I recently read the policy statement on breastfeeding and found it disappointing. The 1997 (updated 2005) statement was a well-researched, thorough document that appeared to take all research into account.
Concerning and breastfeeding and atopic dermatitis, the new statement reads: “There is a protective effect of exclusive breastfeeding for 3 to 4 months in reducing the incidence of clinical asthma, atopic dermatitis, and eczema by 27% in a low-risk population and up to 42% in infants with positive family history.”
The studies cited are a 2007 ARHQ report (Ip, Chung et al) on breastfeeding, and a 2008 (Greer et al) analysis to support its claim that breastfeeding aids in prevention of eczema.
The 2007 AHRQ report (which cites no studies on this subject published after 2002) concludes: “Available evidence from one well-performed systematic review/meta-analysis on full term infants in developed countries suggests that exclusive breastfeeding for at least 3 months was associated with a reduction in the risk of atopic dermatitis in those subjects with a family history of atopy.”1
The 2008 analysis (Greer et al, which cites no research post 2005) on infant feeding and allergic disease, made these conclusions: “In summary, for infants at high risk of developing atopy, there is evidence that exclusive breastfeeding for at least 4 months or breastfeeding with supplements of hydrolyzed infant formulas decreases the risk of atopic dermatitis compared with breastfeeding with supplements of standard cow milk-based formulas. On the basis of currently available evidence, this is less likely to apply to infants who are not at risk of developing atopy, and exclusive breastfeeding beyond 3 to 4 months does not seem to lead to any additional benefit in the incidence of atopic eczema.”2
I would like to know where the 27% and 42% numbers come from.
The rest of this policy statement is not much better. In Table 2, dose responses for reductions in obesity, diabetes, cancer, and asthma are given, when recent research is mixed at best as to whether breast milk is preventative.
I feel that this policy statement is a poor example of an analysis of available research and information. I hope the American Academy of Pediatrics will look at this report with a critical eye and rework it, taking all available research into account.
- Ip S,
- Chung M,
- Raman G
- Greer FR,
- Sicherer SH,
- Burks AW
- 4.Snijders BEP, Thijs C, Kummeling I, Penders J, van den Brandt PA. Breastfeeding and infant eczema in the first year of life in the KOALA birth cohort study: a risk period-specific analysis. Pediatrics 2007;119. Available at: www.pediatrics.org/cgi/content/full/119/1/e137.
- 6.Sandini U, Kukkonen AK, Poussa T, Sandini L, Savilahti E, Kuitunen M. Protective and risk factors for allergic diseases in high-risk children at the ages of two and five years. Int Archives Allergy Immunology. 2011;156(3):339–348
- Copyright © 2012 by the American Academy of Pediatrics