PURPOSE OF THE STUDY.
To determine if exclusive breastfeeding protects against childhood eczema.
There were 51 119 randomly selected 8- to 12-year-olds from 21 different countries who participated in the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two.
Parental questionnaires were used to collect information on eczema and breastfeeding. Children were examined for eczema and skin-prick testing for common allergens. At each study center, an odds ratio (OR) was calculated. ORs were also pooled across study populations.
There was a small positive association between parent-reported eczema ever with breastfeeding ever (pooled adjusted OR 1.11, 95% confidence interval [CI] 1.00–1.22) and breastfeeding <6 months (pooled adjusted OR 1.10, 95% CI 1.02–1.20). There was no significant association between parent-reported eczema ever and breastfeeding >6 months (pooled adjusted OR 1.09, 95% CI 0.94–1.26). There was little difference in risk estimate for exclusive breastfeeding (<2, 2–4, and >4 months) and for eczema symptoms in the past year and eczema on skin examination. Breastfeeding was associated with a negative association with sleep-disturbed eczema (pooled adjusted OR 0.71, 95% CI 0.53–0.96), but this was lost in children who had been exclusively breastfed for >4 months (pooled adjusted OR 1.02, 95% CI 0.67–1.54). History of maternal allergy and the child’s sensitization to aeroallergens did not modify these associations.
Although the authors did not demonstrate that breastfeeding exclusively for >4 months protects against eczema, they did demonstrate a protective effect of ever having been breastfed on sleep-disturbed eczema.
This is a significant study, as it is the largest data set exploring the association between breastfeeding and eczema in affluent and nonaffluent countries. Although these findings are consistent with recent systemic reviews of prospective studies, they contrast with a previous American Association of Pediatrics policy statement suggesting that breastfeeding for ≤4 months, compared with feeding cow milk protein formula, may prevent or delay the development of eczema.
- Copyright © 2012 by the American Academy of Pediatrics