It is well-known that breastfeeding is associated with the prevention of immune-mediated disorders, including asthma and allergic susceptibilities. Therefore, investigators examined data from 960 children aged 4 to 12 years who were regular users of asthma medication (ie, ≥2 years of medication history available, ≥3 prescriptions for any asthma drug within the last 2 years, and ≥1 prescription for an asthma medication in the last 6 months). The patients evaluated had all participated in the Pharmacogenetics of Asthma Medication in Children: Medication With Anti-inflammatory Effects (PACMAN) study, which was initiated in April 2009 via the selection of pediatric asthma medication users from Dutch community pharmacies.
Breastfeeding exposure was based on questionnaires and stratified as follows: ever vs never breastfeeding and ≥6 months vs <6 months of breastfeeding. The severity of the patients’ asthma was based on the occurrence of exacerbations during the preceding year and/or on poorly controlled asthma symptoms during the last week of the study.
The findings demonstrated that breastfeeding was associated with a significantly lower risk for asthma exacerbations (adjusted odds ratio [aOR], 0.55; 95% CI, 0.35-0.87; P =.01). When stratified according to breastfeeding duration, aORs were 0.48 (95% CI, 0.27-0.84; P =.01) for breastfeeding <6 months (demonstrating statistical significance) and 0.71 (95% CI, 0.43-1.20; P =.20) for ≥6 months (no longer significant). Moreover, the association between breastfeeding and asthma exacerbations was strong and statistically significant in children with a family history of asthma (aOR, 0.34; 95% CI, 0.18-0.66; P =.001).
The researchers concluded that in a pediatric population of patients with asthma, breastfed children had a significantly lower risk for asthma exacerbations later in life compared with children with asthma who had not been breastfed. Additional prospective research is warranted to confirm this association and to clarify the underlying mechanisms.
Ahmadizar F, Vijverberg SJH, Arets HGM, et al. Breastfeeding is associated with a decreased risk of childhood asthma exacerbations later in life [published online July 29, 2017]. Pediatr Allergy Immunol. doi:10.1111/pai.12760