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Aims The literature on the associations between breastfeeding and eczema prevalence is conflicting. Early reviews of the literature found that breastfeeding was associated with a reduced risk of eczema, but several recent studies have suggested that breastfeeding may increase the risk of atopic disorders at older ages. A positive association between breastfeeding and eczema risk might reflect reverse causation (longer breastfeeding of at risk children in response to early eczema symptoms). However, few studies have been able to account for the influence of early atopic symptoms on the association between breastfeeding and eczema. Here, we investigate the association between breastfeeding duration and eczema accounting for the effect of early rash on breastfeeding practice. Methods This study used data collected as part of the Avon Longitudinal Study of Parents and Children, a geographically-based cohort study of children born in the Bristol area in 1991-92. Information on breastfeeding duration was obtained prospectively by questionnaire, information on early eczema (up to age 42 months) was obtained by parental report of rash at two time points in questionnaires completed at 6, 18, 30 and 42 months post-natal. Information on eczema at age 7-8 year was from observations of flexural dermatitis at research clinics attended by children at this age. Results Table 1 shows the odds ratios for early eczema according to duration of breastfeeding. Risk of early eczema was significantly higher in ever versus never breastfed children (OR 1.43 95% CI 1.26, 1.61), and there was evidence of increased eczema risk with increasing breastfeeding duration. This association persisted on adjustment for potential confounders including parental education and history of atopy, and on exclusion of children with symptoms of rash in the first six months. There was a similar association with late eczema in unadjusted analysis, but this was lost on adjustment for potential confounders. Conclusion In this study we found no evidence that breastfeeding protects against eczema. On the contrary there was more early eczema among infants breastfed for longer. This association was not explained by changes in breastfeeding practice associated with parental atopy or with symptoms of rash in the first six months.

Aims Wheeze during infancy may be related to development of asthma in childhood. Most studies that have explored this question have been retrospective and have not assessed wheeze at 1 year of age. We have established a genotyped birth cohort (GO-CHILD) to investigate the influence of genetic and environmental factors on childhood atopy. The aim of this preliminary analysis of the cohort data is to identify the environmental risk factors for wheeze at age 1 year. Methods Participants were recruited antenatally. Following Ethics approval and informed consent, the expecting mothers completed a questionnaire on the antenatal risk factors of atopic diseases in the newborn. Family history of atopy was assessed. Details of environmental factors, like exposure to smoking during pregnancy, type of cooking fuel and socioeconomic background, were also collected. A postal questionnaire to assess atopic conditions, infections, feeding was administered at 1 year of age. The data from the antenatal and 1 year follow-up questionnaires were analysed by using SPSS version 16. The study aims to recruit 3000 UK mothers. This analysis only includes the Sussex data. Results 66 (19%) of 341 participants developed wheeze by 1 year. 29% infants required hospital admission due to exacerbation of wheeze. The risk of wheeze was significantly increased in infants with maternal (p value <0.001 (OR 3.92; 95% CI, 2.10-7.32)) and paternal (p value 0.02 (OR 2.09; 95% CI, 1.09-4.01)) asthma. There was a significant increased risk of wheeze in infants attending nursery or playgroups (p value 0.02, (OR 1.93; 95% CI, 0.87-1.57)).The risk of development of wheeze in infants with eczema was significantly increased compared to those without eczema (p 0.05, (OR 1.90; (95% CI, 0.99-3.63)). Conclusions This is the first large prospective study with detailed phenotyping of wheeze at the end of the first year of life. It shows that infants with eczema, family history of asthma and those attending nursery or playgroups are at increased risk of developing wheeze during the first year of life. An earlier presentation of wheeze is associated with more number of attacks of wheeze over the first year of life. Funded by SPARKS