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Published on: August 7, 2017
Timing of infant feeding in relation to childhood asthma and allergic diseases
Bright I Nwaru1, Hanna-Mari Takkinen, Onni Niemelä
1School of Health Sciences, University of Tampere, Tampere, Finland. bright.nwaru@uta.fi
Insights
Introducing certain solid foods early, like cereals, eggs, and fish, may reduce the risk of childhood asthma and allergies. Longer total breastfeeding duration, not just exclusive, also offers protection against nonatopic asthma.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health and Epidemiology
Background:
- Current infant feeding recommendations for allergy prevention are being re-evaluated.
- Evidence linking feeding practices to childhood asthma and allergies is growing but remains inconclusive.
Purpose of the Study:
- To investigate the association between breast-feeding duration and complementary food introduction timing.
- To determine the impact of these feeding practices on asthma, allergic rhinitis, and atopic eczema by age 5.
Main Methods:
- Analysis of data from 3781 children, with dietary exposures treated as time-dependent variables.
- Assessment of asthma, allergic rhinitis, and atopic eczema using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.
- Measurement of IgE antibodies from serum samples at age 5, analyzed using Cox regressions and logistic regressions.
Main Results:
- Total breast-feeding of 9.5 months or less was linked to a higher risk of nonatopic asthma.
- Early introduction (5-5.5 months) of wheat, rye, oats, or barley cereals inversely correlated with asthma and allergic rhinitis.
- Introduction of egg by 11 months and fish by 9 months was associated with reduced risk of asthma, allergic rhinitis, and atopic sensitization.
Conclusions:
- Early introduction of specific cereals, egg, and fish appears to lower the risk of childhood asthma, allergic rhinitis, and atopic sensitization.
- Longer total breast-feeding duration, more so than exclusivity, showed a protective effect against nonatopic asthma.
- Breast-feeding may have differential effects on various asthma phenotypes.
Background:
Emerging evidence questions current recommendations on the timing of infant feeding for the prevention of childhood allergies. The evidence for asthma is inconclusive.
Objective:
We sought to investigate the associations between the duration of breast-feeding and timing of introduction of complementary foods and the development of asthma and allergies by the age of 5 years.
Methods:
Data were analyzed for 3781 consecutively born children. The dietary exposures were categorized into thirds and analyzed as time-dependent variables. Asthma, allergic rhinitis, and atopic eczema end points were assessed by using the International Study of Asthma and Allergies in Childhood questionnaire, whereas IgE antibodies were analyzed from serum samples at the age of 5 years. Cox proportional hazard and logistic regressions were used for the analyses.
Results:
The median duration of exclusive and total breast-feeding was 1.4 months (interquartile range, 0.2-3.5 months) and 7.0 months (interquartile range, 4.0-11.0 months), respectively. Total breast-feeding of 9.5 months or less was associated with an increased risk of nonatopic asthma. Introduction of wheat, rye, oats, or barley at 5 to 5.5 months was inversely associated with asthma and allergic rhinitis, whereas introduction of other cereals at less than 4.5 months increased the risk of atopic eczema. Introduction of egg at 11 months or less was inversely associated with asthma, allergic rhinitis, and atopic sensitization, whereas introduction of fish at 9 months or less was inversely associated with allergic rhinitis and atopic sensitization.
Conclusion:
Early introduction of wheat, rye, oats, and barley cereals; fish; and egg (respective to the timing of introduction of each food) seems to decrease the risk of asthma, allergic rhinitis, and atopic sensitization in childhood. Longer duration of total breast-feeding, rather than its exclusivity, was protective against the development of nonatopic but not atopic asthma, suggesting a potential differing effect of breast-feeding on different asthma phenotypes.
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