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Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old
1Children's Hospital, Helsinki, Finland.
Insights
Breastfeeding significantly reduces the risk of atopic diseases, including eczema and respiratory allergies, throughout childhood and adolescence. Prolonged breastfeeding offers the most protection against these common health issues.
Area of Science:
- Pediatrics
- Allergology
- Public Health
Background:
- Atopic diseases are prevalent health concerns, particularly in infants with a hereditary predisposition.
- Preventive strategies for atopy, such as elimination diets, have been explored for at-risk infants.
Purpose of the Study:
- To investigate the long-term effect of breastfeeding duration on the development of atopic diseases in infants.
- To assess the prophylactic role of breastfeeding against atopic eczema, food allergy, and respiratory allergy.
Main Methods:
- A longitudinal study followed 236 healthy infants for 17 years, with follow-ups at ages 1, 3, 5, 10, and 17 years.
- Infants were categorized into three breastfeeding groups: prolonged (>6 months), intermediate (1-6 months), and short or no (<1 month).
- Data collection included medical history, physical examinations, and allergy-specific laboratory tests.
Main Results:
- The prevalence of manifest atopy was highest in infants with little or no breastfeeding.
- Prolonged breastfeeding was associated with the lowest prevalence of eczema at ages 1 and 3 years.
- Food and respiratory allergies were most prevalent in the short or no breastfeeding group, with respiratory allergy reaching 65% by age 17.
Conclusions:
- Breastfeeding demonstrates a significant prophylactic effect against the development of atopic diseases.
- The protective benefits of breastfeeding extend throughout childhood and adolescence, encompassing eczema, food allergy, and respiratory allergy.
Abstract:
Atopic diseases constitute a common health problem. For infants at hereditary risk, prophylaxis of atopy has been sought in elimination diets and other preventive measures. We followed up healthy infants during their first year, and then at ages 1, 3, 5, 10, and 17 years to determine the effect on atopic disease of breastfeeding. Of the initial 236 infants, 150 completed the follow-up, which included history taking, physical examination, and laboratory tests for allergy. The subjects were divided into three groups: prolonged (> 6 months), intermediate (1-6 months), and short or no (< 1 month) breastfeeding. The prevalence of manifest atopy throughout follow-up was highest in the group who had little or no breastfeeding (p < 0.05, analysis of variance and covariance with repeated measures [ANOVA]). Prevalence of eczema at ages 1 and 3 years was lowest (p = 0.03, ANOVA) in the prolonged breastfeeding group, prevalence of food allergy was highest in the little or no groups (p = 0.02, ANOVA) at 1-3 years, and respiratory allergy was also most prevalent in the latter group (p = 0.01, ANOVA) having risen to 65% at 17 years of age. Prevalences in the prolonged, intermediate, and little or no groups at age 17 were 42 (95% CI 31-52)%, 36 (28-44)%, and 65 (56-74)% (p = 0.02, trend test) for atopy, respectively, and 8 (6-10)%, 23 (21-25)%, and 54 (52-56)% (p = 0.0001, trend test) for substantial atopy. We conclude that breastfeeding is prophylactic against atopic disease--including atopic eczema, food allergy, and respiratory allergy--throughout childhood and adolescence.