what's the cause and what's the effect
Will wonders ever cease? The whole world should have been declared
allergenic centuries ago.
_____
The more I do and read research, the less I believe. Does anybody else
have that problem?
Could long-term breastfeeders breastfeed longterm because they ARE
allergenic? Ever hear a doctor say "maybe you shouldn't push such and
such food. He may be refusing it because he's allergic"? Perhaps some
babies breastfeed longer than other babies and not take in solids well
because they're allergic to them.
Also allergies are uncomfortable. Whether they are rashes, sniffly noses
or full-blown asthma, these little ones may need more comfort and so may
breastfeed longer.
Perhaps long-term breastfeeding and allergies sometimes go hand in hand
for reasons other than cause and effect.
When research studies become more black and white, I'll take them more
seriously. Meanwhile, common sense and doing what is natural is where
I'm headed.
I was never breastfed and have tons of allergies. So did my mom and dad
who were never breastfed.
Cheryl Muller RNC IBCLC
PS I believed taking HRT would help me avoid heart attacks. Because that
is what the studies said. I took them for 7 years.Enough said.
e: Wed, 8 Jan 2003 20:08:04 +0200
From: Jean Ridler <[log in to unmask]>
Subject: Breast feeding and atopy
Study 1: Breast fed children have more atopy long term
------------------------------------------------------------------------
----
------
Breast fed children have more atopy well into adulthood, according to
the results of a recently published long term cohort study of children
in New Zealand.
Subjects: 1,037 New Zealand children entered into the study at age 3
years.
Method: Observational study. Breast feeding history was established at
entry into the study, and the children were reviewed at intervals of 2
to 5 years from age 9 until age 26, using respiratory questionnaires,
pulmonary function, bronchial challenge and skin allergy tests.
Results: Children who were breast fed for at least 4 weeks had more
asthma at each assessment than those who were not (p=0.0008), regardless
of any parental history of asthma or hay fever. See Table 1.
Table 1: Odds ratios for atopic manifestations at various ages (after
controlling for socioeconomic status, parental smoking, birth order, and
use of sheepskin bedding in infancy)
At age OR (95%CI) Signif.
------------------------------------------------------------------------
----
-----------------
Asthma All ages 1.83 p<0.0001
(9 - 26 yrs) (1.35-2.47)
Any allergen +'ve 13 years 1.94 p<0.0001
(1.42-2.65)
Reference: Lancet 2002; 360: 901-07
Study 2: Breast fed children have more eczema to 7 yrs
------------------------------------------------------------------------
----
-----
For each month of additional breastfeeding there is a higher risk of the
child developing eczema, according to results from a new German study.
Subjects: 1,314 infants born in Germany in 1990.
Method: Observational cohort study conducted over 7 years. Objective
blood tests as well as parent reports were used to establish the
presence of atopic eczema, as well as feeding history and family history
of atopic disease.
Children with family history of atopy were analysed separately from
those who developed non-eczema symptoms of atopy and from those with IgE
evidence of atopy. All other children formed a fourth sub-group.
Results: Although parental history of eczema was the strongest
predictive factor for the child developing the disease, in each of these
three groups there was an added risk for each month that the child had
been breast fed (odds ratio 1.03, 95% CI 1.002-1.06, p<0.04 in
multivariate logistic regression).
Reference: Clin Exp Allergy 2002 Feb;32(2):205-9
Study 3: Breast fed children have less atopy to 2 yrs
------------------------------------------------------------------------
----
----
A Swedish study found that breast feeding is associated with reduced
risk of a whole range of atopic manifestations in early childhood.
Subjects: 4,089 Swedish infants.
Method: Observational study. Parental questionnaire was used to assess
allergic symptoms and diagnoses at 1 and 2 years of age.
Results: Exclusive breast feeding for at least 4 months was associated
with a lower risk of a range of atopic disorders in children up to 2
years of age. See Table 2.
Table 2: Odds ratio of atopic manifestations at age up to 2 years
OR (95%CI)
----------------------------------------------------------
Asthma 0.7 (0.5 - 0.8)
Allergic rhinitis 0.7 (0.5 - 1.0)
Multiple disorders* 0.7, (0.5 - 0.9)
* three or more of: asthma, suspected allergic rhinitis, atopic
dermatitis, food allergy related symptoms, suspected allergic
respiratory symptoms after exposure to pets or pollen
Reference: Arch Dis Child 2002 Dec;87(6):478-81
COMMENTS
These are just three of the many papers published on this important and
controversial topic, many within the last year. Another recent
Australian study along similar lines found that exclusive breastfeeding
up to 4 months of age is associated with a lower risk of asthma at 6
years of age (ref 1).
The whole topic is controversial because any research which suggests a
potential disadvantage of breast feeding in the early months of life is
bound to come under close scrutiny, given the importance of breast
feeding to public health worldwide.
On the other hand, there is much interest in the possibillity of
reducing the risk of atopic disease through dietary manipulation in
early childhood (ref 2).
Frankly, anyone looking at the latest study results could be forgiven
for remaining entirely confused on the main question: is a breast fed
infant more or less likely to develop atopic disease in later childhood
and adult life?
This apparent inconsistency is partly because the researchers are
looking at different aspects of atopy in children of different ages and
using different ways of measuring those outcomes.
Another problem is that, despite the best intentions of the researchers
and their careful statistical manipulations, it is not possible to
entirely control for confounding variables. There are many factors that
could conceivably influence both the mother's likelihood of breast
feeding and the risk of her child developing atopy. For example, the
appearance of a rash in the first months of life.
Some of the work in this area has been focused more on avoidance of
foods that might be potentially allergenic in high risk infants (such as
cow's milk), rather than on breast feeding itself (ref 3).
It is not surprising therefore that there is a lack of consensus amongst
doctors and nutritionists on this issue. Some meta-analyses have been
done
- one Israeli group that has done several concluded that there is a
protective effect of around 30% from exclusive breast feeding during the
first 3 months of life against developing asthma, allergic rhinitis and
atopic eczema during childhood (ref 4,5,6).
If the opposite were true, it is not clear why breast feeding would
increase the risk of later atopy. One theory that has been proposed is
that breast fed children have less exposure to infections (which is
true) and that this lack of infections hampers the development of an
efficient immune system, compared with those who get more infections.
We do not believe that the evidence is strong enough as yet to reach a
firm conclusion one way or another. No doubt it would become clearer if
we had some results from randomised controlled intervention trials to
look at. But it will be difficult ethically to conduct such trials in
light of the clear advantages of breast feeding in so many other
respects. So this whole issue may remain uncertain for some time to
come.
References:
1. J Allergy Clin Immunol 2002 Jul;110(1):65-7
2. Med J Aust 2002 Sep 16;177 Suppl:S78-80
3. Cochrane Database Syst Rev 2002;(3):CD003795
4. Acta Paediatr. 2002;91(3):275-9.
5. J Am Acad Dermatol. 2001 Oct;45(4):520-7
6. J Pediatr. 2001 Aug;139(2):261-6.
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
