Increased risk of eczema but reduced risk of early wheezy disorder from exclusive breast-feeding in high-risk infants

Giwercman, Charlotte; Halkjær, Liselotte Brydensholt; Jensen, Signe Marie; Bønnelykke, Klaus; Lauritzen, Lotte; Bisgaard, Hans

doi:10.1016/j.jaci.2010.01.026

Cited by 80 publications

(92 citation statements)

References 44 publications

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“…These suggested an up to 2.22-fold increased risk of recurrent wheezing or asthma at the ages of 2-6 yrs among children who were not breastfed or not exclusively breastfed until the age of 4 months [3][4][5][6][7][8][9][10][11]13]. Our effect estimates are in line with these studies, and, additionally, we observed a dose-response relationship between breastfeeding and the number of wheezing episodes.…”

Section: Discussionsupporting

confidence: 90%

“…Known risk factors in early life for asthma-related symptoms include birth weight, gestational age, parental socioeconomic status, ethnicity, presence of siblings, daycare attendance, family history of asthma or atopy and parental smoking [2]. A substantial body of evidence suggests that breastfeeding is also associated with a reduced risk of childhood asthma and asthmarelated symptoms [3][4][5][6][7][8][9][10][11][12][13][14]. Some studies have reported stronger protective effects of breastfeeding on asthma in children with a positive family history of asthma or allergy [8,15,16], whereas others did not [6,11,12].…”

mentioning

confidence: 99%

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Duration and exclusiveness of breastfeeding and childhood asthma-related symptoms

Voort¹,

Jaddoe²,

Valk³

et al. 2011

European Respiratory Journal

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The aim of our study was to examine the associations of breastfeeding duration and exclusiveness with the risks of asthma-related symptoms in preschool children, and to explore whether these associations are explained by atopic or infectious mechanisms.This study was embedded in a population-based prospective cohort study of 5,368 children. Information on breastfeeding duration, exclusiveness and asthma-related symptoms, including wheezing, shortness of breath, dry cough and persistent phlegm, was obtained by questionnaires.Compared with children who were breastfed for 6 months, those who were never breastfed had overall increased risks of wheezing, shortness of breath, dry cough and persistent phlegm during the first 4 yrs (OR 1.44 (95% CI 1.24-1.66), 1.26 (1.07-1.48), 1.25 (1.08-1.44) and 1.57 (1.29-1.91), respectively). Similar associations were observed for exclusive breastfeeding. The strongest associations per symptom per year were observed for wheezing at 1 and 2 yrs. Additionally adjusted analyses showed that the associations of breastfeeding with asthma-related symptoms were not explained by eczema but partly by lower respiratory tract infections.Shorter duration and nonexclusivity of breastfeeding were associated with increased risks of asthma-related symptoms in preschool children. These associations seemed, at least partly, to be explained by infectious, but not by atopic, mechanisms.

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Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

Duration and exclusiveness of breastfeeding and childhood asthma-related symptoms

Voort¹,

Jaddoe²,

Valk³

et al. 2011

European Respiratory Journal

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“…Giwercman et al has shown, in a birth cohort born of mothers with asthma, that duration of exclusive breast-feeding increased the infant's risk of eczema during the first 2 years of life. In contrast, the same study showed that breast-feeding protected infants from wheezy disorders and severe wheezy exacerbations (15) . Overall, at the present time, firm conclusions about the role of breast-feeding in either preventing or delaying the onset of specific food allergies are not possible (13) .…”

Section: Proceedings Of the Nutrition Societymentioning

confidence: 92%

“…Other studies restricted to populations with increased risk have even reported the increased risk from breast-feeding of eczema, wheezy disorder, asthma and sensitisation. Some authors reported a small protective effect on eczema and a dual effect, protecting in high-risk infants but increasing risk in infants without such heredity (15) . Pohlabeln et al observed a significantly increased risk of developing an atopic disease in children without a genetic allergic disposition who were exclusively breastfed for more than 4 months (OR 1 .…”

Section: Proceedings Of the Nutrition Societymentioning

confidence: 99%

Infant nutrition and allergy

Mišak

2011

Proc. Nutr. Soc.

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Over the past several decades, the incidence of atopic diseases such as asthma, atopic dermatitis and food allergies has increased dramatically. Although atopic diseases have a clear genetic basis, environmental factors, including early infant nutrition, may have an important influence on their development. Therefore, attempts have been made to reduce the risk of the development of allergy using dietary modifications, mainly focused on longer breast-feeding and delayed introduction or elimination of foods identified as potentially most allergenic. Recently, there is also an increasing interest in the active prevention of atopy using specific dietary components. Many studies have shown that breast-feeding may have the protective effect against future atopic dermatitis and early childhood wheezing. Concerning complementary feeding, there is evidence that the introduction of complementary foods before 4 months of age may increase the risk for atopic dermatitis. However, there is no current convincing evidence that delaying introduction of solids after 6 months of age has a significant protective effect on the development of atopic disease regardless of whether infants are fed cow's milk protein formula or human subject's milk, and this includes delaying the introduction of foods that are considered to be highly allergic, such as fish, eggs and foods containing peanut protein. In conclusion, as early nutrition may have profound implications for long-term health and atopy later in life, it presents an opportunity to prevent or delay the onset of atopic diseases.

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“…33,34 Exclusive breastfeeding decreases early childhood viral wheeze, but it has not been shown to protect against long-term asthma risk. 35,36 In fact, some studies show an increased long-term risk of asthma with exclusive breastfeeding. 37 The PROBIT (Promotion of Breastfeeding Intervention Trial) trial, a cluster randomized trial including more than 17 000 mother-infant pairs, noted no protective effect of prolonged and exclusive breastfeeding on asthma or aeroallergen sensitization.…”

Section: What Roles Do Maternal Avoidance Diets and Breastfeeding Play?mentioning

confidence: 99%

Food introduction and allergy prevention in infants

Abrams

Becker

2015

CMAJ

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Increased risk of eczema but reduced risk of early wheezy disorder from exclusive breast-feeding in high-risk infants

Cited by 80 publications

References 44 publications

Duration and exclusiveness of breastfeeding and childhood asthma-related symptoms

Duration and exclusiveness of breastfeeding and childhood asthma-related symptoms

Infant nutrition and allergy

Food introduction and allergy prevention in infants

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