Breastfeeding, maternal asthma and wheezing in the first year of life: A longitudinal birth cohort study

Meghan B. Azad; Lorena Vehling; Zihang Lu; David Dai; Padmaja Subbarao; Allan B. Becker; Piushkumar J. Mandhane; Stuart E. Turvey; Diana L. Lefebvre; Malcolm R. Sears; S. S. Anand; A. D. Befus; M. Brauer; J. R. Brook; E. Chen; M. Cyr; D. Daley; S. Dell; J. A. Denburg; Q. Duan; T. Eiwegger; H. Grasemann; K. HayGlass; R. Hegele; D. L. Holness; P. Hystad; W. Y.W. Lou; M. S. Kobor; T. R. Kollman; A. L. Kozyrskyj; C. Laprise; J. Macri; P. M. Mandhane; G. Miller; T. Moraes; P. D. Paré; C. Ramsey; F. Ratjen; A. Sandford; J. A. Scott; J. Scott; F. Silverman; E. Simons; T. Takaro; S. Tebbutt; T. To

doi:10.1183/13993003.02019-2016

Breastfeeding, maternal asthma and wheezing in the first year of life: A longitudinal birth cohort study

Meghan B. Azad^*, Lorena Vehling, Zihang Lu, David Dai, Padmaja Subbarao, Allan B. Becker, Piushkumar J. Mandhane, Stuart E. Turvey, Diana L. Lefebvre, Malcolm R. Sears, S. S. Anand, A. D. Befus, M. Brauer, J. R. Brook, E. Chen, M. Cyr, D. Daley, S. Dell, J. A. Denburg, Q. DuanT. Eiwegger, H. Grasemann, K. HayGlass, R. Hegele, D. L. Holness, P. Hystad, W. Y.W. Lou, M. S. Kobor, T. R. Kollman, A. L. Kozyrskyj, C. Laprise, J. Macri, P. M. Mandhane, G. Miller, T. Moraes, P. D. Paré, C. Ramsey, F. Ratjen, A. Sandford, J. A. Scott, J. Scott, F. Silverman, E. Simons, T. Takaro, S. Tebbutt, T. To

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Abstract

The impact of breastfeeding on respiratory health is uncertain, particularly when the mother has asthma. We examined the association of breastfeeding and wheezing in the first year of life. We studied 2773 infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Caregivers reported on infant feeding and wheezing episodes at 3, 6 and 12 months. Breastfeeding was classified as exclusive, partial (supplemented with formula or complementary foods) or none. Overall, 21% of mothers had asthma, 46% breastfed for at least 12 months and 21% of infants experienced wheezing. Among mothers with asthma, breastfeeding was inversely associated with infant wheezing, independent of maternal smoking, education and other risk factors (adjusted rate ratio (aRR) 0.52; 95% CI 0.35 - 0.77 for ≥12 versus < 6 months breastfeeding). Compared with no breastfeeding at 6 months, wheezing was reduced by 62% with exclusive breastfeeding (aRR 0.38; 95% CI 0.20 - 0.71) and by 37% with partial breastfeeding supplemented with complementary foods (aRR 0.63; 95% CI 0.43 - 0.93); however, breastfeeding was not significantly protective when supplemented with formula (aRR 0.89; 95% CI 0.61 - 1.30). Associations were not significant in the absence of maternal asthma (p-value for interaction < 0.01). Breastfeeding appears to confer protection against wheezing in a dose-dependent manner among infants born to mothers with asthma.

Original language	English (US)
Article number	1602019
Journal	European Respiratory Journal
Volume	49
Issue number	5
DOIs	https://doi.org/10.1183/13993003.02019-2016
State	Published - May 1 2017

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

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Azad, M. B., Vehling, L., Lu, Z., Dai, D., Subbarao, P., Becker, A. B., Mandhane, P. J., Turvey, S. E., Lefebvre, D. L., Sears, M. R., Anand, S. S., Befus, A. D., Brauer, M., Brook, J. R., Chen, E., Cyr, M., Daley, D., Dell, S., Denburg, J. A., ... To, T. (2017). Breastfeeding, maternal asthma and wheezing in the first year of life: A longitudinal birth cohort study. European Respiratory Journal, 49(5), Article 1602019. https://doi.org/10.1183/13993003.02019-2016

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title = "Breastfeeding, maternal asthma and wheezing in the first year of life: A longitudinal birth cohort study",

abstract = "The impact of breastfeeding on respiratory health is uncertain, particularly when the mother has asthma. We examined the association of breastfeeding and wheezing in the first year of life. We studied 2773 infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Caregivers reported on infant feeding and wheezing episodes at 3, 6 and 12 months. Breastfeeding was classified as exclusive, partial (supplemented with formula or complementary foods) or none. Overall, 21% of mothers had asthma, 46% breastfed for at least 12 months and 21% of infants experienced wheezing. Among mothers with asthma, breastfeeding was inversely associated with infant wheezing, independent of maternal smoking, education and other risk factors (adjusted rate ratio (aRR) 0.52; 95% CI 0.35 - 0.77 for ≥12 versus < 6 months breastfeeding). Compared with no breastfeeding at 6 months, wheezing was reduced by 62% with exclusive breastfeeding (aRR 0.38; 95% CI 0.20 - 0.71) and by 37% with partial breastfeeding supplemented with complementary foods (aRR 0.63; 95% CI 0.43 - 0.93); however, breastfeeding was not significantly protective when supplemented with formula (aRR 0.89; 95% CI 0.61 - 1.30). Associations were not significant in the absence of maternal asthma (p-value for interaction < 0.01). Breastfeeding appears to confer protection against wheezing in a dose-dependent manner among infants born to mothers with asthma.",

author = "Azad, {Meghan B.} and Lorena Vehling and Zihang Lu and David Dai and Padmaja Subbarao and Becker, {Allan B.} and Mandhane, {Piushkumar J.} and Turvey, {Stuart E.} and Lefebvre, {Diana L.} and Sears, {Malcolm R.} and Anand, {S. S.} and Befus, {A. D.} and M. Brauer and Brook, {J. R.} and E. Chen and M. Cyr and D. Daley and S. Dell and Denburg, {J. A.} and Q. Duan and T. Eiwegger and H. Grasemann and K. HayGlass and R. Hegele and Holness, {D. L.} and P. Hystad and Lou, {W. Y.W.} and Kobor, {M. S.} and Kollman, {T. R.} and Kozyrskyj, {A. L.} and C. Laprise and J. Macri and Mandhane, {P. M.} and G. Miller and T. Moraes and Par{\'e}, {P. D.} and C. Ramsey and F. Ratjen and A. Sandford and Scott, {J. A.} and J. Scott and F. Silverman and E. Simons and T. Takaro and S. Tebbutt and T. To",

note = "Publisher Copyright: Copyright {\textcopyright}ERS 2017.",

year = "2017",

month = may,

day = "1",

doi = "10.1183/13993003.02019-2016",

language = "English (US)",

volume = "49",

journal = "European Respiratory Journal",

issn = "0903-1936",

publisher = "European Respiratory Society",

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Azad, MB, Vehling, L, Lu, Z, Dai, D, Subbarao, P, Becker, AB, Mandhane, PJ, Turvey, SE, Lefebvre, DL, Sears, MR, Anand, SS, Befus, AD, Brauer, M, Brook, JR, Chen, E, Cyr, M, Daley, D, Dell, S, Denburg, JA, Duan, Q, Eiwegger, T, Grasemann, H, HayGlass, K, Hegele, R, Holness, DL, Hystad, P, Lou, WYW, Kobor, MS, Kollman, TR, Kozyrskyj, AL, Laprise, C, Macri, J, Mandhane, PM, Miller, G, Moraes, T, Paré, PD, Ramsey, C, Ratjen, F, Sandford, A, Scott, JA, Scott, J, Silverman, F, Simons, E, Takaro, T, Tebbutt, S & To, T 2017, 'Breastfeeding, maternal asthma and wheezing in the first year of life: A longitudinal birth cohort study', European Respiratory Journal, vol. 49, no. 5, 1602019. https://doi.org/10.1183/13993003.02019-2016

TY - JOUR

T1 - Breastfeeding, maternal asthma and wheezing in the first year of life

T2 - A longitudinal birth cohort study

AU - Azad, Meghan B.

AU - Vehling, Lorena

AU - Lu, Zihang

AU - Dai, David

AU - Subbarao, Padmaja

AU - Becker, Allan B.

AU - Mandhane, Piushkumar J.

AU - Turvey, Stuart E.

AU - Lefebvre, Diana L.

AU - Sears, Malcolm R.

AU - Anand, S. S.

AU - Befus, A. D.

AU - Brauer, M.

AU - Brook, J. R.

AU - Chen, E.

AU - Cyr, M.

AU - Daley, D.

AU - Dell, S.

AU - Denburg, J. A.

AU - Duan, Q.

AU - Eiwegger, T.

AU - Grasemann, H.

AU - HayGlass, K.

AU - Hegele, R.

AU - Holness, D. L.

AU - Hystad, P.

AU - Lou, W. Y.W.

AU - Kobor, M. S.

AU - Kollman, T. R.

AU - Kozyrskyj, A. L.

AU - Laprise, C.

AU - Macri, J.

AU - Mandhane, P. M.

AU - Miller, G.

AU - Moraes, T.

AU - Paré, P. D.

AU - Ramsey, C.

AU - Ratjen, F.

AU - Sandford, A.

AU - Scott, J. A.

AU - Scott, J.

AU - Silverman, F.

AU - Simons, E.

AU - Takaro, T.

AU - Tebbutt, S.

AU - To, T.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - The impact of breastfeeding on respiratory health is uncertain, particularly when the mother has asthma. We examined the association of breastfeeding and wheezing in the first year of life. We studied 2773 infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Caregivers reported on infant feeding and wheezing episodes at 3, 6 and 12 months. Breastfeeding was classified as exclusive, partial (supplemented with formula or complementary foods) or none. Overall, 21% of mothers had asthma, 46% breastfed for at least 12 months and 21% of infants experienced wheezing. Among mothers with asthma, breastfeeding was inversely associated with infant wheezing, independent of maternal smoking, education and other risk factors (adjusted rate ratio (aRR) 0.52; 95% CI 0.35 - 0.77 for ≥12 versus < 6 months breastfeeding). Compared with no breastfeeding at 6 months, wheezing was reduced by 62% with exclusive breastfeeding (aRR 0.38; 95% CI 0.20 - 0.71) and by 37% with partial breastfeeding supplemented with complementary foods (aRR 0.63; 95% CI 0.43 - 0.93); however, breastfeeding was not significantly protective when supplemented with formula (aRR 0.89; 95% CI 0.61 - 1.30). Associations were not significant in the absence of maternal asthma (p-value for interaction < 0.01). Breastfeeding appears to confer protection against wheezing in a dose-dependent manner among infants born to mothers with asthma.

AB - The impact of breastfeeding on respiratory health is uncertain, particularly when the mother has asthma. We examined the association of breastfeeding and wheezing in the first year of life. We studied 2773 infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Caregivers reported on infant feeding and wheezing episodes at 3, 6 and 12 months. Breastfeeding was classified as exclusive, partial (supplemented with formula or complementary foods) or none. Overall, 21% of mothers had asthma, 46% breastfed for at least 12 months and 21% of infants experienced wheezing. Among mothers with asthma, breastfeeding was inversely associated with infant wheezing, independent of maternal smoking, education and other risk factors (adjusted rate ratio (aRR) 0.52; 95% CI 0.35 - 0.77 for ≥12 versus < 6 months breastfeeding). Compared with no breastfeeding at 6 months, wheezing was reduced by 62% with exclusive breastfeeding (aRR 0.38; 95% CI 0.20 - 0.71) and by 37% with partial breastfeeding supplemented with complementary foods (aRR 0.63; 95% CI 0.43 - 0.93); however, breastfeeding was not significantly protective when supplemented with formula (aRR 0.89; 95% CI 0.61 - 1.30). Associations were not significant in the absence of maternal asthma (p-value for interaction < 0.01). Breastfeeding appears to confer protection against wheezing in a dose-dependent manner among infants born to mothers with asthma.

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UR - http://www.scopus.com/inward/citedby.url?scp=85019091178&partnerID=8YFLogxK

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DO - 10.1183/13993003.02019-2016

M3 - Article

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AN - SCOPUS:85019091178

SN - 0903-1936

VL - 49

JO - European Respiratory Journal

JF - European Respiratory Journal

IS - 5

M1 - 1602019

ER -

Breastfeeding, maternal asthma and wheezing in the first year of life: A longitudinal birth cohort study

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