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Published on: August 7, 2017
Duration and exclusiveness of breastfeeding and school-age lung function and asthma
Evelien R van Meel1, Mandy de Jong1, Niels J Elbert2
1The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Insights
Shorter breastfeeding duration and non-exclusive practices were linked to reduced lung function in school-aged children, but not asthma. These findings highlight the importance of breastfeeding for respiratory health beyond early childhood.
Area of Science:
- Pediatric respiratory health
- Epidemiology of childhood diseases
- Public health and nutrition
Background:
- Breastfeeding is known to reduce early childhood asthma risk.
- The long-term impact of breastfeeding on respiratory health in later childhood remains unclear.
Purpose of the Study:
- To investigate the association between breastfeeding (any, duration, exclusivity) and lung function/asthma in school-aged children.
- To determine if respiratory infections or atopic status influence these associations.
Main Methods:
- A population-based prospective cohort study of 4,464 children.
- Breastfeeding data collected via questionnaires from birth to 1 year.
- Lung function (spirometry) and asthma assessed at age 10 using questionnaires and regression models.
Main Results:
- Shorter breastfeeding duration correlated with lower forced expiratory volume in 1 second (FEV1).
- Breastfeeding for 2-4 months or non-exclusive breastfeeding at 4 months was linked to reduced forced vital capacity (FVC).
- No significant association was found with asthma, and results were consistent across subgroups.
Conclusions:
- Shorter duration and non-exclusivity of breastfeeding are associated with diminished lung function (FEV1 and FVC) in school-aged children.
- Breastfeeding's protective effect on asthma risk does not appear to extend to later childhood based on this study.
- Findings underscore the lasting impact of breastfeeding on respiratory mechanics into later childhood.
Background:
Breastfeeding reduces the risk of asthma in early childhood, but it is not clear whether its effect on respiratory morbidity is still present in later childhood.
Objective:
To examine the associations of any breastfeeding, breastfeeding duration, and breastfeeding exclusiveness with lung function and asthma in school-aged children and whether associations were influenced by respiratory tract infections and maternal or child's atopic status.
Methods:
This study of 4,464 children was embedded in a population-based prospective cohort study. Information on breastfeeding was obtained by multiple questionnaires from birth until 1 year of age. At 10 years of age, lung function was measured by spirometry, and information on asthma was obtained by questionnaire. Adjusted linear and logistic regression models were used to examine the associations.
Results:
Shorter duration of breastfeeding was associated with a lower forced expiratory volume in 1 second (FEV1) only (z score change, -0.01; 95% confidence interval [CI], -0.02 to -0.00) per month shorter breastfeeding, but not asthma. When categorized, breastfeeding for 2 to 4 months was associated with a lower forced vital capacity (FVC) (z score change, -0.11; 95% CI, -0.20 to -0.03) compared with breastfeeding for 6 months or longer. Nonexclusive breastfeeding for 4 months was associated with a lower FVC (z score change, -0.08; 95% CI, -0.16 to -0.01) compared with exclusive breastfeeding for 4 months. Results did not materially change after additional adjustment for lower respiratory tract infections and were not modified by maternal history of asthma or atopy, child's eczema, or inhalant allergic sensitization.
Conclusion:
Shorter duration and nonexclusivity of breastfeeding were associated with a lower FEV1 and FVC but not asthma at school-age.
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