Atopic dermatitis and skin diseaseIncreased risk of eczema but reduced risk of early wheezy disorder from exclusive breast-feeding in high-risk infants
Section snippets
Methods
The study is reported in accordance with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology).15
Breast-feeding
The COPSAC birth cohort included 411 newborns, of whom 58 were missing information on duration of exclusive breast-feeding. We excluded 11 nonwhite subjects because we adjusted for filaggrin. Twenty-one were never breast-fed and could not be analyzed in the chosen model. The remaining 321 infants (153 boys) were exclusively breast-fed for a mean duration of 121 days (range, 1-274). Sixty-nine infants were exclusively breast-fed less than 3 months, 203 for 3 to 6 months, and 49 for more than 6
Fatty acid composition of mother's milk
Breast milk samples were collected from 314 women 25.2 ± 0.9 (±SEM) days after birth. The confounder-adjusted multivariate analyses of eczema included 249 infants. Of the 321 infants described, the analyses of fatty acid composition were not possible because of missing samples or technical errors for 62 children, 4 had missing information on filaggrin variants R501X and 2282del4, 5 had missing information on the father's atopic history, and 1 lacked information on pets at home at birth. Eczema
Principal findings
Exclusive breast-feeding was a significant risk factor for development of eczema during the first 2 years of life and the risk of eczema increased in infants with increased duration of breast-feeding. This dose-response relation strengthens the validity of the conclusion. In contrast, the risk of wheezy disorder and severe wheezy exacerbations was reduced during the time the infant was exclusively breast-fed. There were no significant effects from the fatty acid composition of the breast milk
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COPSAC is funded by private and public research funds, all listed on www.copsac.com.
The Lundbeck Foundation, the Pharmacy Foundation of 1991, the Augustinus Foundation, the Danish Medical Research Council, and the Danish Pediatric Asthma Center provide core support for COPSAC. The funding agencies did not have any role in study design, data collection and analysis, decision to publish, or preparation of the article.
Disclosure of potential conflict of interest: H. Bisgaard is a consultant for Merck and NeoLab; is a lecturer for AstraZeneca; received research support from the Lundbeck Foundation, the Pharmacy Foundation of 1991, the Augustinus Foundation, the Danish Medical Research Council, and the Danish Pediatric Asthma Center; and has provided expert witness testimony for the Europena Medicines Agency on the topic of the guidelines on pediatric studies for documenting asthma drugs. L. Lauritzen has lectured for Fresenius Kabi and Nutricia. The rest of the authors have declared that they have no conflict of interest.