Breast-feeding does not protect against allergic sensitization in early childhood and allergy-associated disease at age 7 years

• Published in: Journal of allergy and clinical immunology 2015-11, Vol.136 (5), p.1302-1308.e13
• Main Authors: Jelding-Dannemand, Ea, MSc, Malby Schoos, Ann-Marie, MD, Bisgaard, Hans, MD, DMSc
• Format: Article
• Language: English
• Subjects: Age; Algorithms; Allergies; Allergy and Immunology; asthma; Breast Feeding; Breastfeeding & lactation; Child; Child, Preschool; children; Cohort Studies; Denmark - epidemiology; Eczema; Female; Follow-Up Studies; Food; Humans; Hypersensitivity - epidemiology; Hypersensitivity - immunology; Hypersensitivity - prevention & control; Immunization; Immunoglobulin E - blood; Infant; Male; Milk; Mothers; Prospective Studies; sensitization; skin prick test; specific IgE; Studies
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2015.02.023

Background Extended breast-feeding is recommended for newborn children at risk of allergy-associated diseases, but the evidence of a protective effect on sensitization and these diseases remains elusive. Objective The aim of this study was to investigate the effects of the duration of exclusive breast-feeding on the development of sensitization in preschool children. Methods Information on breast-feeding was gathered by interviews involving 335 children aged 1, 6, and 12 months from the Copenhagen Prospective Study on Asthma in Childhood2000 birth cohort born to mothers with a history of asthma. Skin prick test responses and specific IgE levels against 12 common inhalant and 10 food allergens were assessed longitudinally at ages ½ year, 1½ years, 4 years, and 6 years. Eczema, wheeze/asthma, and allergic rhinitis were diagnosed at the Copenhagen Prospective Studies on Asthma in Childhood clinic at 7 years of age, strictly adhering to predefined algorithms. Associations between duration of exclusive breast-feeding and outcomes were analyzed by logistic regression. Results We found no significant association between duration of exclusive breast-feeding and development of sensitization in the first 6 years of life (odds ratio [OR]: ½ year, 1.10 [95% CI, 0.90-1.36]; 1½ years, 1.15 [95% CI, 0.97-1.36]; 4 years, 1.08 [95% CI, 0.93-1.25]; and 6 years, 0.96 [95% CI, 0.84-1.10]) or with current eczema, wheeze/asthma, and allergic rhinitis at age 7 years (OR, 1.07 [95% CI, 0.92-1.24]; OR, 0.97 [95% CI, 0.82-1.14]; and OR, 1.02 [95% CI, 0.84-1.23], respectively). Adjusting for reverse causation by excluding children with eczema, wheeze, or a positive skin prick test response before ending exclusive breast-feeding did not alter the results. Conclusion Exclusive breast-feeding does not affect sensitization in early childhood or associated diseases at 7 years of age in at-risk children.