Laurie writes:
"From my perspective the causes of asthma are still a "black box". We know that there are genetic factors and environmental factors (i.e., air pollution, cigarette smoke and allergens). The laboratory where I work is also studying the role of certain viral infections which may alter the airway epithelium (cells lining the airways) to an asthma phenotype. There is also a
"hygiene hypothesis" which suggests that asthma and allergies are a result of living in a relatively "clean" environment. In developing countries where parasitic infections are prevalent, there is reduced incidence of allergies and asthma. Thus, having an immune response to a parasite may be protective of developing asthma and allergies. Further, within developed countries it has also been found that children living on farms or in homes with animals
have reduced incidence of asthma. However the jury is still out on any definitive cause of asthma.

Similarly, I believe that the jury is also still out on the protective effects of breastfeeding on asthma"

Laurie,
I agree with you. Although I know that underneath all of the mystery, we will find that not breastfeeding is a risk, wehave to be careul about what we say without the facts. In the most recent APPPAH Journal, Michel Odent has a paper in which he discusses the relationship between induction or scheduled cesareans and asthma. He writes that the hormonla melieu that finalizes development of the lungs cannot take place when labor is eitehr induced or ther eis no labor. There is no increased risk of asthma in cesareans after labor, with no induction. This is b/c the chemicals released by the infant's body in the initiation of labor are then responded to by hormones released by the mother and the interplay of those hormones assures full development of the lungs. This process can only take place when labor is initiated normally.

If Odent is correct (I believe that he is), then breastfeeding may or may not be irrelevent, depending on the birth. I am certain that no study done on breastfeeding and asthma has considered this factor. I would conjecture that we might well see increased risk of asthma in AF babies whose births initiate normally, while in those whose births are medically induced, might see no increased risk, since the birth may have been a more formidable risk factor. I would also guess that as inductions and "elective cesareans" are on the rise, we might well see more and more research that suggests breastfeeding is not relevent.
Jennifer Tow, IBCLC, CT, USA

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