title: Association of breastfeeding and exposure to maternal smoking during pregnancy with children's general health status later in childhood.
abstract: BACKGROUND
  Maternal smoking during pregnancy is associated with a variety of risks on fetal health, whereas breastfeeding may protect infants from infections in the early postpartum period. Little has been reported regarding their associations with children's general health later in childhood.
  
  
  METHODS
  Parent-rated children's general health status was investigated among 14,836 children and adolescents 3-17 years old who participated in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) in 2003-2006. Data on breastfeeding and maternal smoking during pregnancy were collected by parent-administered questionnaires. SPSS complex samples logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs).
  
  
  RESULTS
  Exclusive breastfeeding and non-exposure to maternal smoking during pregnancy were associated with better health status overall among all children in the KiGGS (both p<0.001). After adjusting for potential confounding factors including other prior and current exposures, exclusive breastfeeding over 6 months remained significant overall among all children (OR 1.21, 95% CI 1.05-1.38) and in the age groups 7-10 years (OR 1.27, 95% CI 1.01-1.60) and 11-17 years (OR 1.23, 95% CI 1.01-1.50), while non-exposure to maternal smoking during pregnancy remained significant in the age group 11-17 years only (OR 1.49, 95% CI 1.06-2.10).
  
  
  CONCLUSIONS
  Exclusive breastfeeding and non-exposure to maternal smoking during pregnancy may be associated with better children's general health status later in childhood, particularly when children reach adolescence. Further studies are required to elucidate these possible and biologically plausible associations. Health professionals should take opportunities to promote breastfeeding and cessation of smoking among (expectant) mothers for a healthy future of their children.
authors.affiliation: Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany.
authors.forename: Yong
authors.initials: Y
authors.lastname: Du
authors.forename: Ute
authors.initials: U
authors.lastname: Ellert
authors.forename: Thomas
authors.initials: T
authors.lastname: Lampert
authors.forename: Gert B M
authors.initials: GB
authors.lastname: Mensink
authors.forename: Martin
authors.initials: M
authors.lastname: Schlaud
mesh_terms: D000293:Adolescent; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008425:Maternal Behavior; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution