Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood

Anne L Wright, C. J. Holberg, L. M. Taussig, Fernando Martinez

Research output: Contribution to journalArticle

302 Citations (Scopus)

Abstract

Background - The relationship between infant feeding and childhood asthma is controversial. This study tested the hypothesis that the relation between breast feeding and childhood asthma is altered by the presence of maternal asthma. Methods - Healthy non-selected newborn infants (n=1246) were enrolled at birth. Asthma was defined as a physician diagnosis of asthma plus asthma symptoms reported on ≥2 questionnaires at 6, 9, 11 or 13 years. Recurrent wheeze (≥4 episodes in the past year) was reported by questionnaire at seven ages in the first 13 years of life. Duration of exclusive breast feeding was based on prospective physician reports or parental questionnaires completed at 18 months. Atopy was assessed by skin test responses at the age of 6 years. Results - The relationship between breast feeding, asthma, and wheeze differed with the presence or absence of maternal asthma and atopy in the child. After adjusting for confounders, children with asthmatic mothers were significantly more likely to have asthma if they had been exclusively breast fed (OR 8.7, 95% CI 3.4 to 22.2). This relationship was only evident for atopic children and persisted after adjusting for confounders. In contrast, the relation between recurrent wheeze and breast feeding was age dependent. In the first 2 years of life exclusive breast feeding was associated with significantly lower rates of recurrent wheeze (OR 0.45, 95% CI 0.2 to 0.9), regardless of the presence or absence of maternal asthma or atopy in the child. Beginning at the age of 6 years, exclusive breast feeding was unrelated to prevalence of recurrent wheeze, except for children with asthmatic mothers in whom it was associated with a higher odds ratio for wheeze (OR 5.7, 95% CI 2.3 to 14.1), especially if the child was atopic. Conclusion - The relationship between breast feeding and asthma or recurrent wheeze varies with the age of the child and the presence or absence of maternal asthma and atopy in the child. While associated with protection against recurrent wheeze early in life, breast feeding is associated with an increased risk of asthma and recurrent wheeze beginning at the age of 6 years, but only for atopic children with asthmatic mothers.

Original languageEnglish (US)
Pages (from-to)192-197
Number of pages6
JournalThorax
Volume56
Issue number3
DOIs
StatePublished - 2001

Fingerprint

Asthma
Breast Feeding
Mothers
Physicians
Skin Tests
Breast
Odds Ratio
Parturition
Newborn Infant

Keywords

  • Allergic disease
  • Asthma
  • Atopy
  • Breast feeding
  • Infant feeding
  • Wheezing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood. / Wright, Anne L; Holberg, C. J.; Taussig, L. M.; Martinez, Fernando.

In: Thorax, Vol. 56, No. 3, 2001, p. 192-197.

Research output: Contribution to journalArticle

@article{320daac659194ae7bc2b2321ae216914,
title = "Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood",
abstract = "Background - The relationship between infant feeding and childhood asthma is controversial. This study tested the hypothesis that the relation between breast feeding and childhood asthma is altered by the presence of maternal asthma. Methods - Healthy non-selected newborn infants (n=1246) were enrolled at birth. Asthma was defined as a physician diagnosis of asthma plus asthma symptoms reported on ≥2 questionnaires at 6, 9, 11 or 13 years. Recurrent wheeze (≥4 episodes in the past year) was reported by questionnaire at seven ages in the first 13 years of life. Duration of exclusive breast feeding was based on prospective physician reports or parental questionnaires completed at 18 months. Atopy was assessed by skin test responses at the age of 6 years. Results - The relationship between breast feeding, asthma, and wheeze differed with the presence or absence of maternal asthma and atopy in the child. After adjusting for confounders, children with asthmatic mothers were significantly more likely to have asthma if they had been exclusively breast fed (OR 8.7, 95{\%} CI 3.4 to 22.2). This relationship was only evident for atopic children and persisted after adjusting for confounders. In contrast, the relation between recurrent wheeze and breast feeding was age dependent. In the first 2 years of life exclusive breast feeding was associated with significantly lower rates of recurrent wheeze (OR 0.45, 95{\%} CI 0.2 to 0.9), regardless of the presence or absence of maternal asthma or atopy in the child. Beginning at the age of 6 years, exclusive breast feeding was unrelated to prevalence of recurrent wheeze, except for children with asthmatic mothers in whom it was associated with a higher odds ratio for wheeze (OR 5.7, 95{\%} CI 2.3 to 14.1), especially if the child was atopic. Conclusion - The relationship between breast feeding and asthma or recurrent wheeze varies with the age of the child and the presence or absence of maternal asthma and atopy in the child. While associated with protection against recurrent wheeze early in life, breast feeding is associated with an increased risk of asthma and recurrent wheeze beginning at the age of 6 years, but only for atopic children with asthmatic mothers.",
keywords = "Allergic disease, Asthma, Atopy, Breast feeding, Infant feeding, Wheezing",
author = "Wright, {Anne L} and Holberg, {C. J.} and Taussig, {L. M.} and Fernando Martinez",
year = "2001",
doi = "10.1136/thorax.56.3.192",
language = "English (US)",
volume = "56",
pages = "192--197",
journal = "Thorax",
issn = "0040-6376",
publisher = "BMJ Publishing Group",
number = "3",

}

TY - JOUR

T1 - Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood

AU - Wright, Anne L

AU - Holberg, C. J.

AU - Taussig, L. M.

AU - Martinez, Fernando

PY - 2001

Y1 - 2001

N2 - Background - The relationship between infant feeding and childhood asthma is controversial. This study tested the hypothesis that the relation between breast feeding and childhood asthma is altered by the presence of maternal asthma. Methods - Healthy non-selected newborn infants (n=1246) were enrolled at birth. Asthma was defined as a physician diagnosis of asthma plus asthma symptoms reported on ≥2 questionnaires at 6, 9, 11 or 13 years. Recurrent wheeze (≥4 episodes in the past year) was reported by questionnaire at seven ages in the first 13 years of life. Duration of exclusive breast feeding was based on prospective physician reports or parental questionnaires completed at 18 months. Atopy was assessed by skin test responses at the age of 6 years. Results - The relationship between breast feeding, asthma, and wheeze differed with the presence or absence of maternal asthma and atopy in the child. After adjusting for confounders, children with asthmatic mothers were significantly more likely to have asthma if they had been exclusively breast fed (OR 8.7, 95% CI 3.4 to 22.2). This relationship was only evident for atopic children and persisted after adjusting for confounders. In contrast, the relation between recurrent wheeze and breast feeding was age dependent. In the first 2 years of life exclusive breast feeding was associated with significantly lower rates of recurrent wheeze (OR 0.45, 95% CI 0.2 to 0.9), regardless of the presence or absence of maternal asthma or atopy in the child. Beginning at the age of 6 years, exclusive breast feeding was unrelated to prevalence of recurrent wheeze, except for children with asthmatic mothers in whom it was associated with a higher odds ratio for wheeze (OR 5.7, 95% CI 2.3 to 14.1), especially if the child was atopic. Conclusion - The relationship between breast feeding and asthma or recurrent wheeze varies with the age of the child and the presence or absence of maternal asthma and atopy in the child. While associated with protection against recurrent wheeze early in life, breast feeding is associated with an increased risk of asthma and recurrent wheeze beginning at the age of 6 years, but only for atopic children with asthmatic mothers.

AB - Background - The relationship between infant feeding and childhood asthma is controversial. This study tested the hypothesis that the relation between breast feeding and childhood asthma is altered by the presence of maternal asthma. Methods - Healthy non-selected newborn infants (n=1246) were enrolled at birth. Asthma was defined as a physician diagnosis of asthma plus asthma symptoms reported on ≥2 questionnaires at 6, 9, 11 or 13 years. Recurrent wheeze (≥4 episodes in the past year) was reported by questionnaire at seven ages in the first 13 years of life. Duration of exclusive breast feeding was based on prospective physician reports or parental questionnaires completed at 18 months. Atopy was assessed by skin test responses at the age of 6 years. Results - The relationship between breast feeding, asthma, and wheeze differed with the presence or absence of maternal asthma and atopy in the child. After adjusting for confounders, children with asthmatic mothers were significantly more likely to have asthma if they had been exclusively breast fed (OR 8.7, 95% CI 3.4 to 22.2). This relationship was only evident for atopic children and persisted after adjusting for confounders. In contrast, the relation between recurrent wheeze and breast feeding was age dependent. In the first 2 years of life exclusive breast feeding was associated with significantly lower rates of recurrent wheeze (OR 0.45, 95% CI 0.2 to 0.9), regardless of the presence or absence of maternal asthma or atopy in the child. Beginning at the age of 6 years, exclusive breast feeding was unrelated to prevalence of recurrent wheeze, except for children with asthmatic mothers in whom it was associated with a higher odds ratio for wheeze (OR 5.7, 95% CI 2.3 to 14.1), especially if the child was atopic. Conclusion - The relationship between breast feeding and asthma or recurrent wheeze varies with the age of the child and the presence or absence of maternal asthma and atopy in the child. While associated with protection against recurrent wheeze early in life, breast feeding is associated with an increased risk of asthma and recurrent wheeze beginning at the age of 6 years, but only for atopic children with asthmatic mothers.

KW - Allergic disease

KW - Asthma

KW - Atopy

KW - Breast feeding

KW - Infant feeding

KW - Wheezing

UR - http://www.scopus.com/inward/record.url?scp=0035094236&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035094236&partnerID=8YFLogxK

U2 - 10.1136/thorax.56.3.192

DO - 10.1136/thorax.56.3.192

M3 - Article

C2 - 11182011

AN - SCOPUS:0035094236

VL - 56

SP - 192

EP - 197

JO - Thorax

JF - Thorax

SN - 0040-6376

IS - 3

ER -