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Maternal asthma status alters relation of infant feeding to asthma in childhood
A L Wright1, C J Holberg, L M Taussig
1Respiratory Sciences Center, University of Arizona, Tucson, USA.
Insights
Maternal asthma may change how breastfeeding affects a child's asthma risk. Longer exclusive breastfeeding was linked to higher asthma rates in children whose mothers had asthma.
Area of Science:
- Pediatrics
- Allergology
- Epidemiology
Background:
- The link between infant feeding and childhood asthma is debated.
- Maternal asthma's influence on this relationship is not well understood.
Purpose of the Study:
- To investigate if maternal asthma status modifies the association between breastfeeding and childhood asthma.
- To determine the impact of exclusive breastfeeding duration on asthma development in children with and without maternal asthma.
Main Methods:
- A cohort of 1043 children was followed from birth.
- Parental questionnaires assessed asthma and feeding history at ages 6, 9, or 11 years.
- Exclusive breastfeeding duration was categorized (never, <4 months, >=4 months) using physician reports or 18-month questionnaires.
Main Results:
- The relationship between breastfeeding and asthma varied by maternal asthma status.
- For children with maternal asthma, longer exclusive breastfeeding was significantly associated with an increased risk of active physician-diagnosed asthma (OR: 5.7, CI: 2.8-11.5).
- This association remained significant after adjusting for potential confounders.
Conclusions:
- Maternal asthma may alter the protective or risk effects of breastfeeding on childhood asthma.
- Longer exclusive breastfeeding duration was associated with a higher risk of asthma in children born to mothers with asthma.
- Potential biological mechanisms or reporting biases may explain this observed association.
Abstract:
The relation of infant feeding to childhood asthma is controversial. This study tested the hypothesis that maternal asthma alters the relation of breastfeeding to childhood asthma. Questionnaires were completed at age 6, 9 or 11 years by parents of 1043 children enrolled at birth. Active MD asthma was defined as a physician diagnosis of asthma plus asthma symptoms reported on one of the questionnaires. Duration of exclusive breastfeeding, categorized as never, < 4 months, or > or = 4 months, was based on prospective physician reports or questionnaires completed at 18 months. The relationship between breastfeeding and asthma differed by maternal asthma status. For children with maternal asthma, the percent developing active MD asthma increased significantly with longer duration of exclusive breastfeeding. Odds of developing asthma among these children were significantly elevated (OR: 5.7,CI: 2.8-11.5), after adjusting for confounders. This association of longer exclusive breastfeeding with increased risk of reported asthma among children with asthmatic mothers may be biologically based, or may reflect reporting biases.