Infections the major reason infants attend hospital or see a GP

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Infections account for almost three quarters of Australian infants needing to see a doctor and 1 in 10 presenting to an emergency department by 12 months of age, according to a new study.

The research, led by the Murdoch Children’s Research Institute (MCRI) and published in the Journal of Paediatrics and Child Health, found 72% of infants visited a GP and 10% of infants attended the emergency department for an infection, with respiratory illnesses the most common cause.

MCRI’s Dr Rebecca Rowland said few studies have addressed incidence rate, risk factors and health service utilisation of infection in Australian infants until now.

Dr Rowland said this data would inform public health prevention strategies, health systems planning and resource allocation.

“Infant infections place significant burden on primary health care,” she said.

“Quantifying this burden in the Australian setting and understanding the associated factors can help target resources and prevention efforts.”

The research involved 1,074 Geelong families in the Barwon Infant Study, a major study conducted at Barwon Health in collaboration with MCRI and Deakin University. Infection data was collected by parent reports and GP and hospital records at one, three, six, nine and 12 months of age.

Dr Rowland said the study found maternal antibiotic exposure in pregnancy, having older siblings, attending childcare, and reduced rates of breastfeeding were associated with infant infections.

“Antibiotics are potentially life-saving for bacterial infections generally and also in pregnancy, so the key messages are promoting appropriate antibiotic use in pregnancy, and also breastfeeding for at least the first month of life. These factors may help reduce the early life burden of infection,” she said.

“On average, infants who were breastfed for at least four weeks experienced about 30% fewer overall infections.”

The study found a link between attending childcare for anywhere between 1 to 40 weeks and overall infection, but the researchers stressed the broad positive impacts of childcare on child development, the family and society.

On average, infants with siblings aged two to six years had more overall infections, and those with siblings aged 10 to 21 years had an increased risk of gastroenteritis.

Globally, infection is responsible for almost five million deaths worldwide in pre-school children.

MCRI’s Professor David Burgner said respiratory infection presentations, such as the flu, to The Royal Children’s Hospital have dropped dramatically during the COVID-19 lockdowns indicating the importance of good hand hygiene in limiting infection spread, as well as an increased uptake of the influenza vaccine.

“One of the few silver linings of the COVID-19 pandemic has been the emphasis placed on hand hygiene in potentially infectious settings, like childcare and shopping centres,” he said. “This has not only helped limit COVID-19 spread in adults, but also the normal childhood infections we would otherwise have seen over winter.”

Researchers from The Royal Children’s Hospital, Barwon Health, Deakin University, University of Melbourne and Monash University also contributed to the findings.

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