The role of breastfeeding, antibiotics, and antimalarial medicinal exposure in paediatric depression amongst children aged under 5: a population based study.

Umeh, K and Adaji, S (2025) The role of breastfeeding, antibiotics, and antimalarial medicinal exposure in paediatric depression amongst children aged under 5: a population based study. BMC Pediatrics, 25. ISSN 1471-2431

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Abstract

Background
Although paediatric depression is a recognised problem worldwide, there is limited data on its prevalence in children aged under 5 years, and the role of breastfeeding and medicinal exposure. This study examined whether lack of breastfeeding, and exposure to antimalarial and antibiotic medicines, contribute to depression in Nigerian children aged under 5.

Methods
The study examined data from 31,103 children (mean age, 2.11 years (SD, 1.421)), collected during the 6th round of the MICS (Multiple Indicator Cluster Surveys), completed in 2021. A series of binary logistic regression models were used to analyse the data.

Results
Children exposed to antimalarial medicines, specifically ACT (AOR = 1.760, 95%CI [1.316–2.355]), and artesunate injections (AOR = 1.757, 95%CI [1.150–2.684]), and those who were not breastfed (AOR = 0.776, 95%CI [0.625–0.963]), had greater odds of depression, after adjusting for potential confounders. The association between ACT medication use and depression was salient in male children (AOR = 2.347, 95%CI [1.547–3.559]), whereas the relationship between breastfeeding and depression was primarily observed in female children (AOR = 0.689, 95%CI [0.498–0.951]). Robustness checks including variations in managing missing data, breastfeeding measurement, and analysis across subgroups for multiple covariates (e.g., geographical area, mothers’ education, wealth index, medical symptoms), highlighted the importance of contextual factors.

Conclusions
This is the first population-based study to examine the role of breastfeeding and medicinal use in suspected depression amongst children aged under 5, from sub-Sharan Africa. Overall, exposure to antimalaria treatment, particularly ACT, and inadequate breastfeeding may help identify young children susceptible to paediatric depression.

Item Type:	Article
Uncontrolled Keywords:	1114 Paediatrics and Reproductive Medicine; Pediatrics; 3213 Paediatrics; 4204 Midwifery
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RJ Pediatrics
Divisions:	Psychology (from Sep 2019)
Publisher:	BMC
Date of acceptance:	21 November 2024
Date of first compliant Open Access:	22 May 2025
Date Deposited:	22 May 2025 15:46
Last Modified:	22 May 2025 16:00
DOI or ID number:	10.1186/s12887-024-05265-1
URI:	https://researchonline.ljmu.ac.uk/id/eprint/26403

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