0
July 1995, Vol 149, No. 7 >
Article | July 1995

Relationship of Infant Feeding to Recurrent Wheezing at Age 6 Years FREE

Anne L. Wright, PhD; Catharine J. Holberg, MSc; Lynn M. Taussig, MD; Fernando D. Martinez, MD
Arch Pediatr Adolesc Med. 1995;149(7):758-763. doi:10.1001/archpedi.1995.02170200048006.
Text Size: A A A
Published online
Article
References
Comments

Objectives:  To investigate the relationship of infant feeding to recurrent wheezing at age 6 years and to assess whether this relationship is altered by a history of wheezing lower respiratory tract illnesses.

Design:  Prospective, longitudinal study of healthy infants followed up from birth to 6 years of age.

Setting:  Nonselected health maintenance organization population in Tucson, Arizona.

Participants:  There were 1246 healthy infants enrolled at birth, 988 of whom had data on both infant feeding and wheezing at age 6 years.

Interventions:  None.

Main Outcome Measures:  Recurrent wheeze (four or more episodes in the past year) was assessed by a questionnaire that was completed by parents when the children were 6 years old. Children were classified by atopic status on the basis of skin prick tests.

Results:  Breast-feeding information was collected prospectively, and lower respiratory tract illnesses in the first 3 years of life were diagnosed by the pediatrician. Being breast-fed was associated with lower rates of recurrent wheeze at age 6 years (3.1% vs 9.7%, P<.01) for nonatopic children; this relationship was not significant for atopic children. The relationship of breast-feeding with recurrent wheeze was apparent among nonatopic children both with and without a wheezing lower respiratory tract illness in the first 6 months of life. When potential confounders, including early wheezing lower respiratory tract illness, were included in a multivariate model, nonatopic children who had not been breast-fed had three times the odds of wheezing recurrently (odds ratio, 3.03; confidence interval, 1.06 to 8.69). Eleven percent of recurrent wheeze among nonatopic children could be attributed to not breast-feeding.

Conclusions:  Recurrent wheeze at age 6 years is less common among nonatopic children who were breast-fed as infants. This effect is independent of whether the child wheezed with a lower respiratory tract illness in the first 6 months of life.(Arch Pediatr Adolesc Med. 1995;149:758-763)

REFERENCES

1 +
Cunningham AS, Jelliffe DB, Jelliffe EFP.  Breastfeeding and health in the 1980s: a global epidemiologic review . J Pediatr . 1991;;118:659-666.
2 +
Wright AL, Holberg CJ, Martinez FD, et al.  Breastfeeding and lower respiratory tract illness in the first year of life . BMJ . 1989;;299:946-949.
3 +
Holberg CJ, Wright AL, Martinez FD, et al.  Risk factors for respiratory syncytial virus-associated lower respiratory illnesses in the first year of life . Am J Epidemiol . 1991;;133:1135-1151.
4 +
Duncan B, Ey J, Holberg CJ, et al.  Exclusive breastfeeding for four months protects against otitis media . Pediatrics . 1993;;91:867-872.
5 +
Fergusson DM, Horwood JL, Shannon FT, Taylor B.  Breastfeeding, gastrointestinal and lower respiratory illness in the first two years . Aust Paediatr J . 1981;;17:191-195.
6 +
Victoria CG, Vaughan JP, Lombardi C, et al.  Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil . Lancet . 1987;; 2:319-321.
7 +
Howie PW, Forsyth JS, Ogston SA, et al.  Protective effect of breast feeding against infection . BMJ . 1990;:300:11-16.
8 +
Huffman SL, Combest C.  Role of breast-feeding in the prevention and treatment of diarrhoea . J Diarrhoeal Dis Res . 1990;;8( (3) ):66-81.
9 +
Burr ML, Limb ES, Maguire MJ, et al.  Infant feeding, wheezing and allergy: a prospective study . Arch Dis Child . 1993;;68:724-729.
10 +
McConnochie KM, Roghmann KJ.  Breastfeeding and maternal smoking as predictors of wheezing in children age 6 to 10 years . Pediatr Pulmonol . 1986;;2: 260-268.
11 +
Holland WH, Halil T, Bennett AE, et al.  Factors influencing the onset of chronic respiratory disease . BMJ . 1969;;2:205-208.
12 +
McConnochie KN, Roghmann KJ.  Bronchiolitis as a possible cause of wheezing in childhood: new evidence . Pediatrics . 1984;;74:1-10.
13 +
Taussig LM, Wright AL, Harrison HR, et al.  The Tucson Children's Respiratory Study, I: design and implementation of a study of acute and chronic respiratory illness in children . Am J Epidemiol . 1989;;129:1219-1231.
14 +
Wright AL, Taussig LM, Ray CG, et al.  The Tucson Children's Respiratory Study, II: lower respiratory tract illness in the first year of life . Am J Epidemiol . 1989;; 129:1232-1246.
15 +
Wright AL, Holberg C, Martinez FD, Halonen M, Morgan WJ, Taussig LM.  Epidemiology of physician diagnosed allergic rhinitis . Pediatrics . 1994;;94:895-901.
16 +
Halonen M, Stern D, Lyle S, et al.  Relationship of total serum IgE levels in cord and 9 month sera of infants . Clin Exp Allergy . 1991;;21:235-241.
17 +
Rothman KJ. Modern Epidemiology . Boston, Mass: Little Brown & Co; 1986;.
18 +
Wright AL, Holberg CJ, Martinez FD, Taussig LM.  The relationship of parental smoking to wheezing and non-wheezing lower respiratory illness in infancy . J Pediatr . 1991;;118:207-214.
19 +
Martinez FD, Morgan WJ, Wright AL, et al.  Diminished lung function as a predisposing factor for wheezing respiratory illness in infants . N Engl J Med . 1988;; 319:112-117.
20 +
Martinez FD.  Sudden infant death syndrome and small airway occlusion: facts and hypothesis . Pediatrics . 1990;;87:190-198.
21 +
Bauchner H, Leventhal JM, Shapiro ED.  Studies of breastfeeding and infection: how good is the evidence? JAMA . 1986;;256:887-892.
22 +
Burr ML, Miskelly FG, Butland BK, et al.  Environmental factors and symptoms in infants at high risk of allergy . J Epidemiol Community Health . 1989;;43:125-132.
23 +
Taylor B, Wadsworth J, Golding J, et al.  Breastfeeding, eczema, asthma, and hayfever . J Epidemiol Community Health . 1983;;37:95-99.
24 +
Goldman AS.  The immune system of human milk: antimicrobial, antiinflammatory and immunomodulating properties . Pediatr Infect Dis J . 1993;;12:664-671.
25 +
Martinez FD, Morgan WJ, Wright AL, Taussig LM.  Breastfeeding, lung function and LRIs during the first year of life . Am Rev Respir Dis . 1988;;137:405.
26 +
Mayer EJ, Hamman RF, Gay EC, et al.  Reduced risk of IDDM among breastfed children . Diabetes . 1988;;37:1625-1632.
27 +
Campbell DA Jr, Lorber MI, Sweeton JC, et al.  Breastfeeding and maternal-donor renal allographs . Transplantation . 1984;;37:340-344.
28 +
Lucas A, Morley R, Cole TJ, et al.  Breastmilk and subsequent intelligence quotient in children born preterm . Lancet . 1992;;339:261-264.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Cunningham AS, Jelliffe DB, Jelliffe EFP.  Breastfeeding and health in the 1980s: a global epidemiologic review . J Pediatr . 1991;;118:659-666.
2 +
Wright AL, Holberg CJ, Martinez FD, et al.  Breastfeeding and lower respiratory tract illness in the first year of life . BMJ . 1989;;299:946-949.
3 +
Holberg CJ, Wright AL, Martinez FD, et al.  Risk factors for respiratory syncytial virus-associated lower respiratory illnesses in the first year of life . Am J Epidemiol . 1991;;133:1135-1151.
4 +
Duncan B, Ey J, Holberg CJ, et al.  Exclusive breastfeeding for four months protects against otitis media . Pediatrics . 1993;;91:867-872.
5 +
Fergusson DM, Horwood JL, Shannon FT, Taylor B.  Breastfeeding, gastrointestinal and lower respiratory illness in the first two years . Aust Paediatr J . 1981;;17:191-195.
6 +
Victoria CG, Vaughan JP, Lombardi C, et al.  Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil . Lancet . 1987;; 2:319-321.
7 +
Howie PW, Forsyth JS, Ogston SA, et al.  Protective effect of breast feeding against infection . BMJ . 1990;:300:11-16.
8 +
Huffman SL, Combest C.  Role of breast-feeding in the prevention and treatment of diarrhoea . J Diarrhoeal Dis Res . 1990;;8( (3) ):66-81.
9 +
Burr ML, Limb ES, Maguire MJ, et al.  Infant feeding, wheezing and allergy: a prospective study . Arch Dis Child . 1993;;68:724-729.
10 +
McConnochie KM, Roghmann KJ.  Breastfeeding and maternal smoking as predictors of wheezing in children age 6 to 10 years . Pediatr Pulmonol . 1986;;2: 260-268.
11 +
Holland WH, Halil T, Bennett AE, et al.  Factors influencing the onset of chronic respiratory disease . BMJ . 1969;;2:205-208.
12 +
McConnochie KN, Roghmann KJ.  Bronchiolitis as a possible cause of wheezing in childhood: new evidence . Pediatrics . 1984;;74:1-10.
13 +
Taussig LM, Wright AL, Harrison HR, et al.  The Tucson Children's Respiratory Study, I: design and implementation of a study of acute and chronic respiratory illness in children . Am J Epidemiol . 1989;;129:1219-1231.
14 +
Wright AL, Taussig LM, Ray CG, et al.  The Tucson Children's Respiratory Study, II: lower respiratory tract illness in the first year of life . Am J Epidemiol . 1989;; 129:1232-1246.
15 +
Wright AL, Holberg C, Martinez FD, Halonen M, Morgan WJ, Taussig LM.  Epidemiology of physician diagnosed allergic rhinitis . Pediatrics . 1994;;94:895-901.
16 +
Halonen M, Stern D, Lyle S, et al.  Relationship of total serum IgE levels in cord and 9 month sera of infants . Clin Exp Allergy . 1991;;21:235-241.
17 +
Rothman KJ. Modern Epidemiology . Boston, Mass: Little Brown & Co; 1986;.
18 +
Wright AL, Holberg CJ, Martinez FD, Taussig LM.  The relationship of parental smoking to wheezing and non-wheezing lower respiratory illness in infancy . J Pediatr . 1991;;118:207-214.
19 +
Martinez FD, Morgan WJ, Wright AL, et al.  Diminished lung function as a predisposing factor for wheezing respiratory illness in infants . N Engl J Med . 1988;; 319:112-117.
20 +
Martinez FD.  Sudden infant death syndrome and small airway occlusion: facts and hypothesis . Pediatrics . 1990;;87:190-198.
21 +
Bauchner H, Leventhal JM, Shapiro ED.  Studies of breastfeeding and infection: how good is the evidence? JAMA . 1986;;256:887-892.
22 +
Burr ML, Miskelly FG, Butland BK, et al.  Environmental factors and symptoms in infants at high risk of allergy . J Epidemiol Community Health . 1989;;43:125-132.
23 +
Taylor B, Wadsworth J, Golding J, et al.  Breastfeeding, eczema, asthma, and hayfever . J Epidemiol Community Health . 1983;;37:95-99.
24 +
Goldman AS.  The immune system of human milk: antimicrobial, antiinflammatory and immunomodulating properties . Pediatr Infect Dis J . 1993;;12:664-671.
25 +
Martinez FD, Morgan WJ, Wright AL, Taussig LM.  Breastfeeding, lung function and LRIs during the first year of life . Am Rev Respir Dis . 1988;;137:405.
26 +
Mayer EJ, Hamman RF, Gay EC, et al.  Reduced risk of IDDM among breastfed children . Diabetes . 1988;;37:1625-1632.
27 +
Campbell DA Jr, Lorber MI, Sweeton JC, et al.  Breastfeeding and maternal-donor renal allographs . Transplantation . 1984;;37:340-344.
28 +
Lucas A, Morley R, Cole TJ, et al.  Breastmilk and subsequent intelligence quotient in children born preterm . Lancet . 1992;;339:261-264.

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems