Breastfeeding & childhood asthma

Breastfeeding and the risk of childhood asthma: a population-based cohort study

Summary

To determine the possible relationship between breastfeeding and the subsequent development of childhood asthma.

Study description

The question whether breastfeeding protects against asthma and allergies is a matter of ongoing debate. Systematic reviews of all research done until 2001 conclude that breastfeeding might have a small protective effect, but stress that overall the evidence is inconclusive because of methodological weaknesses of many studies. Since then, several new publications suggested that breastfeeding might even increase the risk of asthma, especially in children of allergic mothers.

We will conduct a series of studies to describe the effect of breastfeeding on the development of asthma in children. First, we will summarise the results from earlier studies in a systematic review, paying special attention to the methodological quality of studies. Second, we will analyse data from 3,994 children from Leicestershire, UK, who had been followed from birth to the age of 9 years, to determine whether duration of breastfeeding influences the risk of the child to develop asthma. In doing so, we will investigate whether allergy status of the mother and ethnic group affect the results. Third, using data from the same children, we want to find out if breastfeeding influences lung growth, by studying various measures of lung function in children at the age of 10 years, including lung volumes, measures of airway obstruction and measures of alveolar growth.

This project will give a critical summary of the available literature on this topic and will add important new evidence from a large well established cohort study. Analyses will avoid or minimise important methodological pitfalls. In view of the high public health relevance of breastfeeding, and the rising asthma prevalence also in many developing countries, our study is topical and results are likely to inform policy.

Current status

During the past 2 years, we analysed the association between breastfeeding and lung function and alveolar development in school age children from the Leicester Cohort Studies. We measured lung function using spirometry (The Leicestershire School Study) and alveolar size using an advanced method, helium-3 magnetic resonance (Helium study). We were particularly interested if this association differs in children of asthmatic mothers. We were able to study 1458 children from the Leicester Cohort Studies and controlled for lot of confounders assessed by regular questionnaires. In the mean time, we have conducted a systematic review of the literature on breastfeeding and childhood asthma. We retrieved 927 papers after searching PubMed and Embase by title and abstract. After two selection steps, 80 articles were kept for analyses. Publications are in preparation. 

 

Publications

Dogaru CM, Nyffenegger D, Pescatore AM, Spycher BD, Kuehni CE.  
Dogaru et al. respond to "Does breastfeeding protect against 'asthma'? " 
Am J Epidemiol. 2014 May 15;179(10):1171-2. doi: 10.1093/aje/kwu071. Epub 2014 Apr 11. 

Dogaru CM, Nyffenegger D, Pescatore AM, Spycher BD, Kuehni CE.  
Breastfeeding and childhood asthma: systematic review and meta-analysis
Am J Epidemiol. 2014 May 15;179(10):1153-67. doi: 10.1093/aje/kwu072. Epub 2014 Apr 11. 

Dogaru CM, Strippoli MP, Spycher BD, Beardsmore CS, Silverman M, Kuehni CE. Breastfeeding and Lung Function at School-Age: Does Maternal Asthma Modify the Effect?
Am J Respir Crit Care Med 2012; doi:10.1164/rccm.201108-1490OC. 

 

Conference abstracts

Dogaru C, Pescatore AM, Spycher BD, Beardsmore CS, Silverman M, Kuehni CE. 
Does breastfeeding influence development of atopy? A cohort study
European Respiratory Society annual congress, Vienna, 2012.

Dogaru C, Narayanan M, Strippoli MPF, Pescatore AM, Spycher BD, Beardsmore CS, Silverman M, Owers-Bradley J, Kuehni CE. 
Association between breastfeeding and lung volumes and alveolar size. 
European Respiratory Society annual congress, Amsterdam, 2011.

Dogaru C, Strippoli MPF, Beasrdsmore CS, Silverman M, Kuehni CE.
Association between breastfeeding and lung function in childhood.
European Respiratory Society annual congress, Barcelona, 2010.

Strippoli MPF, Spycher BD, Silverman M, Kuehni CE.
Breastfeeding and the risk of childhood asthma: a population-based cohort study.
European Respiratory Society annual congress, Berlin, 2008.

©  ISPM - University of Bern 2009