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The interplay between eczema and breastfeeding practices may hide breastfeeding’s protective effect on childhood asthma

Published online: September 16, 2020

Breastfeeding is widely regarded as the optimal form of infant feeding and has many benefits for both mother and infant. From previous research, it was not clear whether these benefits extend to a reduced risk of developing asthma. Mothers may choose to breastfeed for longer if infants show early signs of allergic disease, such as eczema. Eczema is also a risk factor for asthma. The interplay between eczema and breastfeeding practices could bias associations. Therefore, it is important to examine the relationship between breastfeeding and asthma separately among children who did and did not have eczema during the breastfeeding period.

In this issue of The Journal of Allergy and Clinical Immunology: In Practice, Peters et al examined the relationship between breastfeeding practices, eczema and the risk of asthma in 6-year-old children, using data from the population-based longitudinal HealthNuts study. Infants (n=5276) were recruited at 12 months of age when eczema and breastfeeding practices were reported and followed up at age 6 years when data on asthma was reported (n=3663).

Increased duration of breastfeeding was associated with a modest reduction in asthma, but only among children who did not have eczema in the first year of life. This association was not apparent in children who were diagnosed with eczema either during or after the breastfeeding period. Future studies examining breastfeeding practices and the risk of allergic outcomes in later childhood need to consider the presence of early-life allergic manifestations impacting on breastfeeding behavior

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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