ORIGINAL ARTICLE

Assessing the population impact of low rates of breast feeding on asthma, coeliac disease and obesity: the use of a new statistical method

Anthony K Akobeng¹, Richard F Heller²

¹ Department of Paediatric Gastroenterology, Central Manchester and Manchester Children’s University Hospitals, Booth Hall Children’s Hospital, Manchester, UK
² Evidence for Population Health Unit, Division of Epidemiology and Health Sciences, University of Manchester, Manchester, UK

Correspondence to:
Dr A K Akobeng
Department of Paediatric Gastroenterology, Central Manchester and Manchester Children’s University Hospitals, Booth Hall Children’s Hospital, Charlestown Road, Blackley, Manchester M9 7AA, UK; tony.akobeng{at}cmmc.nhs.uk

Background: Lack of breast feeding has been reported to be associated with a number of chronic childhood disorders.

Aim: To use a recently described measure, the population impact number of eliminating a risk factor over a time period (PIN-ER-t), to quantify the burden of low rates of breast feeding in a UK population of babies born in 2002 with regard to asthma, coeliac disease and obesity.

Methods: We performed literature searches for systematic reviews with meta-analyses that had investigated the association between breast feeding and asthma, coeliac disease and obesity. Based on these data, and published data on the prevalence of breast feeding and the prevalence of the disorders, we calculated PIN-ER-t and estimated the number of cases of each disorder which could be prevented by eliminating "no breast feeding" as a risk factor.

Results: In the population of the 596 122 babies born in England and Wales in 2002, the number of cases of asthma, coeliac disease and obesity that could be prevented over 7–9 years if "no breast feeding" as a risk factor was eliminated were 33 100 (95% CI 17 710 to 47 543), 2655 (95% CI 1937 to 3343) and 13639 (95% CI 7838 to 19308), respectively.

Conclusions: The population burden of low breast feeding rates is high with regard to these chronic disorders. The use of PIN-ER-t allows the population burden of low breast feeding rates to be quantified and communicated in a way that will make it easier for both the general public and decision makers to understand.

Abbreviations: CI, confidence interval; OR, odds ratio; PAR, population attributable risk; PIN-ER-t, population impact number of eliminating a risk factor over a time period

Keywords: breast feeding; chronic disorders; population burden; PIN-ER-t

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