Millions of infants die each year from diarrhea. It is taken as axiomatic that the bugs enter the mouth from dirty milk, food, water, fingers, utensils,etc, as they can do in children and adults. I think that in infants respiratory organisms are responsible, ie entering throught the nose. So, does anyone have any evidence or references for oral as opposed to respiratory spread for infant diarrhea, as I can't find any.
What I find curious is that this question has been up for 5 weeks, and no doctor or epidemiologist has bothered to address it! But maybe I need to clarify some points:
1. Common sense tells me that sneezes spread diseases via the air, not by hands. What little evidence there is that distinguishes these two possibilities is decidedly flaky.
2. Since I think that infections are commoner in non-breastfed babies because of supine feeding, and not because of general immunological mechanisms, I reviewed the literature to see just which infections were commoner in the non-breastfed. I was a bit surprised to find good evidence that colds were actually commoner in breastfed babies. An ad hoc explanation is that mum's and infants' noses are closer here.
3. By respiratory spread I mean entering the nose from the air, then finding a protected niche somewhere in the respiratory tract to multiply, especialy in the middle ear. The bugs in the air can come from anywhere -- noses, dust, water vapor (eg cholera in infants), etc.
4. The commonest cause of infant diarrhea abroad today is rotavirus.
5. Salmonella is a particularly good example to consider. It is spread orally through food in children and adults, but I cannot find any such example in babies. It has, however, been found in dust. Someone in S America in the 1930's found that salmonella caused respiratory infections in infants.
6. Is dogma a better word than axiomatic?
7. I developed the supine feeding theory after finding clinically that ear infections in children were very easy to miss. I then reasoned that if it was any good, there should be plenty of supportive (or indeed contradictory) evidence in the existing literature. This would also have the considerable advantage of being independent.
I put this question up in order to invite defenders of the conventional wisdom to cite evidence to back up their position, rather than to justify the supine feeding theory. I have previously published sufficient evidence in favor of the supine theory in the medical literature to at least get it taken seriously, though I had given up hope of this happening and moved on to other things.
To address some of Jon's points:
2. If my theory about breastfeeding catches on, there will be several different lynch mobs after me. Hopefully, they will get in each other's way.
3. In olden days when postmortems were routine, middle ears of infants were very often found to be full of fluid and infection that had not been diagnosed clinically. Anatomically, this is explained by the short and wide Eustachian tube in infants, such that food or secretions could easily enter the ear from noses, mouths or throats, and fester there out of range of the body's defense mechanisms. So, if just one vibrio organism found its way from the air into the middle ear, it may be able to rapidly multiply there in a protected niche and deliver a fatal cholerogenic dose down into the stomach when the baby was suddenly held upright.
4. It is useful for my theory that the commonest cause on infant diarrhea is a respiratory virus. For conventional theory, this is quite problematic. Why isn't the commonest cause one of the usual suspects, one of the organisms known to spread via food or the fecal-oral route in older children?
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