Published online November 1, 2007
PEDIATRICS Vol. 120 No. 5 November 2007, pp. 1030-1035 (doi:10.1542/peds.2007-0722)
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ARTICLE

Infant-Feeding Methods and Childhood Sleep-Disordered Breathing

Hawley Evelyn Montgomery-Downs, PhDa, Valerie McLaughlin Crabtree, PhDb, Oscar Sans Capdevila, MDb and David Gozal, MDb

a Department of Psychology, West Virginia University, Morgantown, West Virginia
b Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville, Louisville, Kentucky

OBJECTIVE. Childhood sleep-disordered breathing has an adverse impact on cognitive development, behavior, quality of life, and use of health care resources. Early viral infections and other immune-mediated responses may contribute to development of the chronic inflammation of the upper airway and hypertrophic upper airway lymphadenoid tissues underlying childhood sleep-disordered breathing. Breastfeeding provides immunologic protection against such early exposures. Therefore, we sought to explore whether sleep-disordered breathing severity would differ for children who were breastfed as infants.

METHODS. The parents or guardians of 196 habitually snoring children (mean ± SD: 6.7 ± 2.9 years old) who were undergoing overnight polysomnography at Kosair Children's Hospital Sleep Medicine and Apnea Center completed a retrospective survey on the method(s) used to feed the child as an infant.

RESULTS. Among habitually snoring children, those who were fed breast milk for at least 2 months had significantly reduced sleep-disordered breathing severity on every measure assessed, including apnea-hypopnea index, oxyhemoglobin desaturation nadir, and respiratory arousal index. Breastfeeding for longer than 5 months did not contribute additional benefits.

CONCLUSIONS. Our findings support the notion that breastfeeding may provide long-term protection against the severity of childhood sleep-disordered breathing. Future research should explore mechanism(s) whereby infant-feeding methods may affect the pathophysiology of development of childhood sleep-disordered breathing.

Key Words: infant • child • sleep-disordered breathing • breastfeeding • development

Abbreviations: SDB—sleep-disordered breathing • SpO2—pulse oxygen saturation • TST—total sleep time • AHI—apnea-hypopnea index

Accepted May 17, 2007.




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O. S. Capdevila, L. Kheirandish-Gozal, E. Dayyat, and D. Gozal
Pediatric Obstructive Sleep Apnea: Complications, Management, and Long-term Outcomes
Proceedings of the ATS, February 15, 2008; 5(2): 274 - 282.
[Abstract] [Full Text] [PDF]