The Journal of Allergy and Clinical Immunology
Volume 120, Issue 5 , Pages 1051-1057, November 2007

Breast-feeding and atopic disease: A cohort study from childhood to middle age

  • Melanie Claire Matheson, BSc, MAppSc, PhD

      Affiliations

    • Center for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne, Australia
    • Corresponding Author InformationReprint requests: Melanie Claire Matheson, BSc, MAppSc, PhD, Center for Molecular, Environmental, Genetic and Analytic Epidemiology, Department of Public Health, School of Population Health, University of Melbourne, Level 2/723 Swanston Street, Carlton, Victoria 3053, Australia.
    • ,
  • Bircan Erbas, BSc, PhD

      Affiliations

    • Center for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne, Australia
    • ,
  • Aindralal Balasuriya, MBBS, MSc, MD

      Affiliations

    • Center for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne, Australia
    • ,
  • Mark Andrew Jenkins, BSc(Hons), PhD

      Affiliations

    • Center for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne, Australia
    • ,
  • Cathryn Leisa Wharton, BAppSc

      Affiliations

    • Center for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne, Australia
    • ,
  • Mimi Lai-Kuan Tang, MBBS, PhD, FRACP, FRCPA

      Affiliations

    • Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Australia
    • ,
  • Michael John Abramson, MBBS, BMedSc(Hons), FRACP, PhD, FAFPHM

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Monash University, Monash, Australia
    • ,
  • Eugene Haydn Walters, MA, DM, FRCP, FRACP

      Affiliations

    • Menzies Research Institute, University of Tasmania, Hobart, Australia
    • ,
  • John Llewelyn Hopper, BSc, MSc, PhD, BA

      Affiliations

    • Center for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne, Australia
    • ,
  • Shyamali Chandrika Dharmage, MBBS, MSc, MD, PhD

      Affiliations

    • Center for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne, Australia

Received 25 October 2006; received in revised form 11 June 2007; accepted 12 June 2007. published online 03 September 2007.

Background

The literature regarding the association between breast-feeding and atopic diseases has been contradictory.

Objective

We have assessed the relationship between breast-feeding and atopic disorders in a cohort followed into middle age.

Methods

The Tasmanian Asthma Study is a population-based prospective cohort study that has followed participants from the age of 7 to 44 years. Exclusive breast-feeding in the first 3 months of life was examined as a risk factor for atopic diseases by using multiple logistic regression and generalized estimating equation analyses.

Results

At age 7 years, exclusively breast-fed children with a maternal history of atopy had a marginally lesser risk of current asthma than those not exclusively breast-fed (odds ratio [OR], 0.8; 95% CI, 0.6-1.0). However, after age 7 years, the risk reversed, and exclusively breast-fed children had an increased risk of current asthma at 14 (OR, 1.46; 95% CI, 1.02-2.07), 32 (OR, 1.84; 95% CI, 1.06-3.3), and 44 (OR, 1.57; 95% CI, 1.15-2.14) years. Exclusively breast-fed children also had a reduced risk of food allergy at age 7 years but an increased risk of food allergy (OR, 1.26; 95% CI, 1.1-1.5) and allergic rhinitis (OR, 1.2; 95% CI, 1.0-1.3) at 44 years.

Conclusion

Exclusively breast-fed babies with a maternal history of atopy were less likely to develop asthma before the age of 7 years, but more likely to develop asthma after the age of 7 years.

Clinical implications

The current recommendation to breast-feed high-risk infants for protection against early wheezing illness can be confirmed. However, the recommendation should be reconsidered for protection against allergic asthma and atopy in the longer term.

Key words: Breast-feeding, asthma, allergic rhinitis, food allergy, maternal atopy

Abbreviations used: GEE, Generalized Estimating Equation, OR, Odds ratio

 

 Supported by the National Health and Medical Research Council of Australia, the Clifford Craig Foundation of Tasmania, and the Victorian and Tasmanian Asthma Foundations. M. C. Matheson and S. C. Dharmage are supported by National Health and Medical Research Council of Australia Public Health Research Fellowships.

 Disclosure of potential conflict of interest: M. J. Abramson was a member of the Australian Asthma Study, which was sponsored by GlaxoSmithKline; has received honoraria from Boehringer Ingelheim; and has received travel support from AstraZeneca. S. C. Dharmage has received grant support from the National Health Medical Research Council, the Australian Research Council, GlaxoSmithKline, and the Sypkes Trust. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(07)01252-3

doi:10.1016/j.jaci.2007.06.030

The Journal of Allergy and Clinical Immunology
Volume 120, Issue 5 , Pages 1051-1057, November 2007

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