title: Influence of past breast feeding on pattern and severity of presentation of juvenile idiopathic arthritis.
abstract: This analysis aimed to study the influence of breast feeding on the pattern and severity of juvenile idiopathic arthritis (JIA) at presentation. The association between ever versus never breast feeding and disease severity at onset was compared in 923 children with JIA recruited to the UK Childhood Arthritis Prospective Study at first presentation to rheumatology. Fifty six per cent of children were ever breast fed (median 3.7 months). Breastfed children reported a lower median age at onset, a lower Childhood Health Assessment Questionnaire (CHAQ), a measure of disease severity, lower parent general evaluation scores and lower pain at presentation. There was a trend towards a higher proportion of breastfed children with rheumatoid factor-negative polyarthritis, but lesser enthesitis-related and psoriatic arthritis. There was a statistically significant inverse association between breast feeding and high CHAQ, even after adjusting for differences in socioeconomic status (adjusted OR 0.61 (95% CI 0.39 to 0.95)). Further work to understand the reasons behind these associations is required.
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK.
authors.forename: Kimme L
authors.initials: KL
authors.lastname: Hyrich
authors.affiliation: Department of Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool, UK.
authors.forename: Eileen
authors.initials: E
authors.lastname: Baildam
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Pickford
authors.affiliation: Department of Rheumatology, The Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Chieng
authors.affiliation: Department of Rheumatology, Royal Hospital for Sick Children, Greater Glasgow and Clyde Health Board and Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: Joyce E
authors.initials: JE
authors.lastname: Davidson
authors.affiliation: Department of Rheumatology, Newcastle University and Great North Children's Hospital, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Foster
authors.affiliation: Department of Rheumatology, Glasgow University, Glasgow, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Gardner-Medwin
authors.affiliation: Infection, Immunology, and Rheumatology Section UCL Institute of Child Health, University College London, London, UK Department of Rheumatology, Great Ormond Street Hospital NHS Foundation Trust, London, UK Centre for Adolescent Rheumatology at University College London, University College London Hospital, London, UK.
authors.forename: Lucy R
authors.initials: LR
authors.lastname: Wedderburn
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK.
authors.forename: Wendy
authors.initials: W
authors.lastname: Thomson
mesh_terms: D001171:Arthritis, Juvenile / Q000453:epidemiology*; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords: Epidemiology; Infant Feeding; Rheumatology