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Does breastfeeding protect against allergic rhinitis during childhood? A meta-analysis of prospective studies
A Mimouni Bloch1, D Mimouni, M Mimouni
1The Institute for Child Development and Pediatric Neurology Unit, Sourasky Medical Center, Tel Aviv, Israel. blochy@netvision.net.il
Insights
Exclusive breastfeeding for the first three months protects infants from allergic rhinitis. This protective effect was observed in children with and without a family history of atopy, though statistical significance was borderline.
Area of Science:
- Pediatrics
- Immunology
- Allergy Research
Background:
- The relationship between breastfeeding and atopic conditions like allergic rhinitis is debated.
- Previous studies have yielded controversial results regarding breastfeeding's impact on allergic rhinitis development.
Purpose of the Study:
- To systematically review prospective studies on exclusive breastfeeding's association with allergic rhinitis.
- To evaluate the protective effect of early exclusive breastfeeding on allergic rhinitis in children.
Main Methods:
- Systematic review of prospective studies published between 1966 and 2000.
- Searched MEDLINE databases and reviewed reference lists.
- Assessed methodological quality, breastfeeding duration/exclusivity, and controlled for confounding variables.
Main Results:
- Six prospective studies met the inclusion criteria.
- The overall odds ratio for breastfeeding's protective effect was 0.74 (95% CI 0.54-1.01).
- In studies of children with a family history of atopy, the odds ratio was 0.87 (95% CI 0.48-1.58).
Conclusions:
- Exclusive breastfeeding for the first three months offers protection against allergic rhinitis.
- This protective effect was substantial, even in children with a family history of atopy.
- Further large-scale prospective studies with rigorous methodology and extended follow-up are recommended.
Unlabelled:
The effect of breastfeeding on the development of allergic rhinitis and other atopic conditions has been assessed in many studies but remains controversial. To elucidate this issue, a systematic review was conducted of prospective studies that evaluated the association between exclusive breastfeeding during the first 3 mo after birth and allergic rhinitis. The 1966-2000 MEDLINE databases were searched and the reference lists of relevant articles were reviewed according to predetermined inclusion criteria. The methodological aspects of each study, duration and exclusivity of breastfeeding, outcome measures, control for potential confounding variables and other factors were assessed, and estimates of the association between breastfeeding and allergic rhinitis were abstracted independently by the investigators using a standardized approach. Six prospective studies met the inclusion criteria. The summary odds ratio for the protective effect of breastfeeding was 0.74 (95% confidence interval 0.54-1.01). The effect estimate in studies of children with a family history of atopy was 0.87 (95% confidence interval 0.48-1.58).
Conclusion:
Exclusive breastfeeding during the first 3 mo after birth protects against allergic rhinitis in children, both with and without a family history of atopy. The protective association, although of borderline statistical significance, was substantial. Larger prospective studies with strict methodology and longer periods of follow-up are needed.