Does breast milk bath help hand foot and mouth

Study design

We used information collected from a case-control study conducted in 6 cities in Guangdong Province, China (Figure 1), regarding risk factors for children hand, foot and mouth disease. The survey was conducted during the period from June 2010 to December 2011. These cities account for approximately 19% of the population and 23% of the province’s geographic area. Approval to conduct this study was granted by the Medical Ethics Committee of Guangdong Provincial Centre for Disease Control and Prevention. Informed consent was obtained before each interview.

A list of new diagnosed cases of hand, foot and mouth disease were provided by local hospitals, eligible cases were those aged 4 years or younger, who were newly diagnosed by a clinical doctor within 7 days before the field interview. And this study was restricted to children who have not attended to a kindergarten or child care center, and resided in the study location for at least 6 months. It was estimated that about 30% of the new diagnosed cases were randomly selected from the patient list and included in this analysis. The diagnosis was based on the Hand, Foot and Mouth Disease Clinic Guide (2010 edition) issued by the Ministry of Health of China [20]. Hand, foot and mouth disease is characterized by a brief febrile illness in children and typical skin rash, with or without mouth ulcers. Typically, the rash is papulovesicular and affects the palms or soles of the feet, or both [21].

We got the list of the potentially eligible children under 4 years of age from a neighbor village and 2-3 controls were randomly selected when one case was determined, these villages should not have HFMD cases one year before this survey. The eligible controls should have not been diagnosed as a hand, foot and mouth disease, or any other gastrointestinal tract diseases 6 months before the survey and should have no direct contacts with any cases. In order to avoid any misclassification, the feces of the controls were collected and underwent enterovirus RT-PCR test, if any control was positive for EV71, CA16 and other enterovirus, he/she would be excluded from the analysis. Details about the laboratory testing can be found elsewhere [22].

Face-to-face interviews were conducted at the subjects’ home by trained interviewers using a structured questionnaire. Interviews were administered to the guardians of the subjects, usually their parents. In addition to detailed information about the breastfeeding type at the first 6 months of the children, information was also collected for demographic factors, household information, contacts with HFMD patients, and hand washing habits. Exclusive breastfeeding was defined as excluding solids or any other fluids (including infant formulas) except medicines, vitamins, and minerals, in this study we found that the feeding type was either exclusive breastfeeding or mixed type of breast feeding and supplementary fluids, so we used the mixed feeding type as the reference group in the analysis. We asked about the exposure during 2 weeks before onset of the symptom of HFMD for cases or before the survey for controls, as this infection usually has incubation period of about 1-2 weeks [23],[24]. For example, the subjects were asked whether they went to see a doctor for any illness or whether they went to visit a patient in a hospital or at the patient’s home. We also included the information of the children’s hand-washing habits before dinner, after toilet use and the guardians’ hand washing before contacting with the child. The information about the contacting with other children in the playgrounds indoors and outdoors were also included in this survey. We also included some household factors in the questionnaire, such as monthly household income, household hygiene condition, house area, and number of family members. The household hygiene condition was evaluated using an indicator of whether there was any visible trash around the house of the subjects. We calculated the crowding of the family by dividing the family numbers for per 100 m2 house area.

We recruited and trained public health doctors from community health centers to conduct the interviews. If one subject was not convenient for the interview, one revisit was attempted. As it was unlikely for the interviewers to be blinded to the case/control status, they were unaware of the main study hypothesis and were trained to administer strictly the questionnaires in an equal manner to the cases and controls.

Top 21 does breast milk bath help hand foot and mouth