ORIGINAL ARTICLE

Breast feeding and allergic diseases in infants—a prospective birth cohort study

I Kull¹, M Wickman¹, G Lilja², S L Nordvall³, G Pershagen⁴

¹ Department of Environmental Health, Stockholm County Council, Stockholm, Sweden
² Sachss’ Children’s Hospital, Institutet of Södersjukhuset, Karolinska Institutet, Stockholm
³ Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
⁴ Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Correspondence to:
Correspondence to:
Dr M Wickman, Department of Environmental Health, Norrbacka Building, Level 3, Karolinska Hospital, SE-171 76 Stockholm, Sweden;
magnus.wickman{at}smd.sll.se

Aims: To investigate the effect of breast feeding on allergic disease in infants up to 2 years of age.

Methods: A birth cohort of 4089 infants was followed prospectively in Stockholm, Sweden. Information about various exposures was obtained by parental questionnaires when the infants were 2 months old, and about allergic symptoms and feeding at 1 and 2 years of age. Duration of exclusive and partial breast feeding was assessed separately. Symptom related definitions of various allergic diseases were used. Odds ratios (OR) and 95% confidence intervals (CI) were estimated in a multiple logistic regression model. Adjustments were made for potential confounders.

Results: Children exclusively breast fed during four months or more exhibited less asthma (7.7% v 12%, OR_adj = 0.7, 95% CI 0.5 to 0.8), less atopic dermatitis (24% v 27%, OR_adj = 0.8, 95% CI 0.7 to 1.0), and less suspected allergic rhinitis (6.5% v 9%, OR_adj = 0.7, 95% CI 0.5 to 1.0) by 2 years of age. There was a significant risk reduction for asthma related to partial breast feeding during six months or more (OR_adj = 0.7, 95% CI 0.5 to 0.9). Three or more of five possible allergic disorders—asthma, suspected allergic rhinitis, atopic dermatitis, food allergy related symptoms, and suspected allergic respiratory symptoms after exposure to pets or pollen—were found in 6.5% of the children. Exclusive breast feeding prevented children from having multiple allergic disease (OR_adj = 0.7, 95% CI 0.5 to 0.9) during the first two years of life.

Conclusion: Exclusive breast feeding seems to have a preventive effect on the early development of allergic disease—that is, asthma, atopic dermatitis, and suspected allergic rhinitis, up to 2 years of age. This protective effect was also evident for multiple allergic disease.

Keywords: allergy; asthma; breast feeding; prevention

Abbreviations: AD, atopic dermatitis; CI, confidence interval; OR, odds ratio; SAD, severe symptoms of allergic disease; SAR, suspected allergic rhinitis; SARS, suspected allergic respiratory symptoms

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Nagel, G., Buchele, G., Weinmayr, G., Bjorksten, B., Chen, Y-Z., Wang, H., Nystad, W., Saraclar, Y., Braback, L., Batlles-Garrido, J., Garcia-Hernandez, G., Weiland, S. K., the ISAAC Phase II Study Group, (2009). Effect of breastfeeding on asthma, lung function and bronchial hyperreactivity in ISAAC Phase II. Eur Respir J 33: 993-1002 [Abstract] [Full Text]  
• Lannero, E, Wickman, M, van Hage, M, Bergstrom, A, Pershagen, G, Nordvall, L (2008). Exposure to environmental tobacco smoke and sensitisation in children. Thorax 63: 172-176 [Abstract] [Full Text]  
• Snijders, B. E. P., Thijs, C., Kummeling, I., Penders, J., van den Brandt, P. A. (2007). Breastfeeding and Infant Eczema in the First Year of Life in the KOALA Birth Cohort Study: A Risk Period-Specific Analysis. Pediatrics 119: e137-e141 [Abstract] [Full Text]  
• Burgess, S. W., Dakin, C. J., O'Callaghan, M. J. (2006). Breastfeeding Does Not Increase the Risk of Asthma at 14 Years. Pediatrics 117: e787-e792 [Abstract] [Full Text]  
• (2005). Prevention strategies for asthma -- primary prevention. CMAJ 173: S20-S24 [Full Text]  
• Rona, R J, Smeeton, N C, Bustos, P, Amigo, H, Diaz, P V (2005). The early origins hypothesis with an emphasis on growth rate in the first year of life and asthma: a prospective study in Chile. Thorax 60: 549-554 [Abstract] [Full Text]  
• Lee, N., Banerjee, I., Mukherjee, D., Meier, P. (2005). Letters to the Editor. J Hum Lact 21: 120-123  
• Kilchevsky, E., James, E., Fong, J., Murphy, P. (2004). Atopic Dermatitis and Breastfeeding. Pediatrics 114: 1129-1129 [Full Text]  
• Stabell Benn, C., Wohlfahrt, J., Aaby, P., Westergaard, T., Benfeldt, E., Fleischer Michaelsen, K., Bjorksten, B., Melbye, M. (2004). Breastfeeding and Risk of Atopic Dermatitis, by Parental History of Allergy, during the First 18 Months of Life. Am J Epidemiol 160: 217-223 [Abstract] [Full Text]  
• Oddy, W. H., Peat, J. K. (2003). Breastfeeding, Asthma, and Atopic Disease: An Epidemiological Review of the Literature. J Hum Lact 19: 250-261 [Abstract]  

eLetters:

Read all eLetters

Does exclusive breast feeding prevent allergy?

G.N. Malavige

ADC Online, 7 Jan 2003 [Full text]