Association between breast feeding and asthma in 6 year old children: findings of a prospective birth cohort study

Oddy, W.H., Holt, P.G., Sly, P.D., Read, A.W., Landau, L.I., Stanley, F.J., Kendall, G.E. and Burton, P.R. (1999) Association between breast feeding and asthma in 6 year old children: findings of a prospective birth cohort study. BMJ, 319 7213: 815-819. doi:10.1136/bmj.319.7213.815

Author Oddy, W.H.
Holt, P.G.
Sly, P.D.
Read, A.W.
Landau, L.I.
Stanley, F.J.
Kendall, G.E.
Burton, P.R.
Title Association between breast feeding and asthma in 6 year old children: findings of a prospective birth cohort study
Journal name BMJ   Check publisher's open access policy
ISSN 0959-8138
Publication date 1999-09-01
Year available 1999
Sub-type Article (original research)
DOI 10.1136/bmj.319.7213.815
Open Access Status DOI
Volume 319
Issue 7213
Start page 815
End page 819
Total pages 5
Place of publication London, United Kingdom
Publisher B M J Group
Language eng
Abstract Cross sectional studies suggest a link may exist between tooth emergence and obesity. To explore this relationship, we aimed to evaluate the prospective associations between primary tooth emergence and anthropometric measures in young adults. Multivariable linear regression was used to analyse relationships between primary tooth emergence, and anthropometric measures measured at 17.8 years, in 2977 participants (1362 males and 1615 females) from the Avon Longitudinal Study of Parents and Children (ALSPAC). In minimally adjusted models, 'quintiles of number of paired teeth' (assessed by questionnaire at 15 months) was positively associated with height [change in height (cm) per quintile increase in 'number of paired teeth' (β) = 0.35 (95%CI: 0.18, 0.52) P = 0.0001] and weight [ratio of geometric mean weight per quintile increase in 'number of paired teeth' (RGM) = 1.015 (95%CI: 1.010, 1.019) P<0.0001]. The relationship with weight was largely driven by fat mass, which showed an equivalent relationship with 'quintiles of number of paired teeth' to that seen for weight [RGM = 1.036 (95%CI: 1.022, 1.051) P<0.0001] (adjusted for height)]. Conversely, no association was seen between 'quintiles of number of paired teeth' and lean mass. An increase in 'quintiles of number of paired teeth' at age 15 months was associated with a higher Tanner stage at age 13 in girls but not boys, but further adjustment of associations between 'quintiles of number of paired teeth' and anthropometric traits for Tanner stage was without effect. Primary tooth emergence is associated with subsequent fat mass, suggesting these could share common constitutive factors, and that early primary tooth emergence may represent a hitherto unrecognised risk factor for the development of obesity in later life.
Formatted abstract
To investigate the association between the duration of exclusive breast feeding and the development of asthma related outcomes in children at age 6 years.

Prospective cohort study.

Western Australia.


2187 children ascertained through antenatal clinics at the major tertiary obstetric hospital in Perth and followed to age 6 years.

Main outcome measures.
Unconditional logistic regression to model the association between duration of exclusive breast feeding and outcomes related to asthma or atopy at 6 years of age, allowing for several important confounders: sex, gestational age, smoking in the household, and early childcare.

After adjustment for confounders, the introduction of milk other than breast milk before 4 months of age was a significant risk factor for all asthma and atopy related outcomes in children aged 6 years: asthma diagnosed by a doctor (odds ratio 1.25, 95% confidence interval 1.02 to i.52); wheeze three or more times since 1 year of age (1.41, 1.14 to 1.76); wheeze in the past year (1.31, 1.05 to 1.64); sleep disturbancc due to wheeze within the past year (1.42, 1.07 to 1.89); age when doctor diagnosed asthma (hazard ratio 1.22 1.03 to 1.43); age at first wheeze (1.36, 1.17 to 1.59); and positive skin prick test reaction to at least one common aeroallergen (1.30, 1.04 to 1.61).

A significant reduction in the risk of childhood asthma at age 6 years occurs if exclusive breast feeding is continued for at least the 4 months after birth. These findings are important for our understanding of the cause of childhood asthma and suggest that public health interventions to optimise breast feeding may help to reduce the community burden of childhood asthma and its associated traits.
Keyword ProspectiveE follow-up
Atopic disease
Human milk
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 092731
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 332 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 378 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Wed, 17 Nov 2010, 21:40:36 EST