Fariba Ahmadizar1, Susanne J H Vijverberg1,2, Hubertus G M Arets3, Anthonius de Boer1, Johan Garssen4,5, Aletta D Kraneveld4,6, Anke H Maitland-van der Zee1,2. 1. Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands. 2. Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands. 3. Department of Pediatric Pulmonology and Allergology, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, the Netherlands. 4. Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands. 5. Department of Immunology, Nutricia Research, Utrecht, the Netherlands. 6. Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
Abstract
BACKGROUND: Breastfeeding has been suggested to influence the risk of asthma and asthma severity in children. However, the conclusions from epidemiologic studies are inconsistent. METHODS: We used data from 960 children (aged 4-12 years) using regular asthma medication who participated in the PACMAN study. Breastfeeding exposure was based on questionnaire data and stratified into (i) ever vs never, and (ii) ≥6 vs <6 months duration of breastfeeding. Asthma severity was based on the occurrence of asthma exacerbations in the preceding year and/or poorly controlled asthma symptoms during the last week of study visit. Odds ratios (ORs) were derived from univariate and multivariable logistic regression analyses. RESULTS: Breastfeeding was associated with a decreased risk of asthma exacerbations; adjusted (adj.) OR: 0.55 (95% confidence interval [CI]: 0.35-0.87). After stratification for duration of breastfeeding, the adj. ORs were 0.48 (95% CI: 0.27-0.84) for duration <6 months and 0.71 (95% CI: 0.43-1.20) for duration ≥6 months breastfeeding. When we stratified the analysis by family history of asthma, the association between breastfeeding and asthma exacerbations was strong and statistically significant only in children with a positive family history of asthma; adj. OR: 0.34 (95% CI: 0.18-0.66). There was no association between breastfeeding and risk of poor asthma control; adj. OR: 1.04 (95% CI: 0.76-1.41). CONCLUSION: In a pediatric population with asthma, children who had been breastfed had a statistically significantly lower risk of asthma exacerbations later in life compared to asthmatic children who had not been breastfed.
BACKGROUND: Breastfeeding has been suggested to influence the risk of asthma and asthma severity in children. However, the conclusions from epidemiologic studies are inconsistent. METHODS: We used data from 960 children (aged 4-12 years) using regular asthma medication who participated in the PACMAN study. Breastfeeding exposure was based on questionnaire data and stratified into (i) ever vs never, and (ii) ≥6 vs <6 months duration of breastfeeding. Asthma severity was based on the occurrence of asthma exacerbations in the preceding year and/or poorly controlled asthma symptoms during the last week of study visit. Odds ratios (ORs) were derived from univariate and multivariable logistic regression analyses. RESULTS: Breastfeeding was associated with a decreased risk of asthma exacerbations; adjusted (adj.) OR: 0.55 (95% confidence interval [CI]: 0.35-0.87). After stratification for duration of breastfeeding, the adj. ORs were 0.48 (95% CI: 0.27-0.84) for duration <6 months and 0.71 (95% CI: 0.43-1.20) for duration ≥6 months breastfeeding. When we stratified the analysis by family history of asthma, the association between breastfeeding and asthma exacerbations was strong and statistically significant only in children with a positive family history of asthma; adj. OR: 0.34 (95% CI: 0.18-0.66). There was no association between breastfeeding and risk of poor asthma control; adj. OR: 1.04 (95% CI: 0.76-1.41). CONCLUSION: In a pediatric population with asthma, children who had been breastfed had a statistically significantly lower risk of asthma exacerbations later in life compared to asthmatic children who had not been breastfed.
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