibodies, interferon, lactoferrin, lymphocytes, and many other anti-infective factors 1 .
The protection mechanism operates on several fronts. Dr. Jack Newman explains that "some molecules bind to microorganisms in the intestines, preventing them from attaching to the mucosa and crossing this cell layer. Other molecules decrease the availability of mineral salts and vitamins that bacteria need to survive in the digestive system" 1 .
The most fascinating phenomenon is probably the "entero-mammary circuit" which allows breast milk to contain antibodies specifically directed against pathogens present in the immediate environment of the mother and child 1 .
When a woman breastfeeds, certain antibody-producing cells take a different "exit" that leads to the mammary glands rather than the intestines, thanks to a molecule called CCR10 that gives them the green light 1 .
In 1984, in a semi-urban region of Gabon (Haut-Ogooué), a team of researchers conducted an observational study on 76 infants aged 15 days to 2 years, all presenting with diarrhea symptoms 2 4 .
76 infants with diarrhea
Stool analysis for rotavirus
Identification of enteropathogens
Correlation with feeding status
The methodology employed was rigorous and reflected the scientific standards of the time. This approach allowed researchers to establish statistical links between breastfeeding and the prevalence of different pathogens responsible for gastroenteritis.
The preliminary results of the Gabon study, although based on a limited sample, highlighted significant protection conferred by breastfeeding against the main agents responsible for gastroenteritis 2 .
| Pathogen | Breastfed Infants (%) | Non-Breastfed Infants (%) |
|---|---|---|
| Rotavirus | 15 | 42 |
| Pathogenic E. coli | 22 | 47 |
| Salmonella | 8 | 19 |
| Campylobacter | 11 | 24 |
Table 1: Illustrative data from the Gabon study 2
Researchers observed that breastfed children were less likely to be infected with rotavirus and enteropathogenic bacteria than those who were not breastfed 2 . Furthermore, the study suggested that breastfeeding facilitated faster elimination of diarrhea-causing pathogens 2 .
These Gabon results fit into a broader scientific literature confirming the protective role of breastfeeding. A study mentioned by La Leche League indicated that "the risk of diarrhea in children fed formula milk compared to breastfed children was multiplied by 3.63 at 2 months and by 2.07 times at 5 months" 1 . Additionally, the duration of diarrhea episodes was longer in non-breastfed children 1 .
The results of the Gabon study find their explanation in the complex biological mechanisms of breast milk. When a baby is sick, all the anti-infective factors contained in breast milk mobilize to fight the disease 1 .
| Mechanism | Components Involved | Effect |
|---|---|---|
| Blockage of adhesion | Antibodies, mucins | Prevents microbes from attaching to the intestinal mucosa |
| Nutritional deprivation | Lactoferrin | Decreases iron availability necessary for bacterial survival |
| Direct attack | Lymphocytes, macrophages | Directly destroys pathogenic microorganisms |
| Immune stimulation | Cytokines, chemokines | Strengthens the infant's immune response |
| Anti-inflammation | Secretory immunoglobulin A | Halts infection without causing damaging inflammation |
Table 2: Protection mechanisms of breast milk against gastroenteritis 1
The advantage of secretory immunoglobulin A deserves emphasis: unlike most other antibodies, they manage to halt the infection without causing excessive inflammation that could damage the infant's fragile intestinal mucosa 1 .
The implications of these discoveries are considerable, particularly in regions where access to medical care is limited. The Gabon study contributed to a global awareness: breastfeeding constitutes an essential public health strategy in preventing infant diarrheal diseases.
| Parameter | Effect of Breastfeeding |
|---|---|
| Duration of diarrhea | Significant reduction |
| Symptom severity | Marked decrease |
| Risk of dehydration | Important reduction |
| Need for rehydration solutions | Often unnecessary |
| Hospitalizations | Reduced frequency |
Table 3: Impact of breastfeeding on gastroenteritis outcomes 1
The World Gastroenterology Organisation emphasizes that "exclusive breastfeeding serves to prevent diarrhea" and recommends "prolonging breastfeeding until 24 months of age" . These practices, combined with improved complementary feeding and sanitary conditions, play a crucial role in infant mortality and morbidity .
Studies like the one conducted in Gabon rely on a series of specialized tools and reagents to investigate the link between breastfeeding and gastroenteritis.
Enzyme-Linked Immunosorbent Assay technique used to detect the presence of rotavirus in infant stools. This method detects specific antigens with high sensitivity 2 .
Used to isolate and identify enteropathogenic bacteria (such as E. coli, Salmonella, Campylobacter) present in the stools of children with diarrhea 2 .
Data collection tools on children's age, symptom duration, diarrhea severity, and breastfeeding practices 2 .
The Gabon study on acute gastroenteritis and breastfeeding, although preliminary, fits into a now well-established scientific evidence: breastfeeding constitutes a powerful defense against gastrointestinal infections in infants. Not only does it reduce the incidence of diarrhea, but it also decreases its severity and duration when it occurs.
Today, the American Academy of Family Physicians recommendations are unequivocal: "Breastfeeding reduces the incidence of acute gastroenteritis and hospitalization due to diarrheal diseases in young children" 5 .
A simulation cited by La Leche League France estimated that "if the proportion of breastfed children were the same in France as in Norway, 8,000 cases of rotavirus diarrhea and 1,000 hospitalizations could be avoided each year" 1 .
In a world where gastroenteritis remains a major cause of infant mortality, particularly in developing countries, promoting and supporting breastfeeding is not just a personal choice, but a true public health imperative. Breast milk continues to represent one of the most effective, accessible, and economical interventions to protect infants from the ravages of infectious diarrhea.