Modes of infant feeding and the occurrence of coughing/wheezing in the first year of life.
BACKGROUND
Controversies regarding infant feeding and childhood wheezing may result from insufficient differentiation among various feeding modes.


OBJECTIVE
We conducted prospective analyses of associations between the repeated ascertainment of feeding mode and wheezing in infancy.


METHODS
The Infant Feeding Practices Study II (2833 infants) provided data on coughing/wheezing episodes (CWEs) at 8 time points and feeding modes at 9 time points from months 1 to 12. Feeding modes were defined as direct breastfeeding, indirect breastfeeding (IBF, bottled breast milk), formula feeding (FF), and their combinations. In concurrent and delayed models using repeated measurements, the relative risks (RR) and their 95% confidence intervals (95% CI) of different feeding modes for CWEs were estimated. In the delayed models, only infants without symptoms were considered at risk for consequent CWE.


RESULTS
In a model with a 1-month delay, compared to direct breastfeeding, any other feeding mode showed a statistically significant risk for CWEs (IBF: RR = 1.69, 95% CI [1.05, 2.72]; FF: RR = 1.26, 95% CI [1.08, 1.47]; mixed breast feeding plus FF: RR = 1.25, 95% CI [1.01, 1.55]; and FF and direct breastfeeding: RR = 1.38, 95% CI [1.14, 1.68]). In a concurrent effect model, FF, the combination of FF and IBF, and mixed breastfeeding plus formula were risk factors (RR = 1.38, 95% CI [1.19, 1.59], RR = 1.83, 95% CI [1.27, 2.63], and RR=1.35, 95% CI [1.11, 1.65]; respectively).


CONCLUSIONS
Any mode of feeding that includes formula or bottled breast milk seems to be a moderate risk for cough or wheezing episodes in the first 12 months of life.
Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA. nelis.soto@gmail.com
Nelís
N
Soto-Ramírez
Wilfried
W
Karmaus
Hongmei
H
Zhang
Susan
S
Davis
Saroochi
S
Agarwal
Alycia
A
Albergottie
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D001903:Bottle Feeding / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000706:statistics & numerical data*; D003371:Cough / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D008423:Maternal Age; D011446:Prospective Studies; D044469:Racial Groups; D012135:Respiratory Sounds; D012907:Smoking; D055815:Young Adult