The association between duration of breastfeeding and childhood asthma outcomes

Keadrea Wilson; Tebeb Gebretsadik; Margaret A. Adgent; Christine Loftus; Catherine Karr; Paul E. Moore; Sheela Sathyanarayana; Nora Byington; Emily Barrett; Nicole Bush; Ruby Nguyen; Terry J. Hartman; Kaja Z. LeWinn; Alexis Calvert; W. Alex Mason; Kecia N. Carroll

doi:10.1016/j.anai.2022.04.034

The association between duration of breastfeeding and childhood asthma outcomes

Keadrea Wilson, Tebeb Gebretsadik, Margaret A. Adgent, Christine Loftus, Catherine Karr, Paul E. Moore, Sheela Sathyanarayana, Nora Byington, Emily Barrett, Nicole Bush, Ruby Nguyen, Terry J. Hartman, Kaja Z. LeWinn, Alexis Calvert, W. Alex Mason, Kecia N. Carroll

Epidemiology & Community Health

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

BACKGROUND: Postnatal exposures, including breastfeeding, may influence asthma development.

OBJECTIVE: To investigate the association between breastfeeding duration and child asthma.

METHODS: We studied 2021 mother-child dyads in the ECHO PATHWAYS consortium of prospective pregnancy cohorts (GAPPS, CANDLE, TIDES). Women reported the duration of any and exclusive breastfeeding and child asthma outcomes during follow-up at child age 4 to 6 years. Outcomes included current wheeze (previous 12 months), ever asthma, current asthma (having ≥2 of current wheeze, ever asthma, medication use in past 12-24 months), and strict current asthma (ever asthma with either or both current wheeze and medication use in past 12-24 months). We used multivariable logistic regression to assess associations (odds ratios and 95% confidence intervals) between breastfeeding and asthma outcomes adjusting for potential confounders. We assessed effect modification by mode of delivery, infant sex, and maternal asthma.

RESULTS: Among women, 33%, 13%, 9%, and 45% reported 0 to less than 2, 2 to 4, 5 to 6, and more than 6 months of any breastfeeding, respectively. The duration of any breastfeeding had a protective linear trend with ever asthma but no other outcomes. There was a duration-dependent protective association of exclusive breastfeeding and child asthma outcomes (eg, current asthma adjusted odds ratio [95% confidence interval], 0.64 [0.41-1.02], 0.61 [0.38-0.98], and 0.52 (0.31-0.87) for 2to 4 months, 5 to 6 months, and more than 6 months, respectively, compared with <2 months). For exclusive breastfeeding, protective associations were stronger in dyads with children born by vaginal vs cesarean delivery although interactions did not reach statistical significance (P interactions 0.12-0.40).

CONCLUSION: Longer duration of exclusive breastfeeding had a protective association with child asthma.

Original language	English (US)
Pages (from-to)	205-211
Number of pages	7
Journal	Annals of Allergy, Asthma and Immunology
Volume	129
Issue number	2
DOIs	https://doi.org/10.1016/j.anai.2022.04.034
State	Published - Aug 2022

Bibliographical note

Funding Information:
The Infant Development and the Environment Study (TIDES) was funded by NIH (R01ES016863, 1R01ES25169, P30 ES005022, and UG/UH3OD023305-05).

Funding Information:
The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study was funded by the Urban Child Institute and NIH (R01 HL109977), and Dr Carroll was also supported by NIH K24 HL150312, NIH R01HL132338, and NIH P30 ES023515.

Funding Information:
ECHO PATHWAYS is funded by the National Institutes of Health (NIH) (1UG3OD023271, 4UH3OD023271).

Funding Information:
We are grateful for the participation of families enrolled in the CANDLE, GAPPS, and TIDES cohorts and the dedication of the respective research staff and investigators. The ECHO PATHWAYS Data Center staff harmonized data across cohorts and compiled the analytical data set used in this study. This research was conducted using data collected on behalf of the GAPPS Repository. Disclosures: The authors declare that they have no known competing financial interests or personal relationships that could have seemed to influence the work reported in this article. Funding: ECHO PATHWAYS is funded by the National Institutes of Health (NIH) (1UG3OD023271, 4UH3OD023271). The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study was funded by the Urban Child Institute and NIH (R01 HL109977), and Dr Carroll was also supported by NIH K24 HL150312, NIH R01HL132338, and NIH P30 ES023515. The Infant Development and the Environment Study (TIDES) was funded by NIH (R01ES016863, 1R01ES25169, P30 ES005022, and UG/UH3OD023305-05). Select surveys were administered in REDCap, which was developed with NIH funds (NCATS:UL1 TR002319, ). Dr Karr was supported by NIH P30ES007033 and Dr Barrett was supported by NIH P30ES005022.

Funding Information:
Select surveys were administered in REDCap, which was developed with NIH funds (NCATS:UL1 TR002319, ). Dr Karr was supported by NIH P30ES007033 and Dr Barrett was supported by NIH P30ES005022.

Publisher Copyright:
© 2022 American College of Allergy, Asthma & Immunology

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Research Support, N.I.H., Extramural

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Wilson, K., Gebretsadik, T., Adgent, M. A., Loftus, C., Karr, C., Moore, P. E., Sathyanarayana, S., Byington, N., Barrett, E., Bush, N., Nguyen, R., Hartman, T. J., LeWinn, K. Z., Calvert, A., Mason, W. A., & Carroll, K. N. (2022). The association between duration of breastfeeding and childhood asthma outcomes. Annals of Allergy, Asthma and Immunology, 129(2), 205-211. https://doi.org/10.1016/j.anai.2022.04.034

Wilson, K, Gebretsadik, T, Adgent, MA, Loftus, C, Karr, C, Moore, PE, Sathyanarayana, S, Byington, N, Barrett, E, Bush, N, Nguyen, R, Hartman, TJ, LeWinn, KZ, Calvert, A, Mason, WA & Carroll, KN 2022, 'The association between duration of breastfeeding and childhood asthma outcomes', Annals of Allergy, Asthma and Immunology, vol. 129, no. 2, pp. 205-211. https://doi.org/10.1016/j.anai.2022.04.034

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title = "The association between duration of breastfeeding and childhood asthma outcomes",

abstract = "BACKGROUND: Postnatal exposures, including breastfeeding, may influence asthma development.OBJECTIVE: To investigate the association between breastfeeding duration and child asthma.METHODS: We studied 2021 mother-child dyads in the ECHO PATHWAYS consortium of prospective pregnancy cohorts (GAPPS, CANDLE, TIDES). Women reported the duration of any and exclusive breastfeeding and child asthma outcomes during follow-up at child age 4 to 6 years. Outcomes included current wheeze (previous 12 months), ever asthma, current asthma (having ≥2 of current wheeze, ever asthma, medication use in past 12-24 months), and strict current asthma (ever asthma with either or both current wheeze and medication use in past 12-24 months). We used multivariable logistic regression to assess associations (odds ratios and 95% confidence intervals) between breastfeeding and asthma outcomes adjusting for potential confounders. We assessed effect modification by mode of delivery, infant sex, and maternal asthma.RESULTS: Among women, 33%, 13%, 9%, and 45% reported 0 to less than 2, 2 to 4, 5 to 6, and more than 6 months of any breastfeeding, respectively. The duration of any breastfeeding had a protective linear trend with ever asthma but no other outcomes. There was a duration-dependent protective association of exclusive breastfeeding and child asthma outcomes (eg, current asthma adjusted odds ratio [95% confidence interval], 0.64 [0.41-1.02], 0.61 [0.38-0.98], and 0.52 (0.31-0.87) for 2to 4 months, 5 to 6 months, and more than 6 months, respectively, compared with <2 months). For exclusive breastfeeding, protective associations were stronger in dyads with children born by vaginal vs cesarean delivery although interactions did not reach statistical significance (P interactions 0.12-0.40). CONCLUSION: Longer duration of exclusive breastfeeding had a protective association with child asthma.",

author = "Keadrea Wilson and Tebeb Gebretsadik and Adgent, {Margaret A.} and Christine Loftus and Catherine Karr and Moore, {Paul E.} and Sheela Sathyanarayana and Nora Byington and Emily Barrett and Nicole Bush and Ruby Nguyen and Hartman, {Terry J.} and LeWinn, {Kaja Z.} and Alexis Calvert and Mason, {W. Alex} and Carroll, {Kecia N.}",

note = "Funding Information: The Infant Development and the Environment Study (TIDES) was funded by NIH (R01ES016863, 1R01ES25169, P30 ES005022, and UG/UH3OD023305-05). Funding Information: The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study was funded by the Urban Child Institute and NIH (R01 HL109977), and Dr Carroll was also supported by NIH K24 HL150312, NIH R01HL132338, and NIH P30 ES023515. Funding Information: ECHO PATHWAYS is funded by the National Institutes of Health (NIH) (1UG3OD023271, 4UH3OD023271). Funding Information: We are grateful for the participation of families enrolled in the CANDLE, GAPPS, and TIDES cohorts and the dedication of the respective research staff and investigators. The ECHO PATHWAYS Data Center staff harmonized data across cohorts and compiled the analytical data set used in this study. This research was conducted using data collected on behalf of the GAPPS Repository. Disclosures: The authors declare that they have no known competing financial interests or personal relationships that could have seemed to influence the work reported in this article. Funding: ECHO PATHWAYS is funded by the National Institutes of Health (NIH) (1UG3OD023271, 4UH3OD023271). The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study was funded by the Urban Child Institute and NIH (R01 HL109977), and Dr Carroll was also supported by NIH K24 HL150312, NIH R01HL132338, and NIH P30 ES023515. The Infant Development and the Environment Study (TIDES) was funded by NIH (R01ES016863, 1R01ES25169, P30 ES005022, and UG/UH3OD023305-05). Select surveys were administered in REDCap, which was developed with NIH funds (NCATS:UL1 TR002319, ). Dr Karr was supported by NIH P30ES007033 and Dr Barrett was supported by NIH P30ES005022. Funding Information: Select surveys were administered in REDCap, which was developed with NIH funds (NCATS:UL1 TR002319, ). Dr Karr was supported by NIH P30ES007033 and Dr Barrett was supported by NIH P30ES005022. Publisher Copyright: {\textcopyright} 2022 American College of Allergy, Asthma & Immunology",

year = "2022",

month = aug,

doi = "10.1016/j.anai.2022.04.034",

language = "English (US)",

volume = "129",

pages = "205--211",

journal = "Annals of Allergy, Asthma and Immunology",

issn = "1081-1206",

publisher = "American College of Allergy, Asthma and Immunology",

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TY - JOUR

T1 - The association between duration of breastfeeding and childhood asthma outcomes

AU - Wilson, Keadrea

AU - Gebretsadik, Tebeb

AU - Adgent, Margaret A.

AU - Loftus, Christine

AU - Karr, Catherine

AU - Moore, Paul E.

AU - Sathyanarayana, Sheela

AU - Byington, Nora

AU - Barrett, Emily

AU - Bush, Nicole

AU - Nguyen, Ruby

AU - Hartman, Terry J.

AU - LeWinn, Kaja Z.

AU - Calvert, Alexis

AU - Mason, W. Alex

AU - Carroll, Kecia N.

N1 - Funding Information: The Infant Development and the Environment Study (TIDES) was funded by NIH (R01ES016863, 1R01ES25169, P30 ES005022, and UG/UH3OD023305-05). Funding Information: The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study was funded by the Urban Child Institute and NIH (R01 HL109977), and Dr Carroll was also supported by NIH K24 HL150312, NIH R01HL132338, and NIH P30 ES023515. Funding Information: ECHO PATHWAYS is funded by the National Institutes of Health (NIH) (1UG3OD023271, 4UH3OD023271). Funding Information: We are grateful for the participation of families enrolled in the CANDLE, GAPPS, and TIDES cohorts and the dedication of the respective research staff and investigators. The ECHO PATHWAYS Data Center staff harmonized data across cohorts and compiled the analytical data set used in this study. This research was conducted using data collected on behalf of the GAPPS Repository. Disclosures: The authors declare that they have no known competing financial interests or personal relationships that could have seemed to influence the work reported in this article. Funding: ECHO PATHWAYS is funded by the National Institutes of Health (NIH) (1UG3OD023271, 4UH3OD023271). The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study was funded by the Urban Child Institute and NIH (R01 HL109977), and Dr Carroll was also supported by NIH K24 HL150312, NIH R01HL132338, and NIH P30 ES023515. The Infant Development and the Environment Study (TIDES) was funded by NIH (R01ES016863, 1R01ES25169, P30 ES005022, and UG/UH3OD023305-05). Select surveys were administered in REDCap, which was developed with NIH funds (NCATS:UL1 TR002319, ). Dr Karr was supported by NIH P30ES007033 and Dr Barrett was supported by NIH P30ES005022. Funding Information: Select surveys were administered in REDCap, which was developed with NIH funds (NCATS:UL1 TR002319, ). Dr Karr was supported by NIH P30ES007033 and Dr Barrett was supported by NIH P30ES005022. Publisher Copyright: © 2022 American College of Allergy, Asthma & Immunology

PY - 2022/8

Y1 - 2022/8

N2 - BACKGROUND: Postnatal exposures, including breastfeeding, may influence asthma development.OBJECTIVE: To investigate the association between breastfeeding duration and child asthma.METHODS: We studied 2021 mother-child dyads in the ECHO PATHWAYS consortium of prospective pregnancy cohorts (GAPPS, CANDLE, TIDES). Women reported the duration of any and exclusive breastfeeding and child asthma outcomes during follow-up at child age 4 to 6 years. Outcomes included current wheeze (previous 12 months), ever asthma, current asthma (having ≥2 of current wheeze, ever asthma, medication use in past 12-24 months), and strict current asthma (ever asthma with either or both current wheeze and medication use in past 12-24 months). We used multivariable logistic regression to assess associations (odds ratios and 95% confidence intervals) between breastfeeding and asthma outcomes adjusting for potential confounders. We assessed effect modification by mode of delivery, infant sex, and maternal asthma.RESULTS: Among women, 33%, 13%, 9%, and 45% reported 0 to less than 2, 2 to 4, 5 to 6, and more than 6 months of any breastfeeding, respectively. The duration of any breastfeeding had a protective linear trend with ever asthma but no other outcomes. There was a duration-dependent protective association of exclusive breastfeeding and child asthma outcomes (eg, current asthma adjusted odds ratio [95% confidence interval], 0.64 [0.41-1.02], 0.61 [0.38-0.98], and 0.52 (0.31-0.87) for 2to 4 months, 5 to 6 months, and more than 6 months, respectively, compared with <2 months). For exclusive breastfeeding, protective associations were stronger in dyads with children born by vaginal vs cesarean delivery although interactions did not reach statistical significance (P interactions 0.12-0.40). CONCLUSION: Longer duration of exclusive breastfeeding had a protective association with child asthma.

AB - BACKGROUND: Postnatal exposures, including breastfeeding, may influence asthma development.OBJECTIVE: To investigate the association between breastfeeding duration and child asthma.METHODS: We studied 2021 mother-child dyads in the ECHO PATHWAYS consortium of prospective pregnancy cohorts (GAPPS, CANDLE, TIDES). Women reported the duration of any and exclusive breastfeeding and child asthma outcomes during follow-up at child age 4 to 6 years. Outcomes included current wheeze (previous 12 months), ever asthma, current asthma (having ≥2 of current wheeze, ever asthma, medication use in past 12-24 months), and strict current asthma (ever asthma with either or both current wheeze and medication use in past 12-24 months). We used multivariable logistic regression to assess associations (odds ratios and 95% confidence intervals) between breastfeeding and asthma outcomes adjusting for potential confounders. We assessed effect modification by mode of delivery, infant sex, and maternal asthma.RESULTS: Among women, 33%, 13%, 9%, and 45% reported 0 to less than 2, 2 to 4, 5 to 6, and more than 6 months of any breastfeeding, respectively. The duration of any breastfeeding had a protective linear trend with ever asthma but no other outcomes. There was a duration-dependent protective association of exclusive breastfeeding and child asthma outcomes (eg, current asthma adjusted odds ratio [95% confidence interval], 0.64 [0.41-1.02], 0.61 [0.38-0.98], and 0.52 (0.31-0.87) for 2to 4 months, 5 to 6 months, and more than 6 months, respectively, compared with <2 months). For exclusive breastfeeding, protective associations were stronger in dyads with children born by vaginal vs cesarean delivery although interactions did not reach statistical significance (P interactions 0.12-0.40). CONCLUSION: Longer duration of exclusive breastfeeding had a protective association with child asthma.

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The association between duration of breastfeeding and childhood asthma outcomes

Abstract

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