Relationship between breastfeeding and asthma prevalence in young children exposed to adverse childhood experiences

ABSTRACT

Objective: To investigate if duration of supplemental breastfeeding is associated with a lower asthma risk and whether adverse childhood experiences (ACEs) early in life influence this relationship in children ages 3 to 5 years. Methods: Data were from the 2011–2012 National Survey of Children's Health, a nationally representative cross-sectional survey. Modified Poisson regression models were used to estimate incident risk ratios (IRR) for lifetime and current asthma in young children aged 3 to 5 years (n = 15,642). We tested for effect measure modification using stratified analyses. Results: Exclusive breastfeeding for at least 6 months or supplemental breastfeeding for children ≥12 months significantly reduced the risk of lifetime asthma prevalence compared to never breastfed children (IRR 0.64; 95% CI: 0.46–0.88, p = 0.007; and IRR 0.68; 95% CI: 0.47–0.99, p = 0.044, respectively), adjusted for covariates. In stratified analyses, breastfeeding reduced the risk of lifetime asthma for children who experienced 1 ACE but not for children who experienced 2 or more ACEs. Conclusion: Exclusive breastfeeding for at least 6 months, with and without supplementation, appears to prevent asthma or delay its onset. The protective effect of breastfeeding was attenuated among children who experienced more than 2 ACEs. The known harmful effects that ACEs have on children's health may outweigh the benefits of breastfeeding in reducing the risk of a child developing asthma. Understanding how specific time periods in a child's life may be most affected by exposure to early life adversities, along with the protective effect of breastfeeding against asthma, are important areas of further study.

KEYWORDS:

• Childhood asthma
• breastfeeding
• adverse childhood experiences
• National Survey of Children's Health

Declaration of interest

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

Financial disclosure

The authors have no financial relationships relevant to this article to disclose

Additional information

Notes on contributors

Nancy E. Abarca

Nancy E Abarca, MPH At the time this study was conducted Nancy Abarca was at Brown University. Present address: PO Box 245454, Sacramento, CA 92824; [email protected]

Aris C. Garro

Aris C. Garro, MD, MPH Warren Alpert Medical School of Brown University: 222 Richmond St, Providence, RI 02903 Rhode Island Hospital: 593 Eddy Street, Providence, RI 02903; [email protected]

Deborah N. Pearlman

Deborah N. Pearlman, PhD Brown University, School of Public Health: 121 S. Main Street, Providence, RI 02903; [email protected]