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Breastfeeding and asthma in children: findings from a West Australian study
1TVW Telethon Institute for Child Health Research, West Perth, Western Australia. wendyo@ichr.uwa.edu.au
Insights
Exclusive breastfeeding for at least four months significantly reduces the risk of childhood asthma. Introducing other milk before four months increases asthma-related outcomes in six-year-old children.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Public Health Nutrition
Background:
- Childhood asthma is a significant public health concern.
- Early infant feeding practices are hypothesized to influence asthma development.
- Understanding the role of exclusive breastfeeding is crucial for prevention strategies.
Purpose of the Study:
- To investigate the association between the duration of exclusive breastfeeding and asthma-related traits in children at age six.
- To determine if early introduction of non-breast milk impacts asthma development.
Main Methods:
- Prospective cohort study of 2,979 children from Western Australia, followed from birth to age six.
- Unconditional logistic regression analysis adjusted for confounders (gender, gestational age, smoking, childcare).
- Assessment of asthma outcomes including doctor diagnosis, wheezing frequency, and allergic reactions.
Main Results:
- Introducing milk other than breastmilk before four months was a significant risk factor for all asthma-related outcomes (p < 0.05).
- Odds ratios for doctor-diagnosed asthma, wheezing, and allergic reactions were elevated in children not exclusively breastfed for four months.
- Delayed diagnosis and onset of asthma symptoms were also associated with shorter exclusive breastfeeding durations.
Conclusions:
- Exclusive breastfeeding for at least the first four months of life is associated with a substantial reduction in the risk of childhood asthma.
- Early cessation of exclusive breastfeeding is a modifiable risk factor for childhood asthma.
- Findings support public health initiatives promoting exclusive breastfeeding for asthma prevention.
Abstract:
The primary aim was to determine whether there was an inverse association between the duration of exclusive breastfeeding and the development of traits associated with asthma in children at age six years. A prospective cohort study of children from Western Australia was enrolled prior to birth and followed to age six. Two thousand, nine hundred and seventy-nine children were recruited through antenatal clinics at the major tertiary obstetric hospital in Perth. Unconditional logistic regression was used to model the association between duration of exclusive breastfeeding and outcomes related to asthma or atopy at age six allowing for a number of important confounders. These included gender, gestational age, smoking in pregnancy and early child care. After adjustment for confounders, the introduction of milk other than breastmilk before four months of age was a significant (p < 0.05) risk factor for all asthma-related outcomes in six-year-old children: (i) doctor diagnosed asthma odds ratio ¿OR¿ = 1.25 (95% CI 1.02-1.54); (ii) wheeze three or more times since the age of one year OR 1.42 (1.15-1.76); (iii) wheeze in the last twelve months OR 1.28 (1.02-1.76); (iv) sleep disturbance due to wheeze within the last twelve months OR 1.41 (1.04-1.90); (v) age at doctor diagnosis (hazard ratio ¿HR¿ 1.22 ¿1.03-1.43¿); (vi) age at first wheeze (HR 1.36 ¿1.17-1.59¿) and; (vii) positive reaction to common aeroallergens OR 1.27 (1.01-1.59). There is a substantial reduction in risk of childhood asthma as assessed at age six years, if exclusive breastfeeding is continued for at least the first four months of life. These findings are important for our understanding of the aetiology of and for the potential prevention of asthma in children.