BACKGROUND: Emerging evidence questions current recommendations on the timing of infant feeding for the prevention of childhood allergies. The evidence for asthma is inconclusive. OBJECTIVE: We sought to investigate the associations between the duration of breast-feeding and timing of introduction of complementary foods and the development of asthma and allergies by the age of 5 years. METHODS: Data were analyzed for 3781 consecutively born children. The dietary exposures were categorized into thirds and analyzed as time-dependent variables. Asthma, allergic rhinitis, and atopic eczema end points were assessed by using the International Study of Asthma and Allergies in Childhood questionnaire, whereas IgE antibodies were analyzed from serum samples at the age of 5 years. Cox proportional hazard and logistic regressions were used for the analyses. RESULTS: The median duration of exclusive and total breast-feeding was 1.4 months (interquartile range, 0.2-3.5 months) and 7.0 months (interquartile range, 4.0-11.0 months), respectively. Total breast-feeding of 9.5 months or less was associated with an increased risk of nonatopic asthma. Introduction of wheat, rye, oats, or barley at 5 to 5.5 months was inversely associated with asthma and allergic rhinitis, whereas introduction of other cereals at less than 4.5 months increased the risk of atopic eczema. Introduction of egg at 11 months or less was inversely associated with asthma, allergic rhinitis, and atopic sensitization, whereas introduction of fish at 9 months or less was inversely associated with allergic rhinitis and atopic sensitization. CONCLUSION: Early introduction of wheat, rye, oats, and barley cereals; fish; and egg (respective to the timing of introduction of each food) seems to decrease the risk of asthma, allergic rhinitis, and atopic sensitization in childhood. Longer duration of total breast-feeding, rather than its exclusivity, was protective against the development of nonatopic but not atopic asthma, suggesting a potential differing effect of breast-feeding on different asthma phenotypes.
BACKGROUND: Emerging evidence questions current recommendations on the timing of infant feeding for the prevention of childhood allergies. The evidence for asthma is inconclusive. OBJECTIVE: We sought to investigate the associations between the duration of breast-feeding and timing of introduction of complementary foods and the development of asthma and allergies by the age of 5 years. METHODS: Data were analyzed for 3781 consecutively born children. The dietary exposures were categorized into thirds and analyzed as time-dependent variables. Asthma, allergic rhinitis, and atopic eczema end points were assessed by using the International Study of Asthma and Allergies in Childhood questionnaire, whereas IgE antibodies were analyzed from serum samples at the age of 5 years. Cox proportional hazard and logistic regressions were used for the analyses. RESULTS: The median duration of exclusive and total breast-feeding was 1.4 months (interquartile range, 0.2-3.5 months) and 7.0 months (interquartile range, 4.0-11.0 months), respectively. Total breast-feeding of 9.5 months or less was associated with an increased risk of nonatopic asthma. Introduction of wheat, rye, oats, or barley at 5 to 5.5 months was inversely associated with asthma and allergic rhinitis, whereas introduction of other cereals at less than 4.5 months increased the risk of atopic eczema. Introduction of egg at 11 months or less was inversely associated with asthma, allergic rhinitis, and atopic sensitization, whereas introduction of fish at 9 months or less was inversely associated with allergic rhinitis and atopic sensitization. CONCLUSION: Early introduction of wheat, rye, oats, and barley cereals; fish; and egg (respective to the timing of introduction of each food) seems to decrease the risk of asthma, allergic rhinitis, and atopic sensitization in childhood. Longer duration of total breast-feeding, rather than its exclusivity, was protective against the development of nonatopic but not atopic asthma, suggesting a potential differing effect of breast-feeding on different asthma phenotypes.
Authors: Darcy Güngör; Perrine Nadaud; Concetta C LaPergola; Carol Dreibelbis; Yat Ping Wong; Nancy Terry; Steve A Abrams; Leila Beker; Tova Jacobovits; Kirsi M Järvinen; Laurie A Nommsen-Rivers; Kimberly O O'Brien; Emily Oken; Rafael Pérez-Escamilla; Ekhard E Ziegler; Joanne M Spahn Journal: Am J Clin Nutr Date: 2019-03-01 Impact factor: 7.045
Authors: Anita M Nucci; Suvi M Virtanen; Susa Sorkio; Sonja Bärlund; David Cuthbertson; Ulla Uusitalo; Margaret L Lawson; Marja Salonen; Carol L Berseth; Anne Ormisson; Eveliina Lehtonen; Erkki Savilahti; Dorothy J Becker; John Dupré; Jeffrey P Krischer; Mikael Knip; Hans K Åkerblom Journal: Matern Child Nutr Date: 2016-10-07 Impact factor: 3.092
Authors: Christian Rosas-Salazar; Erick Forno; John M Brehm; Yueh-Ying Han; Edna Acosta-Pérez; Michelle M Cloutier; Dorothy B Wakefield; María Alvarez; Angel Colón-Semidey; Glorisa Canino; Juan C Celedón Journal: Pediatr Pulmonol Date: 2014-08-06
Authors: Sam S Oh; Randal Du; Andrew M Zeiger; Meghan E McGarry; Donglei Hu; Neeta Thakur; Maria Pino-Yanes; Joshua M Galanter; Celeste Eng; Katherine Keiko Nishimura; Scott Huntsman; Harold J Farber; Kelley Meade; Pedro Avila; Denise Serebrisky; Kirsten Bibbins-Domingo; Michael A Lenoir; Jean G Ford; Emerita Brigino-Buenaventura; William Rodriguez-Cintron; Shannon M Thyne; Saunak Sen; Jose R Rodriguez-Santana; Keoki Williams; Rajesh Kumar; Esteban G Burchard Journal: J Asthma Date: 2016-12-08 Impact factor: 2.515