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Effects of Breastfeeding on Respiratory Symptoms in Infancy
Olga Gorlanova1, Simone Thalmann1, Elena Proietti2
1University Children's Hospital (UKBB), University of Basel, Basel, Switzerland.
Insights
Breastfeeding significantly reduces infant respiratory symptoms, particularly in the first 27 weeks. This protective effect is more pronounced in girls and can mitigate risks from maternal smoking and delivery method.
Area of Science:
- Pediatric respiratory health
- Infant development
- Environmental and social determinants of health
Background:
- Infant respiratory symptoms pose a significant health burden.
- Understanding modifiable factors like breastfeeding is crucial for prevention.
- Early life exposures can have long-term health consequences.
Purpose of the Study:
- To evaluate the impact of various risk factors on infant respiratory symptoms.
- To determine how breastfeeding modifies these risks.
- To analyze these effects within the first year of life.
Main Methods:
- Prospective cohort study of 436 healthy term infants.
- Weekly telephone interviews assessed breastfeeding status and respiratory symptoms.
- Risk factors (smoking, delivery mode, maternal atopy, siblings) and environmental data (particulate matter) were collected.
- Generalized additive mixed models were used for analysis.
Main Results:
- Breastfeeding reduced respiratory symptom incidence and severity (RR 0.70) primarily in the first 27 weeks.
- A protective effect was observed in girls but not boys.
- Breastfeeding attenuated risks associated with maternal smoking, gestational age, and cesarean delivery.
- No interaction found with maternal atopy, siblings, childcare, or particulate matter.
Conclusions:
- Breastfeeding demonstrates a risk-specific protective effect against infant respiratory symptoms.
- The benefits of breastfeeding are evident in mitigating risks from specific early-life exposures.
- A comprehensive time-series approach confirms breastfeeding's role in respiratory health.
Objective:
To assess the impact of potential risk factors on the development of respiratory symptoms and their specific modification by breastfeeding in infants in the first year of life.
Study Design:
We prospectively studied 436 healthy term infants from the Bern-Basel Infant Lung Development cohort. The breastfeeding status, and incidence and severity of respiratory symptoms (score) were assessed weekly by telephone interview during the first year of life. Risk factors (eg, pre- and postnatal smoking exposure, mode of delivery, gestational age, maternal atopy, and number of older siblings) were obtained using standardized questionnaires. Weekly measurements of particulate matter <10 μg were provided by local monitoring stations. The associations were investigated using generalized additive mixed model with quasi Poisson distribution.
Results:
Breastfeeding reduced the incidence and severity of the respiratory symptom score mainly in the first 27 weeks of life (risk ratio 0.70; 95% CI 0.55-0.88). We found a protective effect of breastfeeding in girls but not in boys. During the first 27 weeks of life, breastfeeding attenuated the effects of maternal smoking during pregnancy, gestational age, and cesarean delivery on respiratory symptoms. There was no evidence for an interaction between breastfeeding and maternal atopy, number of older siblings, child care attendance, or particulate matter <10 μg.
Conclusions:
This study shows the risk-specific effect of breastfeeding on respiratory symptoms in early life using the comprehensive time-series approach.
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