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Full Breastfeeding and Allergic Diseases-Long-Term Protection or Rebound Effects?
Lars Libuda1,2, Birgit Filipiak-Pittroff2,3, Marie Standl4,5
1Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, Warburger Straße 100, 33098 Paderborn, Germany.
Insights
Early childhood eczema strongly predicts allergies into young adulthood. Breastfeeding protection against eczema diminishes over time, and a rebound effect was not confirmed in this long-term study.
Area of Science:
- Pediatric Allergy and Immunology
- Longitudinal Cohort Studies
- Epidemiology
Background:
- Previous research indicated breastfeeding protects against early eczema.
- This protection may diminish in adolescence, raising questions about a potential rebound effect.
Purpose of the Study:
- To evaluate the long-term impact of early eczema on allergy development until young adulthood.
- To determine if early eczema influences the association between breastfeeding and allergies.
Main Methods:
- Analysis of data from the GINIplus study up to 20 years (N=4058).
- Assessment of physician-diagnosed atopic eczema, asthma, and rhinitis.
- Modeling of adjusted odds ratios using generalized estimating equations.
Main Results:
- Early eczema significantly predicted eczema, asthma, and rhinitis into young adulthood.
- The association between early eczema and eczema decreased with age.
- No significant association was found between breastfeeding and allergies from age 5 to 20.
- Early eczema did not generally modify the breastfeeding-allergy link, except for rhinitis in specific subgroups.
Conclusions:
- Early-onset eczema is a strong predictor of allergies persisting into young adulthood.
- The protective effect of breastfeeding on eczema in infancy does not extend to young adulthood, and a rebound effect was not observed.
Abstract:
A previous follow-up of the GINIplus study showed that breastfeeding could protect against early eczema. However, effects diminished in adolescence, possibly indicating a "rebound effect" in breastfed children after initial protection. We evaluated the role of early eczema until three years of age on allergies until young adulthood and assessed whether early eczema modifies the association between breastfeeding and allergies. Data from GINIplus until 20-years of age (N = 4058) were considered. Information on atopic eczema, asthma, and rhinitis was based on reported physician's diagnoses. Adjusted Odds Ratios (aOR) were modelled by using generalized estimating equations. Early eczema was associated with eczema (aORs = 3.2-14.4), asthma (aORs = 2.2-2.7), and rhinitis (aORs = 1.2-2.7) until young adulthood. For eczema, this association decreased with age (p-for-interaction = 0.002-0.006). Longitudinal models did not show associations between breastfeeding and the respective allergies from 5 to 20 years of age. Moreover, early eczema generally did not modify the association between milk feeding and allergies except for rhinitis in participants without family history of atopy. Early eczema strongly predicts allergies until young adulthood. While preventive effects of full breastfeeding on eczema in infants with family history of atopy does not persist until young adulthood, the hypothesis of a rebound effect after initial protection cannot be confirmed.
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