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Influence of past breast feeding on pattern and severity of presentation of juvenile idiopathic arthritis
  1. Kimme L Hyrich1,2,
  2. Eileen Baildam3,
  3. Hannah Pickford1,
  4. Alice Chieng4,
  5. Joyce E Davidson5,
  6. Helen Foster6,
  7. Janet Gardner-Medwin7,
  8. Lucy R Wedderburn8,9,10,
  9. Wendy Thomson1,2
  1. 1Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
  2. 2NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
  3. 3Department of Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool, UK
  4. 4Department of Rheumatology, The Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  5. 5Department of Rheumatology, Royal Hospital for Sick Children, Greater Glasgow and Clyde Health Board and Royal Hospital for Sick Children, Edinburgh, UK
  6. 6Department of Rheumatology, Newcastle University and Great North Children's Hospital, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  7. 7Department of Rheumatology, Glasgow University, Glasgow, UK
  8. 8Infection, Immunology, and Rheumatology Section UCL Institute of Child Health, University College London, London, UK
  9. 9Department of Rheumatology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
  10. 10Centre for Adolescent Rheumatology at University College London, University College London Hospital, London, UK
  1. Correspondence to Dr Kimme Hyrich, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, The University of Manchester, Manchester Academic Health Science Centre, Room 2.800 Stopford Building, Oxford Road, Manchester M13 9PT, UK; kimme.hyrich{at}manchester.ac.uk

Abstract

This analysis aimed to study the influence of breast feeding on the pattern and severity of juvenile idiopathic arthritis (JIA) at presentation. The association between ever versus never breast feeding and disease severity at onset was compared in 923 children with JIA recruited to the UK Childhood Arthritis Prospective Study at first presentation to rheumatology. Fifty six per cent of children were ever breast fed (median 3.7 months). Breastfed children reported a lower median age at onset, a lower Childhood Health Assessment Questionnaire (CHAQ), a measure of disease severity, lower parent general evaluation scores and lower pain at presentation. There was a trend towards a higher proportion of breastfed children with rheumatoid factor-negative polyarthritis, but lesser enthesitis-related and psoriatic arthritis. There was a statistically significant inverse association between breast feeding and high CHAQ, even after adjusting for differences in socioeconomic status (adjusted OR 0.61 (95% CI 0.39 to 0.95)). Further work to understand the reasons behind these associations is required.

  • Rheumatology
  • Epidemiology
  • Infant Feeding

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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