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Published on: September 18, 2013
Infant feeding practices and childhood acute leukemia: Findings from the Childhood Cancer & Leukemia International
Jeremy M Schraw1,2,3, Helen D Bailey4, Audrey Bonaventure5
1Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA.
Insights
Breastfeeding for 4-12 months is linked to lower risks of childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Promoting longer breastfeeding durations may help prevent childhood leukemia.
Area of Science:
- Pediatric Oncology
- Epidemiology
- Public Health Nutrition
Background:
- Breastfeeding is suspected to protect against childhood leukemia.
- Limited research exists on exclusive breastfeeding and formula milk introduction.
- Understanding breastfeeding's role in leukemia prevention is crucial.
Purpose of the Study:
- To analyze the association between breastfeeding duration and childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).
- To investigate exclusive breastfeeding duration and formula introduction timing with ALL risk.
Main Methods:
- Pooled analyses and meta-analyses of individual participant data from 16 studies (Childhood Leukemia International Consortium).
- Unconditional multivariable logistic regression was used for pooled data analysis.
- Sensitivity analyses adjusted for covariates and specific subgroups were performed.
Main Results:
- Longer breastfeeding durations (4-12 months) were associated with decreased odds of ALL.
- Breastfeeding ≥4 months showed an inverse association with AML risk.
- Exclusive breastfeeding for 4-12 months significantly reduced ALL odds.
Conclusions:
- Extended breastfeeding is associated with reduced odds of childhood ALL and AML.
- Findings underscore the importance of promoting breastfeeding for leukemia prevention.
- Few modifiable risk factors for childhood leukemia are known; breastfeeding is a key target.
Abstract:
Increasing evidence suggests that breastfeeding may protect from childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). However, most studies have limited their analyses to any breastfeeding, and only a few data have examined exclusive breastfeeding, or other exposures such as formula milk. We performed pooled analyses and individual participant data metaanalyses of data from 16 studies (N = 17 189 controls; N = 10 782 ALL and N = 1690 AML cases) from the Childhood Leukemia International Consortium (CLIC) to characterize the associations of breastfeeding duration with ALL and AML, as well as exclusive breastfeeding duration and age at introduction to formula with ALL. In unconditional multivariable logistic regression analyses of pooled data, we observed decreased odds of ALL among children breastfed 4 to 6 months (0.88, 95% CI 0.81-0.96) or 7 to 12 months (OR 0.85, 0.79-0.92). We observed a similar inverse association between breastfeeding ≥4 months and AML (0.82, 95% CI 0.71-0.95). Odds of ALL were reduced among children exclusively breastfed 4 to 6 months (OR 0.73, 95% CI 0.63-0.85) or 7 to 12 months (OR 0.70, 95% CI 0.53-0.92). Random effects metaanalyses produced similar estimates, and findings were unchanged in sensitivity analyses adjusted for race/ethnicity or mode of delivery, restricted to children diagnosed ≥1 year of age or diagnosed with B-ALL. Our pooled analyses indicate that longer breastfeeding is associated with decreased odds of ALL and AML. Few risk factors for ALL and AML have been described, therefore our findings highlight the need to promote breastfeeding for leukemia prevention.
