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Breastfeeding and asthma outcomes at the age of 6 years: The Generation R Study
Herman T den Dekker1,2,3, Agnes M M Sonnenschein-van der Voort1,2,3, Vincent W V Jaddoe1,3,4
1The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Insights
Breastfeeding duration and exclusivity are linked to childhood wheezing and asthma. These effects appear to be partly mediated by infectious mechanisms, influencing respiratory health outcomes.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Environmental Health
Background:
- Breastfeeding's protective effect against early childhood asthma is known, but its influence on older children is less understood.
- Investigating the long-term impact of breastfeeding on asthma development is crucial for public health.
- Understanding the mechanisms, such as atopic or infectious pathways, underlying breastfeeding's effect on asthma is essential.
Purpose of the Study:
- To examine the association between breastfeeding duration and exclusivity and asthma outcomes at age 6.
- To determine if atopic or infectious mechanisms explain these associations.
- To provide insights into the role of breastfeeding in preventing childhood respiratory conditions.
Main Methods:
- Population-based prospective cohort study of 5675 children.
- Breastfeeding data collected via questionnaires; asthma outcomes assessed at age 6 using questionnaires.
- Pulmonary function tests, including fractional exhaled nitric oxide (FeNO) and interrupter resistance (Rint), were measured at age 6.
Main Results:
- Never breastfed children had lower FeNO and increased risks of late and persistent wheezing compared to breastfed children.
- Shorter breastfeeding duration correlated with early wheezing and current asthma at age 6.
- Less exclusive breastfeeding was associated with early wheezing; associations were partly explained by infections.
Conclusions:
- Breastfeeding patterns significantly influence wheezing and asthma development in childhood.
- Infectious mechanisms appear to play a partial role in mediating the protective effects of breastfeeding.
- Findings highlight the importance of breastfeeding for long-term respiratory health in children.
Background:
Breastfeeding is associated with a lower risk of asthma symptoms in early childhood, but its effect at older ages remains unclear. We examined the associations of duration and exclusiveness of breastfeeding with asthma outcomes in children aged 6 years, and whether these associations were explained by atopic or infectious mechanisms.
Methods:
We performed a population-based prospective cohort study among 5675 children. Information about breastfeeding was collected by questionnaires. At age 6 years, we measured interrupter resistance (Rint) and fractional exhaled nitric oxide (FeNO). Information about wheezing patterns (early (≤3 years only), late (>3 years only), persistent (≤3 and >3 years)), and current asthma at 6 years was derived from repeated questionnaires.
Results:
Compared to children who were ever breastfed, those who were never breastfed had lower FeNO levels (sympercent (95% CI): -16.0 (-24.5, -7.5)) and increased risks of late and persistent wheezing (OR(95% CI): 1.69 (1.06, 2.69) and 1.44 (1.00, 2.07), respectively). Shorter duration of breastfeeding was associated with early wheezing and current asthma (1.40 (1.14, 1.73) and 2.19 (1.29, 3.71), respectively). Less exclusive breastfeeding was associated with early wheezing (1.28 (1.08, 1.53)). Breastfeeding duration and exclusiveness were not associated with FeNO or Rint. The associations were not explained by inhalant allergies, partly by lower respiratory tract infections in early life, and to a lesser extent by lower respiratory tract infections in later life.
Conclusions:
Breastfeeding patterns may influence wheezing and asthma in childhood, which seems to be partly explained by infectious mechanisms.
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