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Breast feeding and allergic diseases in infants—a prospective birth cohort study
  1. I Kull1,
  2. M Wickman1,
  3. G Lilja2,
  4. S L Nordvall3,
  5. G Pershagen4
  1. 1Department of Environmental Health, Stockholm County Council, Stockholm, Sweden
  2. 2Sachss’ Children’s Hospital, Institutet of Södersjukhuset, Karolinska Institutet, Stockholm
  3. 3Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
  4. 4Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  1. 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

Abstract

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%, ORadj = 0.7, 95% CI 0.5 to 0.8), less atopic dermatitis (24% v 27%, ORadj = 0.8, 95% CI 0.7 to 1.0), and less suspected allergic rhinitis (6.5% v 9%, ORadj = 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 (ORadj = 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 (ORadj = 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.

  • allergy
  • asthma
  • breast feeding
  • prevention
  • AD, atopic dermatitis
  • CI, confidence interval
  • OR, odds ratio
  • SAD, severe symptoms of allergic disease
  • SAR, suspected allergic rhinitis
  • SARS, suspected allergic respiratory symptoms

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