Breast-feeding, maternal IgE, and total serum IgE in childhood,☆☆,

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Abstract

Background: There is controversy regarding the relationship of the effect of breast-feeding on markers of allergy such as total serum IgE in childhood. Objective: This study, using longitudinal data, tested the hypothesis that the relation of breast-feeding to IgE in childhood differs depending on maternal total IgE level. Methods: Total serum IgE was assessed with the paper radioimmunosorbent test at 4 ages in nonselected children enrolled at birth into the prospective Tucson Children’s Respiratory Study. Children were classified as never breast-fed, breast-fed less than 4 months, or breast-fed 4 months or longer, on the basis of physician report or questionnaires completed by parents by the time the child was 18 months old. A longitudinal random effects model was used to test for group differences and temporal trends in IgE for children classified with reference to maternal IgE (high tertile vs all others) and breast-feeding history. A total of 664 children with 1457 observations were included. Results: Among children whose mothers were in the 2 lower tertiles of IgE, breast-feeding was associated with lower total serum IgE at age 6 years (24.2 vs 44.3 IU/mL for never breast-fed children; P < .02); similar trends existed at age 11 years. In contrast, for children whose mothers were in the highest tertile of IgE, breast-feeding of 4 months or longer was associated with higher IgE levels in the child compared with those never breast-fed or breast-fed less than 4 months (97.0 vs 38.9 IU/mL; P < .005). These cross-sectional analyses were confirmed with the longitudinal random effects model, which also showed no effect of confounders. Paternal IgE showed no similar relation with child IgE. Conclusion: Breast-feeding appears to have paradoxic relations with IgE in childhood, depending on maternal IgE level. These findings may help explain the contradictory results found in other investigations of the relation of breast-feeding to allergic symptoms and markers. (J Allergy Clin Immunol 1999;104:589-94.)

Section snippets

METHODS

Data for this analysis came from the Tucson Children’s Respiratory Study, a prospective longitudinal study of the risk factors for the development of asthma in childhood. A total of 1246 healthy newborns and their families who obtained care from the pediatricians at the largest health maintenance organization in Tucson (78% of those eligible) were enrolled at birth between 1980 and 1984; more detailed descriptions are available elsewhere.18, 19 Infants were not selected with reference to

Sample characteristics

Measures of total serum IgE levels were available for 1047, 790, 534, and 599 children at birth, 9 months, 6 years, and 11 years, respectively. Total serum IgE level was measured on 717 mothers and 548 fathers.

Table I shows the characteristics of children with reference to infant feeding practices.

. Characteristics of children by infant feeding history

Empty CellPercent never breast-fed (n = 170)Percent breast-fed <4 mo (n = 377)Percent breast-fed never ≥4 mo (n = 567)
Ethnicity*
 Hispanic parents (n = 184)

DISCUSSION

This study suggests that the relation of breast-feeding to one allergic marker in childhood is complex and may differ depending on maternal status for this marker. Among children of mothers with lower IgE levels, breast-feeding was associated with diminished IgE levels in the child; whereas among children of mothers with high IgE levels, breast-feeding was associated with elevated IgE levels relative to never breast-fed children in that maternal IgE strata. These observations were not

Acknowledgements

We thank Debra Stern for her assistance in creating the Figure.

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    Supported by National Institutes of Health SCOR grant HL14136 and HL R01 56177.

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    Reprint requests: Anne L. Wright, PhD, Respiratory Sciences Center, Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724.

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