Acute respiratory illness in Adelaide children: breast feeding modifies the effect of passive smoking.

Woodward, Alistair; Douglas, Robert M.; Graham, Neil M.H.; Miles, Helen

doi:10.1136/jech.44.3.224

Cited by 88 publications

(65 citation statements)

References 23 publications

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“…Focusing on infections between 7-12 months revealed a plausible time sequence supporting a true protective effect of breastfeeding. Our observation of a weaker effect of exposure to tobacco smoke products on LRTIs in long-term breastfed children, is consistent with results of a cross-sectional study of acute respiratory illness among children in Adelaide, Australia [29]. The results do not support a hypothesis that exposure to tobacco smoke products through breastmilk increases the risk of LRTIs.…”

Section: Discussionsupporting

confidence: 80%

“…The protective effect of breastfeeding has been difficult to establish. Results from developing countries are consistent with a protective effect of breastfeeding [16][17][18], while studies undertaken in industrialized societies have shown conflicting results [19][20][21][22][23][24][25][26][27][28][29][30][31]. There is recent evidence from a cross-sectional study of Australian children that breastfeeding protects from the adverse effects of passive smoking on acute respiratory illness [29].…”

supporting

confidence: 62%

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Breastfeeding, maternal smoking and lower respiratory tract infections

Nafstad¹,

Jaakkola²,

Hagen³

et al. 1996

Eur Respir J

152

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B Br re ea as st tf fe ee ed di in ng g, , m ma at te er rn na al l s sm mo ok ki in ng g a an nd d P. Nafstad*, J.J.K. Jaakkola* + , J.A. Hagen*, G. Botten*, J. Kongerud** Breastfeeding, maternal smoking and lower respiratory tract infections. P. Nafstad, J.J.K. Jaakkola, J.A. Hagen, G. Botten, J. Kongerud. ERS Journals Ltd 1996. ABSTRACT: The objective of the study was to assess the relationship between breastfeeding and lower respiratory tract infections (LRTIs) during the first year of life, with special reference to maternal smoking.A cohort of 3,754 children born in 1992-1993 in the City of Oslo, Norway was recruited and data were collected at birth, 6 and 12 months of age. Complete information was obtained from 3,238 children (follow-up rate 86%). The main outcome was an episode of a LRTI, such as pneumonia, bronchitis or bronchiolitis, based on a self-administered questionnaire addressed to parents when the child was 6 and 12 months old. The outcome was specified as physician-diagnosed.In logistic regression analysis adjusting for confounding, maternal smoking increased the risk of LRTIs in children breastfed for 0-6 months (odds ratio (AOR) 1.7; 95% confidence interval (95% CI) 1.2-2.4), but not essentially when the child was breastfed for more than 6 months (AOR 1.1; 95% CI 0.7-1.6). Short-term breastfeeding (0-6 months) and no maternal smoking was related to an adjusted AOR of LRTIs of 1.3 (95% CI 1.0-1.7), and short-term breastfeeding combined with maternal smoking was related to an adjusted AOR of 2.2 (95% CI 1.6-3.1), as compared with long-term breastfeeding and no maternal smoking.The present study indicates a protective effect of long-term breastfeeding on the risk of lower respiratory tract infection during the first year of life. The results suggest that the protective effect is strongest in children exposed to environmental tobacco smoke.

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Section: Discussionsupporting

confidence: 80%

supporting

confidence: 62%

Breastfeeding, maternal smoking and lower respiratory tract infections

Nafstad¹,

Jaakkola²,

Hagen³

et al. 1996

Eur Respir J

152

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“…Outros estudos também mostraram que o aleitamento natural é um fator de proteção para as infecções respiratórias 6,27,28 . Este efeito pode ser decorrente de uma combinação de mecanismos comportamentais, que podem produzir mudanças relacionadas à exposição da criança ao tabagismo domiciliar, e biológi-cos, por meio da aquisição de imunidade específica crescente para um maior grupo de vírus, que se observa quando a criança está sendo aleitada 29 .…”

Section: Discussionunclassified

Tabagismo no domicílio e doença respiratória em crianças menores de cinco anos

et al. 2006

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A fumaça do tabaco no ambiente doméstico é o principal irritante do trato respiratório de crianças. Avaliaram-se os fatores associados aos sintomas e às enfermidades respiratórias, assim como a principal fonte de exposição ao tabagismo no domicílio de 2.037 crianças menores de cinco anos atendidas para vacinação em 10 dos 38 postos de saúde de Cuiabá, Mato Grosso, Brasil (aproximadamente duzentas crianças por posto). Exposição ao tabagismo, a morbidade respiratória e as características sócio-demográficas foram obtidas por entrevista com o responsável pela criança. A prevalência de sintomáticos respiratórios foi de 59,9%, sendo maior para os que convivem com fumantes. A asma/bronquite foi a patologia que esteve mais fortemente associada com o tabagismo, sendo as variáveis que permaneceram associadas em modelo logístico hierarquizado: nível socioeconômico (OR = 2,93; IC95%: 1,57-5,45), escolaridade (OR = 1,46; IC95%: 1,08-1,98) e ocupação da mãe (OR = 1,68; IC95%: 1,04-2,74), distrito sanitário (RP = 1,47; IC95%: 1,06-2,02), faixa etária (OR = 3,38; IC95%: 2,31-4,95) e sexo da criança (OR = 1,46; IC95%: 1,09-1,94), aleitamento natural (OR = 1,66; IC95%: 1,15-2,40) e tabagismo dos moradores (OR = 1,58; IC95%: 1,18-2,11). Crianças pertencentes aos níveis socioeconômicos mais baixos e expostas ao tabagismo dos moradores do domicílio apresentam maior associação com a doença respiratória.

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“…In fact, Chen (22') and co-workers (28,29) reported an increased risk of acute respiratory illnesses in Chinese children living with smoking fathers in the absence of smoking mothers. Furthermore, Woodward and coworkers (30) found that children of smoking mothers were significantly more susceptible to acute respiratory illnesses even after mothers who smoked during pregnancy were excluded from the analysis.…”

Section: Discussionmentioning

confidence: 99%

Maternal Smoking during Pregnancy and Postnatal Exposure to Environmental Tobacco Smoke as Predisposition Factors to Acute Respiratory Infections

Jędrychowski¹

1997

Environmental Health Perspectives

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The evidence for an effect of ETS was weaker and less convincing for school-age children, although the trends were the same as those reported for younger children. This may be due to a decrease in illness frequency, to physiological development of the respiratory tract or immune system with age, or to decreased contact between smoking parents and the child with age. However, the literature contains a remarkable lack of information on the long-term consequences of maternal smoking during pregnancy in terms of respiratory morbidity in older children after accounting for current ETS status and atopy, which is the major predisposing factor to acute episodes of respiratory illness.The present study had three specific objectives. First, we aimed to compare the susceptibility to respiratory morbidity over the last 12 months in a cohort of 9-year-old children exposed postnatally to ETS with that of an unexposed cohort. Second, we wanted to test the hypothesis that susceptibility to respiratory infections in older children is the consequence of both maternal cigarette smoking during pregnancy and postnatal ETS exposure. Another objective was to test the hypothesis that atopy significantly modifies the susceptibility of children to acute respiratory infections induced by ETS. Materials and MethodsThe study was carried out in the course of the epidemiologic research project on childrens' health in Krak6w, Poland. The field study was conducted in 1995 among 9-year-old schoolchildren attending 14 schools located in different areas of Krak6w.The study sample included 1,129 subjects; 594 boys and 535 girls attending the 2nd grade of grammar schools in the city. The data on respiratory infections were available for 97% (1,116) of the defined sample.Trained health professionals interviewed the mothers at schools or at homes and gathered standardized information about social background, family and child's respiratory health, and data on episodes of respiratory infections over the last 12 months. Respiratory infections of the upper (tonsillitis) and lower respiratory tract (laryngitis/tracheitis and bronchitis) that occurred in the last year before the interview and that were diagnosed by a doctor were the subject of the analysis. No data on severity ofrespiratory illness or the kind ofmedical interventions were collected.At the interview, data were also collected about the mother's smoking habit during pregnancy, the duration and average number of cigarettes smoked daily, and the time of giving up smoking if the mother was previously a smoker. Mothers were also asked whether the child had been exposed to ETS at home. ETS exposure was categorized as 1) no lifetime exposure (ETSO), 2) 9 or fewer cigarettes smoked daily in the household over the child's lifetime (ETS1), or 3) 10 or more cigarettes smoked daily in the household over the child's lifetime (ETS2). In the category ETS1 we also included subjects reporting smoking more than 9 cigarettes daily within the household but irregularly and not over the child's lifetime. The weigh...

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Acute respiratory illness in Adelaide children: breast feeding modifies the effect of passive smoking.

Cited by 88 publications

References 23 publications

Breastfeeding, maternal smoking and lower respiratory tract infections

Breastfeeding, maternal smoking and lower respiratory tract infections

Tabagismo no domicílio e doença respiratória em crianças menores de cinco anos

Maternal Smoking during Pregnancy and Postnatal Exposure to Environmental Tobacco Smoke as Predisposition Factors to Acute Respiratory Infections

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