Evaluating the efficacy of breastfeeding guidelines on long-term outcomes for allergic disease

Abstract

Background WHO guidelines advocate breastfeeding for six months, and EAACI recommends exclusive breastfeeding for 4–6 months. However, evidence for breastfeeding to prevent asthma and allergic disease is conflicting. We examined whether following recommended breastfeeding guidelines alters the long-term risks of asthma, eczema, rhinitis, or atopy. Methods The effect of non-exclusive (0, >0–6, >6 months), and exclusive breastfeeding (0, >0–4, >4 months) on repeated measures of asthma (10, 18 years), eczema, rhinitis, and atopy (1-or-2, 4, 10, 18 years) risks were estimated in the IoW cohort (n=1456) using log-linear models with generalised estimating equations. The Food Allergy and Intolerance Research (FAIR) cohort (n=988), also from the IoW, was examined to replicate results. Results Breastfeeding (any or exclusive) had no effect on asthma and allergic disease in the IoW cohort. In the FAIR cohort, any breastfeeding for >0–6 months protected against asthma at 10 years (RR=0.50, 95%CI=0.32–0.79, p=0.003) but not other outcomes, while exclusive breastfeeding for >4 months protected against repeated rhinitis (RR=0.36, 95%CI=0.18–0.71, p=0.003). Longer breastfeeding was protective against late-onset wheeze in the IoW cohort. Conclusion The protective effects of non-exclusive and exclusive breastfeeding against long-term allergic outcomes were inconsistent between these co-located cohorts, agreeing with previous observations of heterogeneous effects. Although breastfeeding should be recommended for other health benefits, following breastfeeding guidelines did not appear to afford consistent protection against long-term asthma, eczema, rhinitis or atopy. Further research is needed into the long-term effects of breastfeeding on allergic disease.

Full breastfeeding and allergies from infancy until adolescence in the GINIplus cohort

“…[1][2][3] We used the large GINIplus cohort 4 to study short-and long-term effects of full breastfeeding during the first 4 months compared to formula or mixed feeding on the occurrence of eczema, allergic rhinitis, and asthma from birth up to the age of 15 years.…”

“…Moreover, in a subanalysis 2 no significant association between exclusive breastfeeding for longer than 3-4 months and asthma at 5-18 years was found, similarly as in the 6.5-year follow-up of the PROBIT. 8 The published effects of breastfeeding on allergic rhinitis are heterogeneous: While a meta-analysis 2 suggested a protective effect of breastfeeding until 5 years of age, supported by the 10-year follow-up results from the FAIR cohort, 3 no effect was found in the IoW cohort 3 until 18 years or in the PROBIT. 8 We observed protective effects of full breastfeeding at 5-6 years compared to the cow's milk-supplemented group of the I-cohort and up to 10 years of age in non-risk children of the NI-cohort.…”

“…Selected codes and clinical validation were based on the current accepted international diagnostic criteria for anaphylaxis. [1][2][3][5][6][7] Data about the characteristics of the French population by region, year, sex, and age were collected from the databases of the French…”

Beneficios de la lactancia materna y riesgos de no amamantar

“…Another recent SR reported that in the general population breastfeeding is a protective factor for asthma up to 2 years of age, but this effect decreases with time18. However other studies have been less conclusive about this 1,15 .…”

“…However other reviews have not found this correlation, so there is still no conclusive evidence 1 . EBF for at least four months protects against recurrent rhinitis 15 .…”