title: Breastfeeding practice and its association with respiratory symptoms and atopic disease in 1-3-year-old children in the city of Riyadh, central Saudi Arabia.
abstract: BACKGROUND
  Saudi Arabia has a declining rate of breastfeeding and increasing levels of childhood asthma and atopic disease. In highly economically developed countries, breastfeeding of children at high risk of atopic disease reduces the likelihood of atopic dermatitis, wheezing associated with respiratory infections, and possibly asthma. This study investigated the prevalence of breastfeeding and its association with wheezing/asthma and atopic disease in 1-3-year-old children in Riyadh, Saudi Arabia.
  
  
  METHODS
  A cross-sectional study of children attending routine "well-baby" clinics in three Saudi State Hospitals in Riyadh. An interviewer administered a questionnaire to collect data on sociodemographics, breastfeeding, wheezing symptoms, asthma, and atopic disease.
  
  
  RESULTS
  In total, 622 children 1-3 years old were recruited. Of these, 75% of children were ever breastfed, and 36% of children were fully breastfed, with 20% of children being fully breastfed for ≥ 3 months. Increasing duration of full breastfeeding was associated with a reduced likelihood of maternal reporting of her child having "ever wheezed," "wheezed' in the last 12 months," and "ever having asthma," with adjusted odds ratio for full breastfeeding ≥ 12 months versus never breastfed of 0.51 (95% confidence interval 0.29-0.90), 0.48 (0.26-0.88), and 0.46 (0.22-0.94), respectively. No associations were demonstrable between full or ever breastfeeding and atopic dermatitis/eczema, irrespective of family history of atopic disease.
  
  
  CONCLUSIONS
  Although breastfeeding does not protect children from developing eczema in Riyadh, full breastfeeding is associated with reduced childhood wheezing and possibly asthma. Further efforts should be made to promote breastfeeding in Saudi Arabia.
authors.affiliation: Department of Child Health, University of Aberdeen, Aberdeen, United Kingdom. a.makoshi@gmail.com
authors.forename: Amel
authors.initials: A
authors.lastname: Al-Makoshi
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Al-Frayh
authors.forename: Stephen
authors.initials: S
authors.lastname: Turner
authors.forename: Graham
authors.initials: G
authors.lastname: Devereux
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004485:Eczema / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004522:Educational Status; D005260:Female; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D016017:Odds Ratio; D011247:Pregnancy; D015995:Prevalence; D012135:Respiratory Sounds; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors