Asthma diagnosis and treatment
The relationship of breast-feeding, overweight, and asthma in preadolescents

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Background

Breast-feeding is suggested to be associated with overweight or asthma in children. Overweight and asthma may share common environmental influences of which breast-feeding may be one.

Objective

We evaluated whether short duration of exclusive breast-feeding and subsequent overweight were associated with asthma.

Methods

A nested case-control study included 246 children with pediatric allergist–diagnosed asthma and 477 controls without asthma at age 8 to 10 years. Information on exclusive breast-feeding was obtained from questionnaire data. Overweight at 8 to 10 years of age was defined as body mass index ≥85th percentile of age and sex-specific growth charts. The association between asthma and exclusive breast-feeding <12 weeks plus overweight, adjusted for sex, parental asthma, aboriginal origin, passive smoking at birth, residence location, and family income, was determined in logistic regression analyses.

Results

Exclusive breast-feeding <12 weeks was closely associated with overweight at age 8 to 10 years (P < .001). Exclusive breast-feeding <12 weeks plus overweight was significantly associated with asthma (adjusted OR, 1.81; 95% CI, 1.11-2.95; P = .018). This association appeared to be strong in children whose mothers had asthma (adjusted OR, 3.93; 95% CI, 1.17-13.2) and also in boys (adjusted OR, 2.22; 95% CI, 1.14-4.34). Asthma was not associated with either exclusive breast-feeding <12 weeks or overweight in the absence of the other.

Conclusion

Short duration of exclusive breast-feeding and subsequent overweight are associated with asthma in susceptible children, suggesting a common pathway.

Clinical implications

This finding adds to the importance of promoting prolonged breast-feeding for the prevention of overweight and asthma.

Section snippets

Methods

This was a nested case-control study that included 246 children with pediatric allergist–diagnosed asthma and 477 controls without asthma at 8 to 10 years of age. Cases and controls were recruited from the same cohort of children born in 1995 in the province of Manitoba, Canada, after parent response to a mailed survey on child health when these children were 8 to 10 years of age. The 1995 cohort was identified from the records of the Manitoba Health Services Insurance Plan, which was a

Results

Sex, maternal asthma, paternal asthma, aboriginal origin, passive smoking at birth, residence location, and family income were significantly associated with exclusive breast-feeding and/or overweight and/or asthma (Table I) and thus were included in the multivariate logistic regression analyses. No significant associations were found between low birth weight or exposure to pets and exclusive breast-feeding, overweight, or asthma, and these factors were excluded from multivariate models.

In

Discussion

In our study, short duration of exclusive breast-feeding had a marginal association with asthma in preadolescents after adjustment for overweight and other covariates, which was consistent with findings in children at a younger age.3, 4, 5, 6, 7, 29 More interestingly, we found that combined exclusive breast-feeding <12 weeks and overweight was significantly associated with asthma. Because exclusive breast-feeding <12 weeks was closely associated with overweight in our study and that of others,

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    Supported by the Canadian Institutes of Health Research, AllerGen NCE Inc, the National Training Program in Asthma and Allergy, and the Manitoba Institute of Child Health. Dr Mai is the recipient of a postdoctoral fellowship award from the Canadian Institutes of Health Research.

    Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

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