Children exclusively breastfed for the first three months of life had significantly lower odds of having eczema at age 6 compared with peers who were not breastfed or were breastfed for less time, according to preliminary research presented during the American Academy of Allergy, Asthma & Immunology 2019 Annual Meeting.
Eczema is a chronic condition characterised by extremely itchy skin that, when scratched, becomes inflamed and covered with blisters that crack easily. While genes and the environment are implicated in this inflammatory disease, many questions remain unanswered, such as how best to prevent it. According to the Centres for Disease Control and Prevention (CDC), breastfed infants have reduced risks for developing many chronic conditions, including asthma and obesity.
“The evidence that being exclusively breastfed protects children from developing eczema later in life remains mixed,” says Katherine M Balas, a clinical research assistant at Children’s National and the study’s lead author. “Our research team is trying to help fill that data gap.”
Balas and colleagues tapped data collected in Infant Feeding Practices Study II, a longitudinal study co-led by the CDC and the Food and Drug Administration (FDA) from 2005 to 2007, as well as the agencies’ 2012 follow-up examination of that study cohort. This study first tracked the diets of about 2,000 pregnant women from their third trimester and examined feeding practices through their babies’ first year of life. Their follow-up inquiry looked at the health, development and dietary patterns for 1,520 of these children at 6 years of age.
About 300 of the children had been diagnosed with eczema at some point in their lives, and 58.5 percent of the 6-year-olds had eczema at the time of the CDC/FDA Year Six Follow-Up. Children with higher socioeconomic status or a family history of food allergies had higher odds of being diagnosed with eczema.
“Children who were exclusively breastfed for three months or longer were significantly less likely (adjusted odds ratio: 0.477) to have continued eczema at age 6, compared with peers who were never breastfed or who were breastfed for less than three months,” Balas adds. “While exclusive breastfeeding may not prevent kids from getting eczema, it may protect them from experiencing extended flare-ups.”
Rationale: There is mixed evidence on whether breastfeeding is a protective factor for the development of eczema; furthermore, the impact of breastfeeding exclusivity remains unclear. The purpose of this study was to examine the association of exclusive breastfeeding with reported eczema diagnosis and active eczema in childhood.
Methods: Survey data from the Infant Feeding Practices Study II and its Year 6 Follow-Up were analyzed. Multivariable logistic regression models controlling for sociodemographic variables and familial history of allergic disease were used to examine associations of maternal reports of exclusive breastfeeding duration with reports at follow-up of ever being diagnosed with eczema and current symptoms of eczema among 6-year-olds (N=1520).
Results: Prevalence of any eczema diagnosis ever was 20.33% (n=309). Among those with a previous diagnosis, prevalence of current eczema at 6 years old was 58.58% (n=181). Higher socioeconomic status (≥185% federal poverty level) and family history of food allergies were significantly associated with higher odds of ever and current eczema diagnosis. Exclusive breastfeeding duration was not significantly associated with general eczema diagnosis; however, children exclusively breastfed for ≥ 3 months had significantly lower odds of continued eczema at 6 year follow-up (aOR=0.477 [95%CI 0.259, 0.878], p=0.017) as compared to those who were not breastfed or breastfed 0-3 months.
Conclusions: Exclusive breastfeeding may not prevent eczema or eczema diagnosis, but may play a protective role in decreasing the chronicity of eczema in childhood. Future work should explore how maternal diet while breastfeeding further impacts this relationship and whether this protection continues throughout adolescence.
Katherine M Balas, Karen A Robbins, Marni Jacobs, Ashley Ramos, Daniel V DiGiacomo, Linda Herbert