Association between Acute Respiratory Infection and Type of Feeding in Children up to 2 Years of Age: A Comparative Study of Breast Feeding, Formula Feeding and Mixed Feeding in CMH Abbottabad

Objectives: To determine the association between acute respiratory infection and type of feeding in children up to 2 years of age presenting at the pediatric outpatient department. Study Design: Case-control study. Place and duration of study: This study was conducted at the Department of Pediatrics, CMH Abbottabad, from October 2024 to March 2025. Methods: A total of 50 children aged ≤2 years presenting with acute respiratory infection were included in the study group. Another 50 children of the same age group without any diagnosis of infections or any serious illness were added in the control group. Interviews of mothers were conducted to find the feeding history of children during the first six months of life. Infants were then categorized into exclusive breastfeeding, exclusive formula feeding, and mixed feeding as per WHO classification. The association between feeding type and the incidence of infection was assessed using the chi-square test and odds ratios. Results: The mean age of children was 8.21±5.71 months with a predominant male population (61%). Exclusive formula feeding was the most common (60%), while exclusive breastfeeding was the least common (10%) in the study group. Conversely, exclusive breastfeeding was most common (56%) and exclusive formula feeding was least common (20%) in the control group. A statistically significant association was found between feeding type and the incidence of acute respiratory infection (p < 0.0001). Infants on exclusive formula feeding had significantly higher odds of developing the infection (OR: 16.8), whereas exclusive breastfeeding was associated with the lowest risk. Conclusion: A significant association was found between feeding practices and the risk of acute respiratory infection in children up to 2 years of age.