Anti-microbial susceptibility pattern of infant feeding bottles from bottle fed infants

Chandra Sekhar Kondapalli, Garikapati Siddhartha


Background: Breastfeeding, which has been declining in the recent years because of advances in science. Thought the importance of breastfeeding have been studied, the implementation of the same is being difficult, because of lack of awareness among mothers, health care workers etc.

Methods: Consent was taken from the parents who fed their babies with infant feeding bottle and explained about the necessity to obtain culture of the bottles and nipples. Swab was inoculated on the MacConkey agar culture. Antibiotic susceptibility testing will be done for all the isolates.

Results: This study showed that 32% were initiated on bottle feeding before 6mo of age and 45% during 6-12mo of age and 23% after age of 1 yr. The most common presenting illness were diarrhea (43%) followed by respiratory illness (39%). Bottle feeding has contribution to the malnutrition and showed that adequate cleaning practices were followed by only 41 % of mothers and 9% of mothers had poor cleaning practices. The incidence of illness is 60. 7% in only top fed babies compared to babies who are both breast fed and bottle fed 39.3%. The most common isolate found was E-coli 45% (24) followed by. Kliebsella 24% (12), Staphylococcus 16% (9), CONS 9% (5), Enterobacterecciea 3% (2) and Pseudomonas 0.8% (1). 52% of the sample showed fungal isolation positive.

Conclusions: The incidence of bottle feeding was found more common in working women(53%) compared to housewife(19%). Illiteracy of the family contributed to the over dilution of top milk .most common organism is E-coli.


Culture, Exclusive breast milk, Feeding bottle, Infant feeding practice, Malnutrition, Microbiology

Full Text:



Zhou Q, Younger KM, Kearney JM. An exploration of the knowledge and attitudes towards breastfeeding among a sample of Chinese mothers in Ireland. BMC Public Health. 2010;10:72.

Jones G, Steketee R, Bhutta Z, Morris S, the Bellagio Child Survival Study Group. How many child deaths can we prevent this year? Lancet. 2003;362:65-71.

International Institute for Population Science, Mumbai for Government of India. National Family Health Survey-3 (NFHS-3); 2005-06.

World Health Organization: Global strategy for infant and young child feeding. Geneva: World Health Organization. 2001;1-5.

Tarrant M, Fong DYT, Wu KM, Lee IL Y, Wong EMY, Sham A et al. Breastfeeding and weaning practices among Hong Kong mothers: a prospective study. BMC Pregnancy Childbirth. 2010;10:27.

Gupta A, Dadhich JP, Faridi MM. Breastfeeding and complementary feeding as a public health intervention for child survival in India. Indian J Pediatr. 2010 Apr 1;77(4):413-8.

Kogan MD, Singh GK, Dee DL, Belanoff C, Grummer-Strawn LM. Multivariate analysis of state variation in breastfeeding rates in the United States. Am J Public Health. 2008;98:10.

Kimani-Murage EW, Madise NJ, Fatso JC, Kyubutungi C, Mutua MK, Gitau TM et al. Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health. 2011;11:396.

Diallo FB, Bell L, Moutquin JM, Garant MP. The effects of exclusive versus non-exclusive breastfeeding on specific infant morbidities in Conakry. Pan Afr Med J. 2009;2(1).

Agampodi SB, Agampodi TC, Piyaseeli UK. Breastfeeding practices in a public health field practice area in Sri Lanka: a survival analysis. Int Breastfeeding J. 2007 Oct 11;2(1):13.

World Health Organization. The optimal duration of exclusive breastfeeding: report of an expert consultation. Geneva: WHO, 2001. Available at WWW. who. int/childadolescent-health/New Publications/ Nutrition/WHO.

Huttly SRA, Morris SS, Pisani V. Prevention of diarrhea in young children in developing countries. Bull World Health Organ. 1997;75:163-74.

Kemberling SR. Supporting breastfeeding. Paediatrics. 1979;63:60-3.

Tiwari R, Mahajan PC Lahariya C. The determinants of exclusive breastfeeding in urban slums: a community based study. J Trop Pediatr. 2009;55:49-54.

Lahariya C, Khandekar J. How the findings of national family health survey-3 can act as a trigger for improving the status of anemic mothers and undernourished children in India: a review. Indian J Med Sci. 2007;61:535544.

Fein SB, Roe B. The effect of work status on initiation and duration of breast-feeding. Am J Public Health. 1998 Jul;88(7):1042-6.

Tiwari R, Mahajan PC, Lahariya C. The determinants of exclusive breast feeding in urban slums: a community based study. J Trop Pediatr. 2008;55(1):49-54.

Dewey KG, Heinig MJ, Nommsen-Rivers LA. Differences in morbidity between breast-fed and formula-fed infants. J Pediatr. 1995 May;126(5):696-702.

Ball TM, Wright AL. Health care costs of formula-feeding in the first year of life. J Pediatr. 1999;103:870-6.

Joseph N, Naik VA, Mahantshetti NS, Unnikrishnan B, Mallapur M, Kotian SM. Factors associated with morbidities among infants in three sub centre areas of belgaum district of South India: a longitudinal study. Indian J Community Med. 2013 Jul;38(3):168-174

Brown KH, Black RE, Lopez de Romana G, Creed de Kanashiro H. Infant-feeding practices and their relationship with diarrheal and other diseases in Huascar (Lima), Peru. Pediatrics. 1989 Jan;83(1):31-40.

Mayuri M, Garg V, Mukherji C, Aggarwal D, Ganguly S. Bovine milk usage and infant feeding practices. Indian J Public Health. 2012 Jan-Mar;56(1):75-81.

Banik ND, Krishna R, Mane SI, Raj L. Longitudinal study on morbidity and mortality pattern of children in Delhi during the first two years of life: A review of 1000 children. Indian J Med Res. 1967;55:504-12.

Redmond EC, Griffith CJ, Riley S. Contamination of bottles used for feeding reconstituted powdered infant formula and implications for public health. Perspect Public Health. 2009 Mar; 129(2):85-94.

Arifeen S, Black RE, Antelman G, Baqui A, Caulfield L, Becker S. Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics. 2001 Oct 1;108(4):e67.

Kulkarni RN, Anjenaya S, Gujar R. Breast feeding practices in an urban community of kalamboli, Navi Mumbai. Indian J Community Med. 2004 Oct;29(4):3.

Bergstrom E. Bacterial contamination and nutrient concentration of infant Milk in South Africa: A sub-study of the National PMTCT Cohort Study. June 2003. Thesis. Uppsala University, Sweden.

Redmond EC, Griffith CJ, Riley S. Contamination of bottles used or feeding reconstituted powdered infant formula and implications for public health. Perspect Public Health. 2009 Mar;129(2):85-94.

Iversen C, Lane M, Forsythe SJ. The growth profile, thermotolerance and biofilm formation of Enterobacter sakazakii grown in infant formula milk. Letters Appl Microbiol. 2004 May 1;38(5):378-82.

Himelright I, Harris E, Lorch V, Anderson M. Enterobacter sakazakii infections associated with the use of powdered infant formula -Tennessee, 2001. J Am Med Assoc. 2002;287:2204-5.

Van Acker J, de Smet F, Muyldermans G, Bougatef A, Naessens A, Lauwers S. Outbreak of necrotizing enterocolitis associated with Enterobacter sakazakii in powdered milk formula. J Clin Microbiol. 2001;39:293-7.

Muytjens HL, Zanen HC, Sonderkamp HJ, Kellee LA, Wachsmuth IK, Farmer JJ. Analysis of eight cases of neonatal meningitis and sepsis due to Enterobacter sakazakii. J Clin Microbiol. 1983;18:115-120.