Elsevier

The Journal of Pediatrics

Volume 151, Issue 4, October 2007, Pages 347-351.e2
The Journal of Pediatrics

Original article
Breast-Feeding Duration and Infant Atopic Manifestations, by Maternal Allergic Status, in the First 2 Years of Life (KOALA Study)

https://doi.org/10.1016/j.jpeds.2007.03.022Get rights and content

Objective

To investigate the potential effect of modification by maternal allergic status on the relationship between breast-feeding duration and infant atopic manifestations in the first 2 years of life.

Study design

Data from 2705 infants of the KOALA Birth Cohort Study (The Netherlands) were analyzed. The data were collected by repeated questionnaires at 34 weeks of gestation and 3, 7, 12, and 24 months postpartum. Total and specific immunoglobulin E measurements were performed on venous blood samples collected during home visits at age 2 years. Relationships were analyzed using logistic regression analyses.

Results

Longer duration of breast-feeding was associated with a lower risk for eczema in infants of mothers without allergy or asthma (Ptrend = .01) and slightly lower risk in those of mothers with allergy but no asthma (Ptrend = .14). There was no such association for asthmatic mothers (Ptrend = .87). Longer breast-feeding duration decreased the risk of recurrent wheeze independent of maternal allergy (Ptrend = .02) or asthma status (Ptrend = .06).

Conclusions

Our findings show that the relationship between breast-feeding and infant eczema in the first 2 years of life is modified by maternal allergic status. The protective effect of breast-feeding on recurrent wheeze may be associated with protection against respiratory infections.

Section snippets

Study Population

The study subjects were mother–infant pairs previously enrolled in the KOALA Birth Cohort Study between 2000 and 2002.5 We recruited participants with diverse lifestyles (“conventional” and “alternative”) who were at 34 weeks of gestation. The women with a conventional lifestyle (n = 2343) were recruited from an ongoing prospective cohort study on pregnancy-related pelvic girdle pain in The Netherlands. The women with an alternative lifestyle (n = 491) were recruited through various channels,

Results

Of the 2834 infants enrolled at birth, 3 were excluded because of Down syndrome and 126 because of missing information on breast-feeding, leaving 2705 infants for the study. The response rate for the questionnaire at age 2 years was 93% (n = 2516). Home visits at age 2 years were made in 818 infants. Most infants were breast-fed (85%; n = 2287). Mothers in the alternative recruitment group had a higher rate and a longer duration of breast-feeding compared with those in the conventional

Discussion

We found that longer duration of breast-feeding was associated with a decreased risk for recurrent wheeze in the first 2 years of life, regardless of the mother’s allergy history. Moreover, longer duration of breast-feeding was associated with a decreased risk of eczema (by questionnaire) in infants of mothers without allergy or asthma. When atopic dermatitis (according to UK-WP criteria), increased total IgE levels, or sensitization were taken as the outcome, no associations with

References (20)

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Supported by The Netherlands Organisation for Health Research and Development (Zon-Mw), program of Innovative Prevention Research (Prevention Program 1, no. 210-00-090).

The sponsoring organization had no involvement in the study design, data collection, analysis, or interpretation, or in writing of the report or the decision to submit the manuscript for publication. There are no conflicts of interest to report.

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