Journal
AMERICAN JOURNAL OF CLINICAL NUTRITION
Volume 113, Issue 6, Pages 1609-1618Publisher
ELSEVIER SCIENCE INC
DOI: 10.1093/ajcn/nqaa442
Keywords
nutrition; breastfeeding; infant; wheeze; respiratory; pediatrics; high-risk; health-care use; early life
Categories
Funding
- NHMRC [APP1155810, APP1084816]
- University of Newcastle
- Peggy Lang Hunter Children's Research Foundation Early Career Fellowship
- University of Newcastle ECRRTP Higher Degree by Research scholarship
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Breastfeeding is associated with reduced odds of wheezing in high-risk infants, especially within the first 6 months of life. Further research is needed to explore the impact of breastfeeding intensity on wheezing and other respiratory outcomes.
Background: The risk of wheezing is high in infancy and is heightened in infants with a family history of asthma/atopy. The role of breastfeeding in influencing respiratory health for these high-risk infants is unclear. Objectives: To systematically appraise evidence for the association between breastfeeding and wheeze incidences and severity in high-risk infants. Methods: Studies identified through electronic databases and reference lists were eligible if they assessed breastfeeding and respiratory outcomes in infants with a family history of asthma/atopy. The primary outcome was wheeze incidences in the first year of life. Secondary outcomes were wheeze incidences in the first 6 months of life, indicators of wheeze severity (recurrent wheeze, health-care utilization, and medication use), and other wheeze-related outcomes [bronchiolitis, pneumonia, croup, and incidence of lower respiratory tract infection (LRTI)] up to 12 months old. Meta-analyses were conducted where possible. Results: Of 1843 articles screened, 15 observational studies met the inclusion criteria. Breastfeeding was associated with 32% reduced odds of wheezing during the first year of life (ever vs. never: OR, 0.68; 95% CI: 0.53, 0.88; n = 9 studies); this association was even stronger in the first 6 months (OR, 0.45; 95% CI: 0.27, 0.75; n = 5 studies). Breastfeeding for a longer versus shorter time (approximately longer vs. shorter than 3 months) was associated with 50% reduced odds of wheezing at the age of 6 months (OR, 0.50; 95% CI: 0.39, 0.64; n = 3 studies). Conclusions: Breastfeeding was associated with reduced odds of wheezing in high-risk infants, with the strongest protection in the first 6 months. More research is needed to understand the impact of breastfeeding intensity on wheezing and to examine additional respiratory outcomes, including wheeze severity.
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