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PEDIATRICS Vol. 110 No. 6 December 2002, pp. e77

ELECTRONIC ARTICLE

Bottle Feeding in the Bed or Crib Before Sleep Time and Wheezing in Early Childhood

Juan C. Celedón, MD, DrPH^*,,, Augusto A. Litonjua, MD, MPH^*,,, Louise Ryan, PhD^||,¶, Scott T. Weiss, MD, MS^*,, and Diane R. Gold, MD, MPH^*,,

^* Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Harvard Medical School, Boston, Massachusetts
^|| Harvard School of Public Health, Boston, Massachusetts
^¶ Dana-Farber Cancer Institute, Boston, Massachusetts

--> Objective. Bottle feeding in the bed or crib before sleep time has been associated with an increased risk of wheezing in the first year of life. We examined whether bottle feeding in the bed or crib before sleep time in the first year of life is associated with wheezing in the first 5 years of life.

Methods. In a prospective cohort study of 448 children with parental history of atopy followed from birth, we examined the relation between the number of bimonthly parental reports of bottle feeding in the bed or crib before sleep time in the first year of life (range: 0–6 reports) and parental report of wheezing in the first 5 years of life. Additional outcome measures included recurrent wheezing (2 episodes of wheezing in the previous year) and asthma (physician-diagnosed asthma and 1 episode of wheezing in the previous year) at the age of 5 years.

Results. The risk of recurrent wheezing and asthma at 5 years of age increased significantly with each additional report of bottle feeding in the bed or crib before sleep time in the first year of life. The risk of wheezing between the ages of 1 and 5 years increased with each additional report of bottle feeding in the bed or crib before sleep time in the first year of life. As an example, a child whose parents reported bottle feeding in the bed or crib before sleep time on 3 occasions in the first year of life had 1.5 times higher risk of wheezing between the ages of 1 and 5 years than a child whose parents did not report bottle feeding in the bed or crib before sleep time in the first year of life (95% confidence interval for relative risk: 1.12–2.12).

Conclusions. Among children with parental history of atopy, bottle feeding in the bed or crib before sleep time in the first year of life is a risk factor for recurrent wheezing and asthma at 5 years of age and a risk factor for wheezing between the ages of 1 and 5 years.

Key Words: bottle feeding • sleep time • wheezing

Abbreviations: IgE, immunoglobulin E • OR, odds ratio • CI, confidence interval • GER, gastroesophageal reflux

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Received for publication May 16, 2002; Accepted Aug 26, 2002.

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