Breastfeeding May Decrease Flexural Dermatitis Risk, But Not Asthma

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Exclusive breastfeeding may have a protective effect against flexural dermatitis development.
Exclusive breastfeeding may have a protective effect against flexural dermatitis development.

Implementation of a breastfeeding promotion intervention may reduce flexural dermatitis risk in infants, but it has no long-term effect on lung function or measures of atopic eczema or asthma in adolescents, according to a study published in JAMA Pediatrics.

Researchers followed up on a cohort of infants currently enrolled in the Promotion of Breastfeeding Intervention Trial (PROBIT, ClinicalTrials.gov Identifier: NCT01561612) in 30 Belarusian maternity hospitals that were cluster randomized. Patients were randomly assigned to receive either a breastfeeding promotion intervention (n=7064) or usual care (n=6493). 

Primary outcomes of this study were spirometery and flexural eczema on standardized skin examinations of study participants at 16 years of age.

Study results showed 0.3% (21/7064) of those in the breastfeeding promotion intervention group were diagnosed with flexural eczema, compared with 0.7% (43/6493) of those receiving usual care. 

The mean (standard deviation) forced expiratory volume in the first second of expiration/forced vital capacity ratio z scores for those in the intervention and usual care groups were -0.10 (1.82) and 0.35 (1.34), respectively.

A 54% lower risk for flexural eczema on skin examination was found in the breastfeeding promotion intervention treatment group compared with those in the control group (cluster-adjusted odds ratio, 0.46; 95% CI, 0.25-0.86). 

A limitation of the study is the possibility that study pediatricians may have had an unconscious bias when examining participants.

The study investigators concluded that participants in the intervention group who received a breastfeeding promotion intervention had a reduced risk for flexural dermatitis, but the intervention did not have any detectable effect on lung function, questionnaire-derived measures of asthma, or atopic eczema during adolescence (16 years of age). Therefore, clinicians should consider the implementation of a breastfeeding promotion intervention in an effort to reduce the incidence of flexural dermatitis.

Reference

Flohr C, Henderson AJ, Kramer MS, et al. Effect of an intervention to promote breastfeeding on asthma, lung function, and eczema at age 16 years: follow-up of the PROBIT randomized trial [published online November 13, 2017]. JAMA Pediatrics. doi:10.1001/jamapediatrics.2017.4064

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