Wasilewska E, Małgorzewicz S, Szczepankiewicz A, Myśliwczyk D, Hennig M, Jassem E, Skotnicka M
Department of Pulmonology and Allergology, Medical University of Gdansk, Gdansk, Poland.
Eur Rev Med Pharmacol Sci. 2022 Mar;26(5):1658-1667. doi: 10.26355/eurrev_202203_28234.
Although breastfeeding has been suggested as a candidate for the prevention of obesity and allergies, recent studies have reported mixed results. The aim of the study was (1) to assess breastfeeding length in obese children or children with allergic diseases compared to healthy children; (2) to evaluate the impact of the duration of breastfeeding on the incidence of obesity, allergy rhinitis and asthma.
408 children were evaluated (mean age 11.9±3.7 years; M/F 220/188) and divided into three groups (Obesity, n=103; Allergy, n=163; and Healthy, n=142). Breastfeeding history was collected during an interview. Physical examination, anthropometry, allergy (skin prick test with aeroallergens; Allergopharma) and a spirometry (Jaeger) assessment were performed in each participant.
Most of the children (75%) were breastfed with a mean duration of 7.5 months (range 0-36; SD=7.9 months). The time of breastfeeding was longer in the healthy compared to the obese and allergic groups (p=0.003) and was correlated with BMI centile in all groups of subjects (R Spearman = -0.2, p<0.05). There was a higher number of subjects with hypersensitivity to the allergen of house dust mites and animals in the non-breastfed compared to the breastfed children (p<0.003, p<0.000, respectively). Non-breastfed children compared to the breastfed presented more often asthma (chi2=3.6 df=1 p=0.05), but not allergic rhinitis (chi2=9.0 df=1 p=0.002). Non-breastfed asthmatics, compared to the breastfed asthmatics, presented a significantly higher severity of asthma (OR=0.43; p=0.008). In multivariate regression models, a short breastfeeding time was associated with a higher risk of both obesity and asthma.
School-age children with obesity and asthma were breastfed less often and for a shorter duration than their healthy peers. Longer breastfeeding may result in a reduced number of children with obesity, asthma, and allergy to house dust mites, but further investigation is needed on a larger population of school-age children.
尽管母乳喂养被认为是预防肥胖和过敏的一个因素，但近期研究报告的结果不一。本研究的目的是：（1）评估肥胖儿童或患有过敏性疾病的儿童与健康儿童相比的母乳喂养时长；（2）评估母乳喂养持续时间对肥胖、过敏性鼻炎和哮喘发病率的影响。
对408名儿童进行了评估（平均年龄11.9±3.7岁；男/女为220/188），并将其分为三组（肥胖组，n = 103；过敏组，n = 163；健康组，n = 142）。在访谈过程中收集母乳喂养史。对每位参与者进行体格检查、人体测量、过敏检测（使用气传变应原进行皮肤点刺试验；Allergopharma）和肺功能测定（Jaeger）评估。
大多数儿童（75%）接受过母乳喂养，平均时长为7.5个月（范围0 - 36个月；标准差 = 7.9个月）。与肥胖组和过敏组相比，健康组的母乳喂养时间更长（p = 0.003），且在所有受试组中，母乳喂养时间与BMI百分位数相关（斯皮尔曼相关系数R = -0.2，p < 0.05）。与母乳喂养儿童相比，非母乳喂养儿童对屋尘螨和动物变应原过敏的人数更多（分别为p < 0.003，p < 0.000）。与母乳喂养儿童相比，非母乳喂养儿童哮喘的发生率更高（卡方检验χ2 = 3.6，自由度df = 1，p = 0.05），但过敏性鼻炎的发生率并非如此（卡方检验χ2 = 9.0，自由度df = 1，p = 0.002）。与母乳喂养的哮喘患儿相比，非母乳喂养的哮喘患儿哮喘严重程度明显更高（比值比OR = 0.43；p = 0.008）。在多因素回归模型中，母乳喂养时间短与肥胖和哮喘的较高风险相关。
肥胖和哮喘的学龄儿童母乳喂养的频率低于健康同龄人，且母乳喂养持续时间更短。更长时间的母乳喂养可能会减少肥胖、哮喘以及对屋尘螨过敏的儿童数量，但需要对更多的学龄儿童进行进一步研究。
