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Breastfeeding and asthma outcomes at the age of 6 years: The Generation R Study
Author(s) -
Dekker Herman T.,
Sonnenscheinvan der Voort Agnes M. M.,
Jaddoe Vincent W. V.,
Reiss Irwin K.,
Jongste Johan C.,
Duijts Liesbeth
Publication year - 2016
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12576
Subject(s) - medicine , breastfeeding , asthma , pediatrics , respiratory tract infections , exhaled nitric oxide , cohort study , population , prospective cohort study , breast feeding , cohort , allergy , respiratory system , immunology , spirometry , environmental health
Background Breastfeeding is associated with a lower risk of asthma symptoms in early childhood, but its effect at older ages remains unclear. We examined the associations of duration and exclusiveness of breastfeeding with asthma outcomes in children aged 6 years, and whether these associations were explained by atopic or infectious mechanisms. Methods We performed a population‐based prospective cohort study among 5675 children. Information about breastfeeding was collected by questionnaires. At age 6 years, we measured interrupter resistance (Rint) and fractional exhaled nitric oxide (Fe NO ). Information about wheezing patterns (early (≤3 years only), late (>3 years only), persistent (≤3 and >3 years)), and current asthma at 6 years was derived from repeated questionnaires. Results Compared to children who were ever breastfed, those who were never breastfed had lower Fe NO levels (sympercent (95% CI ): ‐16.0 (‐24.5, ‐7.5)) and increased risks of late and persistent wheezing ( OR (95% CI ): 1.69 (1.06, 2.69) and 1.44 (1.00, 2.07), respectively). Shorter duration of breastfeeding was associated with early wheezing and current asthma (1.40 (1.14, 1.73) and 2.19 (1.29, 3.71), respectively). Less exclusive breastfeeding was associated with early wheezing (1.28 (1.08, 1.53)). Breastfeeding duration and exclusiveness were not associated with Fe NO or Rint. The associations were not explained by inhalant allergies, partly by lower respiratory tract infections in early life, and to a lesser extent by lower respiratory tract infections in later life. Conclusions Breastfeeding patterns may influence wheezing and asthma in childhood, which seems to be partly explained by infectious mechanisms.