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 Akobeng ^1* and Richard F Heller ²

¹ Central Manchester and Manchester Children's University Hospitals, Manchester, United Kingdom
² Evidence for Population Health Unit, University of Manchester, United Kingdom

^* To whom correspondence should be addressed. E-mail: tony.akobeng{at}cmmc.nhs.uk.

Accepted 10 July 2006

Abstract

Background: Lack of breast-feeding has been reported to be associated with a number of chronic childhood disorders. A simple demonstration of the population burden of this problem could be helpful in risk communication.

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 three chronic disorders (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 the three disorders. Based on these data, and published data on 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 (defined as a body mass index greater than the 95th centile) that could be prevented over 7-9 years if 'no breast-feeding' as a risk factor was eliminated were 33100 (95% CI, 17710 to 47543), 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.

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

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