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Breastfeeding and infant eczema in the first year of life in the KOALA birth cohort study: a risk period-specific analysis.

Snijders BE, Thijs C, Kummeling I, Penders J, van den Brandt PA

Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 Maastricht, The Netherlands. bep.snijders@epid.unimaas.nl

OBJECTIVE: We studied the association between breastfeeding and eczema, taking into account the possible influence of reverse causation, with risk period-specific analyses. METHODS: Information on breastfeeding, determinants, and outcomes at 1 year of age was collected with repeated questionnaires for 2405 mother-infant pairs participating in the KOALA (Child, Parent and Health: Lifestyle and Genetic Constitution [in Dutch]) birth cohort study. By using multivariate logistic regression analysis, we compared an overall analysis with risk period-specific analyses. RESULTS: By the age of 1 year, 535 infants (22.2%) had developed eczema. In an overall analysis, we found a weak nonsignificant trend toward a reduced risk of eczema in the first year of life with increasing duration of breastfeeding (lowest risk for those breastfed for > or = 7 months versus never breastfed). In the risk period-specific analysis (confined to infants "at risk" for eczema onset after 3 months of age), no indication for reverse causation was found (results were not very different, compared with the overall analysis). Infants who were breastfed from birth on had a slightly (although not statistically significantly) increased risk for eczema in the first 3 months of life, compared with infants who were formula fed from birth on. CONCLUSIONS: Our results indicated that no strong effect of breastfeeding on eczema in the first year of life was present. This conclusion was strengthened by risk period-specific analysis, which made the influence of reverse causation unlikely.

Published 3 January 2007 in Pediatrics, 119(1): e137-41.
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