Effects of Breastfeeding on Respiratory Symptoms in Infancy

Gorlanova, Olga; Thalmann, Simone; Proietti, Elena; Stern, Georgette; Latzin, Philipp; Kühni, Claudia; Röösli, Martin; Frey, Urs

doi:10.1016/j.jpeds.2016.03.041

Cited by 27 publications

(23 citation statements)

References 41 publications

(90 reference statements)

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“…In our study, breastfeeding was not associated with respiratory infections in infancy. This contrasts with an earlier study of the same cohort [ 16 ] which found a protective effect of breastfeeding but only during the first six months after birth, and mainly in girls, whereas we investigated associations during the whole first year of life for both sexes. Furthermore, N0 2 concentrations were only associated with lower respiratory infections when adjusted for other factors but not with any respiratory symptoms in crude or adjusted models.…”

Section: Discussioncontrasting

confidence: 58%

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Neighbourhood child population density as a proxy measure for exposure to respiratory infections in the first year of life: A validation study

et al. 2018

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BackgroundAssessing exposure to infections in early childhood is of interest in many epidemiological investigations. Because exposure to infections is difficult to measure directly, epidemiological studies have used surrogate measures available from routine data such as birth order and population density. However, the association between population density and exposure to infections is unclear. We assessed whether neighbourhood child population density is associated with respiratory infections in infants.MethodsWith the Basel-Bern lung infant development study (BILD), a prospective Swiss cohort study of healthy neonates, respiratory symptoms and infections were assessed by weekly telephone interviews with the mother throughout the first year of life. Using population census data, we calculated neighbourhood child density as the number of children < 16 years of age living within a 250 m radius around the residence of each child. We used negative binomial regression models to assess associations between neighbourhood child density and the number of weeks with respiratory infections and adjusted for potential confounders including the number of older siblings, day-care attendance and duration of breastfeeding. We investigated possible interactions between neighbourhood child population density and older siblings assuming that older siblings mix with other children in the neighbourhood.ResultsThe analyses included 487 infants. We found no evidence of an association between quintiles of neighbourhood child density and number of respiratory symptoms (p = 0.59, incidence rate ratios comparing highest to lowest quintile: 1.15, 95%-confidence interval: 0.90–1.47). There was no evidence of interaction with older siblings (p = 0.44). Results were similar in crude and in fully adjusted models.ConclusionsOur study suggests that in Switzerland neighbourhood child density is a poor proxy for exposure to infections in infancy.

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Section: Discussioncontrasting

confidence: 58%

“…The BILD Cohort [ 13 – 16 ] ( www.bild-cohort.ch ) is an ongoing prospective birth cohort study including unselected infants born after April 1999 in the regions of Bern and Basel, Switzerland. Details of the study design are provided elsewhere [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

Neighbourhood child population density as a proxy measure for exposure to respiratory infections in the first year of life: A validation study

et al. 2018

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“…Breastfeeding reduced the severity of respiratory problems in the first 27 weeks of life (RR 0.70; 95% CI 0.55–0.88) (127) and reduces risks for acute otitis media, non-specific gastroenteritis, lower respiratory tract infections, atopic dermatitis, asthma, obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome, and necrotizing enterocolitis (125). The American Academy of Pediatrics recommends exclusive breastfeeding for approximately 6 months, followed by continued breastfeeding with complementary foods for 1 year or longer (128).…”

Section: Resultsmentioning

confidence: 99%

Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication

2017

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Physiologic adaptations during pregnancy unmask a woman’s predisposition to diseases. Complications are increasingly predicted by first-trimester algorithms, amplify a pre-existing maternal phenotype and accelerate risks for chronic diseases in the offspring up to adulthood (Barker hypothesis). Recent evidence suggests that vice versa, pregnancy diseases also indicate maternal and even grandparent’s risks for chronic diseases (reverse Barker hypothesis). Pub-Med and Embase were reviewed for Mesh terms “fetal programming” and “pregnancy complications combined with maternal disease” until January 2017. Studies linking pregnancy complications to future cardiovascular, metabolic, and thrombotic risks for mother and offspring were reviewed. Women with a history of miscarriage, fetal growth restriction, preeclampsia, preterm delivery, obesity, excessive gestational weight gain, gestational diabetes, subfertility, and thrombophilia more frequently demonstrate with echocardiographic abnormalities, higher fasting insulin, deviating lipids or clotting factors and show defective endothelial function. Thrombophilia hints to thrombotic risks in later life. Pregnancy abnormalities correlate with future cardiovascular and metabolic complications and earlier mortality. Conversely, women with a normal pregnancy have lower rates of subsequent diseases than the general female population creating the term: “Pregnancy as a window for future health.” Although the placenta works as a gatekeeper, many pregnancy complications may lead to sickness and earlier death in later life when the child becomes an adult. The epigenetic mechanisms and the mismatch between pre- and postnatal life have created the term “fetal origin of adult disease.” Up to now, the impact of cardiovascular, metabolic, or thrombotic risk profiles has been investigated separately for mother and child. In this manuscript, we strive to illustrate the consequences for both, fetus and mother within a cohesive perspective and thus try to demonstrate the complex interrelationship of genetics and epigenetics for long-term health of societies and future generations. Maternal–fetal medicine specialists should have a key role in the prevention of non-communicable diseases by implementing a framework for patient consultation and interdisciplinary networks. Health-care providers and policy makers should increasingly invest in a stratified primary prevention and follow-up to reduce the increasing number of manifest cardiovascular and metabolic diseases and to prevent waste of health-care resources.

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“…Meanwhile, any breastfeeding for at least 6 months decreased the occurrence of asthmatic and allergic symptoms induced by PM 2.5 [63], as well as the adverse effects of NO 2 and benzene on mental development [72]. However, a study conducted in Switzerland showed a higher but nonsignificant negative association between PM 10 and respiratory symptoms among breastfed infants compared with non-breastfed ones [83]. The authors explained that this may be the effect of the chemical contamination of the breastmilk of mothers exposed to air pollution.…”

Section: Findings and Discussionmentioning

confidence: 99%

Protective Effect of Breastfeeding on the Adverse Health Effects Induced by Air Pollution: Current Evidence and Possible Mechanisms

Zielińska

Hamułka

2019

IJERPH

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Air pollution is a major social, economic, and health problem around the world. Children are particularly susceptible to the negative effects of air pollution due to their immaturity and excessive growth and development. The aims of this narrative review were to: (1) summarize evidence about the protective effects of breastfeeding on the adverse health effects of air pollution exposure, (2) define and describe the potential mechanisms underlying the protective effects of breastfeeding, and (3) examine the potential effects of air pollution on breastmilk composition and lactation. A literature search was conducted using electronic databases. Existing evidence suggests that breastfeeding has a protective effect on adverse outcomes of indoor and outdoor air pollution exposure in respiratory (infections, lung function, asthma symptoms) and immune (allergic, nervous and cardiovascular) systems, as well as under-five mortality in both developing and developed countries. However, some studies reported no protective effect of breastfeeding or even negative effects of breastfeeding for under-five mortality. Several possible mechanisms of the breastfeeding protective effect were proposed, including the beneficial influence of breastfeeding on immune, respiratory, and nervous systems, which are related to the immunomodulatory, anti-inflammatory, anti-oxidant, and neuroprotective properties of breastmilk. Breastmilk components responsible for its protective effect against air pollutants exposure may be long chain polyunsaturated fatty acids (LC PUFA), antioxidant vitamins, carotenoids, flavonoids, immunoglobins, and cytokines, some of which have concentrations that are diet-dependent. However, maternal exposure to air pollution is related to increased breastmilk concentrations of pollutants (e.g., Polycyclic aromatic hydrocarbons (PAHs) or heavy metals in particulate matter (PM)). Nonetheless, environmental studies have confirmed that breastmilk’s protective effects outweigh its potential health risk to the infant. Mothers should be encouraged and supported to breastfeed their infants due to its unique health benefits, as well as its limited ecological footprint, which is associated with decreased waste production and the emission of pollutants.

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Effects of Breastfeeding on Respiratory Symptoms in Infancy

Abstract: This study shows the risk-specific effect of breastfeeding on respiratory symptoms in early life using the comprehensive time-series approach.

Cited by 27 publications

References 41 publications

Neighbourhood child population density as a proxy measure for exposure to respiratory infections in the first year of life: A validation study

Neighbourhood child population density as a proxy measure for exposure to respiratory infections in the first year of life: A validation study

Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication

Protective Effect of Breastfeeding on the Adverse Health Effects Induced by Air Pollution: Current Evidence and Possible Mechanisms

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