title: Breastfeeding protects against adverse respiratory outcomes at 15 months of age.
abstract: The relationship between breastfeeding, respiratory and other allergic disorders has been controversial. Our aim was to investigate the relationships between breastfeeding, respiratory outcomes, eczema and atopy at 15 months of age in a prospective birth cohort in New Zealand. A total of 1105 children were enrolled at birth, and 1011 (91.2%) were followed up at 15 months. Logistic regression was used to model associations between breastfeeding duration and respiratory outcomes, eczema and atopy after adjusting for relevant confounding variables: ethnicity, socio-economic status, parity, body mass index, smoking in pregnancy, gender and respiratory infections in the first 3 months of life. Breastfeeding was associated with a significant reduction in the risk of adverse respiratory outcomes at 15 months. After adjustment for confounders, each month of exclusive breastfeeding reduced the risk of doctor-diagnosed asthma by 20% (odds ratio 0.80, 95% confidence interval 0.71 to 0.90), wheezing by 12% (0.88, 0.82 to 0.94) and inhaler use by 14% (0.86, 0.78 to 0.93). Associations for both exclusive and additional breastfeeding durations, and respiratory outcomes remained independently significant when modelled simultaneously. Although independently associated with all respiratory outcomes, adjusting for parental history of allergic disease or maternal history of asthma did not alter our findings. Breastfeeding was not associated with eczema or atopy at 15 months. In conclusion, there was a significant protective effect of breastfeeding on infant wheezing and other adverse respiratory outcomes that may be early indicators of asthma in New Zealand children.
authors.affiliation: Department of Medicine, University of Otago, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand. karen.silvers@xtra.co.nz
authors.forename: Karen M
authors.initials: KM
authors.lastname: Silvers
authors.forename: Chris M
authors.initials: CM
authors.lastname: Frampton
authors.forename: Kristin
authors.initials: K
authors.lastname: Wickens
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Epton
authors.forename: Philip K
authors.initials: PK
authors.lastname: Pattemore
authors.forename: Tristram
authors.initials: T
authors.lastname: Ingham
authors.forename: David
authors.initials: D
authors.lastname: Fishwick
authors.forename: Julian
authors.initials: J
authors.lastname: Crane
authors.forename: G Ian
authors.initials: GI
authors.lastname: Town
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000517:prevention & control; D015992:Body Mass Index; D001942:Breast Feeding; D004485:Eczema / Q000453:epidemiology / Q000517:prevention & control; D005006:Ethnicity; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000517:prevention & control; D007223:Infant; D016015:Logistic Models; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D011247:Pregnancy; D012135:Respiratory Sounds; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000517:prevention & control*; D012737:Sex Factors; D012907:Smoking; D012959:Socioeconomic Factors