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Evaluating the efficacy of breastfeeding guidelines on long-term outcomes for allergic disease

Evaluating the efficacy of breastfeeding guidelines on long-term outcomes for allergic disease
Evaluating the efficacy of breastfeeding guidelines on long-term outcomes for allergic disease
Background: WHO guidelines advocate breastfeeding for six months, and EAACI recommends exclusive breastfeeding for 4-6 months. However, evidence for breastfeeding to prevent asthma and allergic disease is conflicting. We examined whether following recommended breastfeeding guidelines alters the long-term risks of asthma, eczema, rhinitis, or atopy.

Methods: The effect of non-exclusive (0, >0-6, >6 months), and exclusive breastfeeding (0, >0-4, >4 months) on repeated measures of asthma (10, 18 years), eczema, rhinitis, and atopy (1-or-2, 4, 10,18 years) risks were estimated in the IoW cohort (n=1456) using log-linear models with generalised estimating equations. The Food Allergy and Intolerance Research (FAIR) cohort (n=988), also from the IoW, was examined to replicate results.

Results: Breastfeeding (any or exclusive) had no effect on asthma and allergic disease in the IoW cohort. In the FAIR cohort, any breastfeeding for >0-6 months protected against asthma at 10 years (RR=0.50, 95%CI=0.32-0.79, p=0.003) but not other outcomes, while exclusive breastfeeding for >4 months protected against repeated rhinitis (RR=0.36, 95%CI=0.18-0.71, p=0.003). Longer breastfeeding was protective against late-onset wheeze in the IoW cohort.

Conclusion: The protective effects of non-exclusive and exclusive breastfeeding against long-term allergic outcomes were inconsistent between these co-located cohorts, agreeing with previous observations of heterogeneous effects. Although breastfeeding should be recommended for other health benefits, following breastfeeding guidelines did not appear to afford consistent protection against long-term asthma, eczema, rhinitis or atopy. Further research is needed into the long-term effects of breastfeeding on allergic disease.
0105-4538
661-670
Bion, Victoria
ed3bace5-ebdf-4725-839a-cf1a9feb00db
Lockett, Gabrielle A.
4d92a28c-f54c-431b-81f6-e82ad9057d7a
Soto-Ramírez, Nelís
3526295b-e2ec-4cf3-bc74-088d10943f45
Zhang, Hongmei
9f774048-54d6-4321-a252-3887b2c76db0
Venter, Carina
a9b7dd5e-b0cb-4068-be82-e15b587cc20b
Karmaus, Wilfried
281d0e53-6b5d-4d38-9732-3981b07cd853
Holloway, John W.
4bbd77e6-c095-445d-a36b-a50a72f6fe1a
Arshad, S. Hasan
917e246d-2e60-472f-8d30-94b01ef28958
Bion, Victoria
ed3bace5-ebdf-4725-839a-cf1a9feb00db
Lockett, Gabrielle A.
4d92a28c-f54c-431b-81f6-e82ad9057d7a
Soto-Ramírez, Nelís
3526295b-e2ec-4cf3-bc74-088d10943f45
Zhang, Hongmei
9f774048-54d6-4321-a252-3887b2c76db0
Venter, Carina
a9b7dd5e-b0cb-4068-be82-e15b587cc20b
Karmaus, Wilfried
281d0e53-6b5d-4d38-9732-3981b07cd853
Holloway, John W.
4bbd77e6-c095-445d-a36b-a50a72f6fe1a
Arshad, S. Hasan
917e246d-2e60-472f-8d30-94b01ef28958

Bion, Victoria, Lockett, Gabrielle A., Soto-Ramírez, Nelís, Zhang, Hongmei, Venter, Carina, Karmaus, Wilfried, Holloway, John W. and Arshad, S. Hasan (2016) Evaluating the efficacy of breastfeeding guidelines on long-term outcomes for allergic disease. Allergy, 71 (5), 661-670. (doi:10.1111/all.12833). (PMID:26714430)

Record type: Article

Abstract

Background: WHO guidelines advocate breastfeeding for six months, and EAACI recommends exclusive breastfeeding for 4-6 months. However, evidence for breastfeeding to prevent asthma and allergic disease is conflicting. We examined whether following recommended breastfeeding guidelines alters the long-term risks of asthma, eczema, rhinitis, or atopy.

Methods: The effect of non-exclusive (0, >0-6, >6 months), and exclusive breastfeeding (0, >0-4, >4 months) on repeated measures of asthma (10, 18 years), eczema, rhinitis, and atopy (1-or-2, 4, 10,18 years) risks were estimated in the IoW cohort (n=1456) using log-linear models with generalised estimating equations. The Food Allergy and Intolerance Research (FAIR) cohort (n=988), also from the IoW, was examined to replicate results.

Results: Breastfeeding (any or exclusive) had no effect on asthma and allergic disease in the IoW cohort. In the FAIR cohort, any breastfeeding for >0-6 months protected against asthma at 10 years (RR=0.50, 95%CI=0.32-0.79, p=0.003) but not other outcomes, while exclusive breastfeeding for >4 months protected against repeated rhinitis (RR=0.36, 95%CI=0.18-0.71, p=0.003). Longer breastfeeding was protective against late-onset wheeze in the IoW cohort.

Conclusion: The protective effects of non-exclusive and exclusive breastfeeding against long-term allergic outcomes were inconsistent between these co-located cohorts, agreeing with previous observations of heterogeneous effects. Although breastfeeding should be recommended for other health benefits, following breastfeeding guidelines did not appear to afford consistent protection against long-term asthma, eczema, rhinitis or atopy. Further research is needed into the long-term effects of breastfeeding on allergic disease.

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More information

Accepted/In Press date: 27 December 2015
e-pub ahead of print date: 30 December 2015
Published date: May 2016
Organisations: NIHR Southampton Respiratory Biomedical Research Unit, Human Development & Health, Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 385473
URI: https://eprints.soton.ac.uk/id/eprint/385473
ISSN: 0105-4538
PURE UUID: 8998022b-e19a-44db-a70c-82ba0a8a0b27
ORCID for John W. Holloway: ORCID iD orcid.org/0000-0001-9998-0464

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Date deposited: 20 Jan 2016 10:01
Last modified: 06 Jun 2018 12:59

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