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(Accepted 2 June 1999)Association between breast feeding and asthma in 6 year old children: findings of a prospective birth cohort study W H Oddy, P G Holt, P D Sly, A W Read, L I Landau, F J Stanley, G E Kendall, P R Burton AbstractObjectives To investigate the association between the duration of exclusive breast feeding and the development of asthma related outcomes in children at age 6 years.

Aim: To examine the relation between the duration of breast feeding and morbidity as a result of respiratory illness and infection in the first year of life. Methods: Prospective birth cohort study of 2602 live born children ascertained through antenatal clinics at the major tertiary obstetric hospital in Perth, Western Australia. Main outcome measures were hospital, doctor, or clinic visits, and hospital admissions for respiratory illness and infection in the first year of life. Main exposure measures were the duration of predominant breast feeding (defined as the age other milk was introduced) and partial (any) breast feeding (defined as the age breast feeding was stopped). Main confounders were gender, gestational age less than 37 weeks, smoking in pregnancy, older siblings, maternal education, and maternal age. Results: Hospital, doctor, or clinic visits for four or more upper respiratory tract infections were significantly greater if predominant breast feeding was stopped before 2 months or partial breast feeding was stopped before 6 months. Predominant breast feeding for less than six months was associated with an increased risk for two or more hospital, doctor, or clinic visits and hospital admission for wheezing lower respiratory illness. Breast feeding for less than eight months was associated with a significantly increased risk for two or more hospital, doctor, or clinic visits or hospital admissions because of wheezing lower respiratory illnesses. Conclusions: Predominant breast feeding for at least six months and partial breast feeding for up to one year may reduce the prevalence and subsequent morbidity of respiratory illness and infection in infancy. Breast feeding is clearly an issue for public health consideration as it provides significant protection against infections in newborns and infants.1 2 Because breast feeding has been shown to protect against infections so profoundly in developing countries, it is estimated that an increase in breast feeding worldwide by 40% would reduce deaths from respiratory infection by 50% in children less than 18 months of age. 3Although breast feeding is associated with lower rates of both morbidity and mortality in the developing world, 2 4 5 evidence in the developed world has been and remains more controversial.6 7 Yet, recent investigations show that respiratory tract infections [8][9][10][11][12] and asthma 13 14 are reduced in breast fed infants. On the other hand inverse relationships with breast feeding and health outcomes have been reported.Respiratory infections and illness may be a risk factor for asthma in children 15 and their associated effects in relation to infant feeding need to be elucidated further. The effect of different feeding regimes was investigated in relation to respiratory infections and illness in a prospective birth cohort and following careful assessment of outcomes and exposures. We aimed to document the association of duration of predominant feeding and duration of any breast feeding with respiratory illness and infection morbidi...

(Accepted 2 June 1999)Association between breast feeding and asthma in 6 year old children: findings of a prospective birth cohort study W H Oddy, P G Holt, P D Sly, A W Read, L I Landau, F J Stanley, G E Kendall, P R Burton AbstractObjectives To investigate the association between the duration of exclusive breast feeding and the development of asthma related outcomes in children at age 6 years.