Best Prevention Strategy for Intussusception
Exclusive breastfeeding during the first months of life is the most effective primary preventive measure for intussusception, providing passive immunologic protection throughout the peak risk window of approximately 3-9 months of age. 1, 2
Why Exclusive Breastfeeding (Answer D)
Breastfed infants have significantly lower rates of intussusception compared to formula-fed infants, with the protective effect maximized during the peak incidence at 4 months of age 2
The American Academy of Pediatrics reports that breastfeeding provides lower rates of gastrointestinal conditions including intussusception, extending beyond just GERD protection 2
This protection operates through passive immunologic mechanisms that are active precisely during the vulnerable period when 75-90% of idiopathic cases occur (5-9 months) 1
Why the Other Options Are Incorrect
Education About Early Symptoms (Option A)
This represents secondary prevention (early detection) rather than primary prevention and does not reduce the actual occurrence of intussusception 1
While important for reducing morbidity from delayed diagnosis, education does not prevent the telescoping event itself 1
High-Fiber Diet (Option B)
No demonstrated link exists between high-fiber diets and preventing intussusception in infants 1
Infants in the typical age range (3 months to 5 years) are primarily consuming breast milk or formula, making dietary fiber modification inapplicable and ineffective 2
High-fiber foods are actually a risk factor for bezoar formation in certain contexts, not a preventive measure 2
Physical Activity in Infancy (Option C)
No established role exists for increased physical activity in preventing intussusception 1
The pathophysiology involves intestinal motility disorders and anatomical factors, not sedentary behavior 2
Supporting Role of Rotavirus Vaccination
The Advisory Committee on Immunization Practices (ACIP) recommends routine rotavirus vaccination, which prevents rotavirus gastroenteritis—a known trigger for intussusception 1
Contemporary rotavirus vaccines (RotaTeq, Rotarix) showed no increased risk of intussusception in pre-licensure trials of approximately 70,000 vaccinated infants 1
By reducing rotavirus infection, vaccination indirectly lowers intussusception risk during the vulnerable infant period 1
Clinical Context
The peak incidence occurs at 5-9 months of age, with 75-90% of cases being idiopathic without identifiable anatomic lead points 1
The classic triad (intermittent abdominal pain with legs drawn to chest, red currant jelly stool, palpable mass) is present in only 46-50% of cases 3, 4, 5
Delayed recognition beyond 48 hours significantly increases morbidity and mortality, but prevention through breastfeeding remains superior to relying on early symptom detection 2