Abstract

Purpose of the Study. To investigate the effect of breastfeeding in various phenotypes of eczema. Study Population. A birth cohort of 4089 children followed up to 4 years of age. Methods. Data on breastfeeding, allergic symptoms, and potential confounders were obtained from questionnaires when the children were 2 months and 1, 2, and 4 years old. At 4 years, blood allergen-specific immunoglobulin E was analyzed. Children with symptoms of eczema and asthma during the period of breastfeeding were excluded in most analyses on risk assessment of eczema and asthma, respectively, to avoid disease-related modification of exposure. Results. Exclusive breastfeeding for ≥4 months reduced the risk for eczema at the age of 4 years (odds ratio [OR]: 0.78; 95% confidence interval [CI]: 0.63–0.96) irrespective of combination with asthma, sensitization to common allergens, or parental allergic disease. This decreased risk was most evident for children with onset of eczema during the first 2 years persisting to 4 years (OR: 0.59; 95% CI: 0.45–0.77). Among children with early-onset eczema, irrespective of persistency, followed by late onset of asthma or early-onset asthma, irrespective of persistency, followed by late-onset eczema to 4 years, a protective effect of breastfeeding was also seen (OR: 0.48; 95% CI: 0.30–0.76). Conclusions. Breastfeeding ≥4 months reduces the risk for eczema and asthma to 4 years of age. Reviewer Comments. Many studies to date have shown that breastfeeding confers a protective effect against early atopic diseases including eczema. This is yet another argument to support breastfeeding.

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