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Background Asthma is a common chronic respiratory disease. The risk factors of asthma are allergic factors, familial atopy, race, gender, and smoking during pregnancy. Other risk factors are gastroesophageal reflux and micro-aspiration which cause bronchospasm and bronchial hyperreactivity due to repeated airway irritation. Objective To determine the association between bottle feeding given in supine position before sleep time in the first year of life with asthma in 4 to 7 years old. Methods A case control study was conducted on pediatric patients from Sardjito Hospital and Muhammadiyah kindergarten, Yogyakarta. Two structured questionnaires were used; the first identified the case group (asthma) and control group (nonasthma), whereas the second one identified whether the subjects had bottle feeding in supine position in the first year of life or not. Results 122 subjects were studied, 62 subjects in asthma group and 60 in control group. In asthma group, feeding in supine position before sleep time in the first year had OR of 2.45 (95% CI 1.21 to 6.93), whereas regurgitation when bottle-feeding in supine position had OR of 4.53 (95% CI 1.54 to 13.16). Sudden cry when bottle-feeding in supine position had OR of 5.02 (95% CI 1.69 to 15.71). Asthma in the family increased risk of asthma [OR 3.12 (95% CI 1.16 to 6.50)] and atopicfamily has OR 3.25 (95% CI 1.01 to 6.27). Conclusion Bottle feeding in supine position before sleep time during first year oflife is associated with occurrence of asthma in preschool children.

Relationship between bottle feeding in supine position in infants and the presence of asthma among preschoolers