Breastfeeding and the development of asthma and atopy during childhood: a birth cohort study
Keywords:
Breastfeeding, Asthma, Atopy, ChildhoodAbstract
Objective. Within the context of a population based-birthcohort, we investigated the association between breastfeedingand development of asthma and atopy in childhood. Methods. Children (n=1072) were followed from birth andreviewed at age one, three, five and eight years. Based on theonset and resolution of symptoms, we assigned children intothe wheeze phenotypes (never, transient, intermittent, lateonsetand persistent). Atopy was determined by skin testingand specific IgE measurement. According to the duration ofbreastfeeding, participants were assigned as not breastfed,breastfed ≤ four months and breastfed > four months. Results. In a multinomial regression model adjusted for gender,we found that breastfeeding > four months was protective of transient early wheeze (aOR: 0.61, 95% CI 0.41-0.90, p=0.01),with no significant association between breastfeeding andother wheeze phenotypes. In a multivariate model, we founda significant protective effect of breastfeeding >four monthson doctor-diagnosed asthma by age eight (aOR 0.59, 95%CI 0.39-0.88, p=0.01). However, we observed a strong trendwhich failed to reach statistical significance for breastfeeding>four months to increase the risk of atopy at age one year(aOR 2.41, 95% CI 0.94-6.14, p=0.07). There was no significantassociation between breastfeeding and atopy at any othertime point. Conclusion. Breastfeeding may prevent viral-infectioninduced wheezing illnesses in early childhood (transientearly wheezing).Downloads
References
Greer FR, Sicherer SH, Burks AW. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008;121:183-91.
Mihrshahi S, Ampon R, Webb K, Almqvist C, Kemp AS, Hector D, et al. The association between infant feeding practices and subsequent atopy among children with a family history of asthma. Clin Exp Allergy. 2007;37:671-9.
Wright AL, Holberg CJ, Taussig LM, Martinez FD. Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood. Thorax. 2001;56:192-7.
Sears MR, Greene JM, Willan AR, Taylor DR, Flannery EM, Cowan JO, et al. Long-term relation between breastfeeding and development of atopy and asthma in children and young adults: a longitudinal study. Lancet. 2002;360:901-7.
Rigotti E, Piacentini GL, Ress M, Pigozzi R, Boner AL, Peroni DG. Transforming growth factor-beta and interleukin-10 in breast milk and development of atopic diseases in infants. Clin Exp Allergy. 2006;36:614-8.
Semic-Jusufagic A, Simpson A, Custovic A. Environmental exposures, genetic predisposition and allergic diseases: one size never fits all. Allergy. 2006;61:397-9.
Henderson J, Granell R, Heron J, Sherriff A, Simpson A, Woodcock A, et al. Associations of wheezing phenotypes in the first 6 years of life with atopy, lung function and airway responsiveness in mid-childhood. Thorax. 2008;63:974-80.
Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995;332:133-8.
Smith JA, Drake R, Simpson A, Woodcock A, Pickles A, Custovic A. Dimensions of respiratory symptoms in preschool children: populationbased birth cohort study. Am J Respir Crit Care Med. 2008;177:1358-63.
Lowe LA, Simpson A, Woodcock A, Morris J, Murray CS, Custovic A. Wheeze phenotypes and lung function in preschool children. Am J Respir Crit Care Med. 2005;171:231-7.
Spycher BD, Silverman M, Brooke AM, Minder CE, Kuehni CE. Distinguishing phenotypes of childhood wheeze and cough using latent class analysis. Eur Respir J. 2008;31:974-81.
Custovic A, Simpson BM, Murray CS, Lowe L, Woodcock A. The National Asthma Campaign Manchester Asthma and Allergy Study. Pediatr Allergy Immunol. 2002;13(Suppl 15):32-7.
Lowe L, Murray CS, Custovic A, Simpson BM, Kissen PM, Woodcock A. Specific airway resistance in 3-year-old children: a prospective cohort study. Lancet. 2002;359:1904-8.
Lowe LA, Woodcock A, Murray CS, Morris J, Simpson A, Custovic A. Lung function at age 3 years: effect of pet ownership and exposure to indoor allergens. Arch Pediatr Adolesc Med. 2004;158:996-1001.
Marinho S, Simpson A, Soderstrom L, Woodcock A, Ahlstedt S, Custovic A. Quantification of atopy and the probability of rhinitis in preschool children: a population-based birth cohort study. Allergy. 2007;62:1379-86.
Nicolaou NC, Simpson A, Lowe LA, Murray CS, Woodcock A, Custovic A. Day-care attendance, position in sibship, and early childhood wheezing: a population-based birth cohort study. J Allergy Clin Immunol. 2008;122:500-6.e5.
Simpson A, Maniatis N, Jury F, Cakebread JA, Lowe LA, Holgate ST, et al. Polymorphisms in a disintegrin and metalloprotease 33 (ADAM33) predict impaired early-life lung function. Am J Respir Crit Care Med. 2005;172:55-60.
Simpson A, Soderstrom L, Ahlstedt S, Murray CS, Woodcock A, Custovic A. IgE antibody quantification and the probability of wheeze in preschool children. J Allergy Clin Immunol. 2005;116:744-9.
Smillie FI, Elderfield AJ, Patel F, Cain G, Tavenier G, Brutsche M, et al. Lymphoproliferative responses in cord blood and at one year: no evidence for the effect of in utero exposure to dust mite allergens. Clin Exp Allergy. 2001;31:1194-204.
Marinho S, Simpson A, Lowe L, Kissen P, Murray C, Custovic A. Rhinoconjunctivitis in 5-year-old children: a population-based birth cohort study. Allergy. 2007;62:385-93.
Nicolaou NC, Lowe LA, Murray CS, Woodcock A, Simpson A, Custovic A. Exhaled breath condensate pH and childhood asthma: unselected birth cohort study. Am J Respir Crit Care Med. 2006;174:254-9.
Semic-Jusufagic A, Bachert C, Gevaert P, Holtappels G, Lowe L, Woodcock A, et al. Staphylococcus aureus sensitization and allergic disease in early childhood: population-based birth cohort study. J Allergy Clin Immunol. 2007;19:930-6.
Custovic A, Simpson BM, Simpson A, Kissen P, Woodcock A. Effect of environmental manipulation in pregnancy and early life on respiratory symptoms and atopy during first year of life: a randomised trial. Lancet. 2001;358:188-93.
Lowe L, Murray CS, Martin L, Deas J, Cashin E, Poletti G, et al. Reported versus confirmed wheeze and lung function in early life. Arch Dis Child. 2004;89:540-3.
Calam R, Gregg L, Simpson B, Morris J, Woodcock A, Custovic A. Childhood asthma, behavior problems, and family functioning. J Allergy Clin Immunol. 2003;112:499-504.
Calam R, Gregg L, Simpson A, Simpson B, Woodcock A, Custovic A. Behavior problems antecede the development of wheeze in childhood: a birth cohort study. Am J Respir Crit Care Med. 2005;171:323-7.
Simpson A, Tan VY, Winn J, Svensen M, Bishop CM, Heckerman DE, et al. Beyond atopy: multiple patterns of sensitization in relation to asthma in a birth cohort study. Am J Respir Crit Care Med. 2010;181:1200-6.
Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995;8:483-91.
Brand PL, Baraldi E, Bisgaard H, Boner AL, Castro-Rodriguez JA, Custovic A, et al. Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach. Eur Respir J. 2008;32:1096-110.
Burr ML, Limb ES, Maguire MJ, Amarah L, Eldridge BA, Layzell JC, et al. Infant feeding, wheezing, and allergy: a prospective study. Arch Dis Child. 1993;68:724-8.
Murray CS, Pipis SD, McArdle EC, Lowe LA, Custovic A, Woodcock A. Lung function at one month of age as a risk factor for infant respiratory symptoms in a high risk population. Thorax. 2002;57:388-92.
Elliott L, Henderson J, Northstone K, Chiu GY, Dunson D, London SJ. Prospective study of breast-feeding in relation to wheeze, atopy, and bronchial hyperresponsiveness in the Avon Longitudinal Study of Parents and Children (ALSPAC).
J Allergy Clin Immunol. 2008;122:49-54,e1-3.
Scholtens S, Wijga AH, Brunekreef B, Kerkhof M, Hoekstra MO, Gerritsen J, et al. Breast feeding, parental allergy and asthma in children followed for 8 years. The PIAMA birth cohort study. Thorax. 2009;64:604-9.
