Asthma, Rhinitis, Other Respiratory Diseases
Maternal asthma, infant feeding, and the risk of asthma in childhood

https://doi.org/10.1067/mai.2002.125296Get rights and content

Abstract

Controversy surrounds the issue of whether children with asthmatic mothers should be breast-fed. The aim of this study was to investigate whether maternal asthma status alters the association between asthma and breast-feeding. In a cohort study of 2602 West Australian children enrolled before birth and followed prospectively, we collected data on method of infant feeding, maternal asthma (as reported by parental questionnaire), atopy (as measured by skin prick test), and current asthma (defined as a physician's diagnosis of asthma and wheeze in the last year) at 6 years of age. The risk of childhood asthma increased if exclusive breast-feeding was stopped (other milk was introduced) before 4 months (odds ratio, 1.28; 95% CI, 1.01-1.62; P = .038), and this risk was not altered by atopy or maternal asthma status. After adjusting for covariates, exclusive breast-feeding for less than 4 months was a significant risk factor for current asthma (odds ratio, 1.35; 95% CI, 1.00-1.82; P = .049). There was no formal statistical interaction between breast-feeding and maternal asthma status (P = .970). In this study maternal asthma status did not modify the association between asthma and breast-feeding duration. We recommend that infants with or without a maternal history of asthma be exclusively breast-fed for 4 months and beyond. (J Allergy Clin Immunol 2002;110:65-7.)

Section snippets

Study population

The Western Australian Pregnancy Cohort Study is a prospective birth cohort study that was established between 1989 and 1992 to investigate several hypotheses about antenatal and perinatal antecedents of disease. Details of recruitment and follow-up have been described elsewhere.2, 3 Briefly, a total of 2979 Western Australian children were enrolled by 18 weeks' gestation. At the time of enrolment, parents completed a questionnaire about their own respiratory illness, smoking behavior, and

Population characteristics

The majority of children (89.3%) were breast-fed, with nearly half (48.4%) exclusively breast-fed for less than 4 months. By age 6 years, 17% of the children had current asthma, 22% had wheeze in the last year, and 31% had physician-diagnosed asthma ever. Of the entire cohort, 15% had mothers with current asthma.

Association among maternal asthma, child's asthma, and infant feeding

Maternal asthma status was significantly associated with increased prevalence of current asthma in the child (P < .001). The association between exclusive breast-feeding and asthma was

Discussion

We did not find any evidence that the child's atopy status or maternal asthma status altered the effect of exclusive breast-feeding for 4 months or longer, which protected against current asthma.

There are a number of strengths of the Western Australian Pregnancy Cohort Study. The cohort was representative of the general population and included very preterm infants. The breast-feeding data were collected prospectively, and follow-up included 91% of eligible children at 6 years. We adjusted for a

References (10)

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Reprint requests: Wendy H. Oddy, PhD, Telethon Institute for Child Health Research, PO Box 855, West Perth, Western Australia 6872, Australia.

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