Diarrhea and rotavirus infection associated with differing regimens for postnatal care of newborn babies

Surveillance of 2,041 babies born during 4 winter months in one obstetric hospital in Melbourne, Australia, showed that 215 developed acute diarrhea during the first 2 weeks of life. Babies requiring special care from birth had a high incidence of sporadic diarrhea (36%). The incidence of diarrhea among healthy full-term babies was low if they were "rooming-in" with their mothers (2 to 3%) but high if they were housed in communal nurseries (29%). The most important factor influencing incidence of diarrhea was proximity to other newborn babies and frequency of handling by related adults. Breast feeding did not always protect babies from diarrhea. Excretion of rotaviruses was temporally retlated to diarrhea in 61 to 76% of healthy full-term babies and in 44% of babies requiring special care. Other eneteric pathogens, including enerotoxigenic Escherichia coli, were occasionally isolated. Calculation of the ratios of symptomatic to asymptomatic infection suggests that babies requiring special care are much more likely to develop symptomatic illness after rotavious infection than are full-term babies.