Breastfeeding associated with higher lung function in African American youths with asthma

ABSTRACT

Objective: In the United States, Puerto Ricans and African Americans have lower prevalence of breastfeeding and worse clinical outcomes for asthma compared with other racial/ethnic groups. We hypothesize that the history of breastfeeding is associated with increased forced expiratory volume in 1 second (FEV₁) % predicted and reduced asthma exacerbations in Latino and African American youths with asthma. Methods: As part of the Genes-environments & Admixture in Latino Americans (GALA II) Study and the Study of African Americans, asthma, Genes & Environments (SAGE II), we conducted case-only analyses in children and adolescents aged 8–21 years with asthma from four different racial/ethnic groups: African Americans (n = 426), Mexican Americans (n = 424), mixed/other Latinos (n = 255), and Puerto Ricans (n = 629). We investigated the association between any breastfeeding in infancy and FEV¹% predicted using multivariable linear regression; Poisson regression was used to determine the association between breastfeeding and asthma exacerbations. Results: Prevalence of breastfeeding was lower in African Americans (59.4%) and Puerto Ricans (54.9%) compared to Mexican Americans (76.2%) and mixed/other Latinos (66.9%; p < 0.001). After adjusting for covariates, breastfeeding was associated with a 3.58% point increase in FEV₁% predicted (p = 0.01) and a 21% reduction in asthma exacerbations (p = 0.03) in African Americans only. Conclusion: Breastfeeding was associated with higher FEV₁% predicted in asthma and reduced number of asthma exacerbations in African American youths, calling attention to continued support for breastfeeding.

KEYWORDS:

• Asthma
• breastfeeding
• exacerbations
• genetic admixture
• Hispanics
• lung function
• minority

Acknowledgements

The authors thank the participants and their families for their contribution, as well as the health care professionals and clinics for their support and participation in the Genes-environments & Admixture in Latino Americans Study and the Study of African Americans, Asthma, Genes & Environments. In particular, the authors thank the study coordinator Sandra Salazar and the recruiters who obtained the data: Duanny Alva, MD, Gaby Ayala-Rodriguez, Ulysses Burley, Lisa Caine, Elizabeth Castellanos, Jaime Colon, Denise DeJesus, Iliana Flexas, Blanca Lopez, Brenda Lopez, MD, Louis Martos, Vivian Medina, Juana Olivo, Mario Peralta, Esther Pomares, MD, Jihan Quraishi, Johanna Rodriguez, Shahdad Saeedi, Dean Soto, Ana Taveras, and Emmanuel Viera. The authors would also like to thank Marquitta White, PhD, for her advice on statistical analysis. Lastly, they would like to thank the University of California, San Francisco School of Pharmacy for their continued support for the Pharmaceutical Sciences Pathway research program.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Funding

Funding for this study was provided by the American Asthma Foundation, National Center for Advancing Translational Sciences (KL2-TR000143), National Heart, Lung, and Blood Institute (K23-HL111636), National Institute on Minority Health and Health Disparities (M01-RR00188, P60-MD006902), National Institutes of Health (K23-HL093023, R01-AI061774, R01-AI079139, R01-ES015794, R01-HL004464, R01-HL078885, R01-HL088133, R01-HL104608, R25-CA113710, T32-GM007546, U19-AI077439, U54-MD009523), Hind Distinguished Professorship, Robert Wood Johnson Foundation (Amos Medical Faculty Development Award), Sandler Foundation, and Tobacco-Related Disease Research Program (24RT-0025).