Effects of breast milk nutrition on chronic adenoiditis, chronic tonsillitis, adenotonsillary hypertrophy and allergy

Aim: In our study, it was aimed to reveal whether breastfeeding has an effect against recurrent upper respiratory tract infections, allergies and adenotonsillar hypertrophy, which is the result of inflammation triggered by infections. Materials and Methods: Our study was planned as a prospective, clinical study in the Department of Otorhinolaryngology and Pediatrics in the Faculty of Medicine of Karadeniz Technical University. The study group consisted of 300 children aged 0-15 years, who applied to the Otorhinolaryngology Clinic with the complaints of frequent throat infections, snoring, sleeping with an open mouth and decreased hearing, the control group consisted of 300 children aged 0-15 years, who applied to the Pediatrics Clinic for control purposes only. Adenoidectomy, tonsillectomy, adenotonsillectomy and ventilation tube application were decided for the patients who applied to the Otorhinolaryngology Clinic as a result of medical history, physical examination, audiological evaluations and direct lateral cervical radiographs taken when necessary. Both groups were compared regarding to gender, age, birth weight, duration of breastfeeding, duration of formula use and eosinophil count in complete blood count and time to supplementary food. Results: When the applications made to the clinics in both groups are evaluated; there were 166 (55.3%) girls and 134 (44.7%) boys in the control group, 130 (43.3%) girls and 170 (56.7%) boys in the study group. It was observed that adenoidectomy, tonsillectomy, adenotonsillectomy and, when necessary, ventilation tube application were performed more frequently in boys than in girls (p = 0.003). When both groups were compared according to their birth weights; Of 600 children, 36 (6%) had lower than normal birth weight, 536 (89.3%) had normal birth weight, and 28 (4.6%) had high birth weight. 7 (19.4%) of 36 children with lower than normal birth weight were in the control group, 29 (80.6%) were in the study group, 283 (52.8%) of 536 children with normal birth weight were in the control group, 253 (47.2%) were in the study group, 10 (35.7%) of 28 children with high birth weight were in the control group and 18 (64.3%) were in the study group. It was observed that more adenoidectomy, tonsillectomy, adenotonsillectomy and ventilation tube application were performed in children with lower than normal birth weight (<2500 g) (p<0.001). When both groups were compared according to the duration of breastfeeding; Of 600 children, 16 (2.7%) were not breastfed, and 584 (97.3%) were breastfed. Of 584 breastfed children, 299 (51.2%) were in the control group, 285 (48.8%) were in the study group, 1 (6.2%) of 16 children who were not breastfed were in the control group, and 15 (93.8%) were in the study group. Of the children who were breastfed, 100 (16.7%) were breastfed for 0-6 months, 148 (24.7%) for 7-12 months, and 352 (58.6%) for more than 12 months. It was observed that 8 (8%) of 100 children who were breastfed for 0-6 months were in the control group and 92 (92%) were in the study group. It was observed that 89 (60.1%) of 148 children who were breastfed for 7-12 months were in the control group and 59 (39.9%) were in the study group. It was observed that 203 (57.7%) of 352 children who were breastfed for more than 12 months were in the control group and 149 (42.3%) were in the study group. It was observed that adenoidectomy, tonsillectomy, adenotonsillectomy and ventilation tube application when necessary were performed more frequently in children who were breastfed for less than 6 months compared to children who were breastfed for more than 6 months (p <0.001). When both groups were compared according to the duration of feeding; Of 600 children, 418 (69.7%) did not receive formula, and 182 (30.3%) received formula. Of 418 children who did not receive formula, 285 (68.2%) were in the control group, 133 (31.8%) were in the study group, 15 (8.2%) of 182 children who received formula were in the control group, and 167 (91.8%) were in the study group. Of 55 (30.2%) children who received formula for 6 months or less, 8 (14.5%) were in the control group, 47 (85.5%) were in the study group, of 71 (39%) children who received formula for 7-12 months, 7 (9.9%) were in the control group, 64 (90.1%) in the study group, 56 (100%) of 56 (30.8%) children who received formula for more than 12 months were in the study group. It was observed that adenoidectomy, tonsillectomy, adenotonsillectomy, and ventilation tube application were more common in children who received formula for more than 6 months compared to children who received formula for less than 6 months (p <0.001). When both groups were compared according to the number of eosinophils in the complete blood count; 399 (66.5%) of 600 children did not have eosinophilia in the complete blood count, eosinophilia was found in 201 (33.5%). Out of 399 children with no eosinophilia, 239 (59.9%) were in the control group, 160 (40.1%) were in the study group, 61 (30.3%) out of 201 children with eosinophilia were in the control group, and 140 (69.7%) were in the study group. Eosinophil count was found to be higher in the complete blood count of the children in the study group compared to the children in the control group (p <0.001). When both groups were compared in terms of transition time to supplementary food; 506 (84.3%) of 600 children passed between 0-6 months, 94 (15.7%) passed after 6 months. Of 506 children who passed to solid food between 0-6 months, 259 (51.2%) were in the control group, 247 (48.8%) in the study group, of the 94 children who passed to solid food after the 6th month, 41 (43.6%) were in the control group and 53 (56.4%) were in the study group. There was no significant relationship between the control and study groups in terms of passing to supplementary food before or after 6 months (p=0.178). Conclusion: In our study, we found that the patients who underwent adenoidectomy, tonsillectomy, and bilateral ventilation tube operations were mostly male, had lower birth weight, had higher eosinophilia rates in complete blood counts, received breast milk for less time and formula for a longer period of time. From this point of view, we can say that breast milk protects the child from adenotonsillar infections and allergies, and from adenotonsillar hypertrophy caused by hypoxia and reoxygenation as a result of activation of neuroimmunomodulatory pathways resulting from recurrent infections. In this direction, we can contribute to the literature by supporting breast milk intake by saying that the number of surgical procedures due to allergies, recurrent adenotonsillar infection and adenotonsillar hypertrophy can be reduced. Key Words: Breastfeeding, Adenotonsillar Hypertrophy.