A breastfeeding promotion intervention may reduce infants’ risk for flexural eczema during their adolescent years, according to a recent study.
Atopic diseases such as atopic eczema, asthma, and low lung function are among the most common chronic conditions in children. However, it is not currently known whether a prolonged breastfeeding intervention influences the risk for these conditions later in life.
To explore this further, Carsten Flohr, FRCP, PhD, of King’s College London, and colleagues conducted a follow-up study of the Promotion of Breastfeeding Intervention Trial (PROBIT), which recruited 17,046 healthy term infants from June 16, 1996 to December 31, 1997. Patients were placed in either the intervention group or the control group.
A data analysis was performed from May 9, 2016 to April 21, 2017, and the modified intention-to-treat analysis served as the primary analytic approach. The primary outcomes included spirometry and flexural eczema based on standardized skin examination by study pediatricians, and secondary outcomes included symptoms of flexural eczema within the last year.
Of 17,046 participants, 13,557 (79.5%) were followed up from September 15, 2012 to July 15, 2015. Mean participant age at follow-up was 16.2 years in the intervention group (n = 7064) and 16.1 years in the control group (n = 6493). Results indicated that 21 (0.3%) patients in the intervention group had flexural eczema upon skin examination, compared with 43 (0.7%) patients in the control group.
Findings from the modified intention-to-treat analysis demonstrated that the risk for flexural eczema upon skin examination was 54% lower in the intervention group vs the control group. Furthermore, the rate of self-reported flexural eczema symptoms within the last year was lower in the intervention group vs the control group. However, the researchers noted that 95% confidence intervals were wide and included the null.
All results remained similar following additional adjustment for baseline characteristics, on instrumental variable analysis, and following multiple imputation in all 17,046 participants.
“A breastfeeding promotion intervention reduced flexural dermatitis risk but had no detectable effect on lung function or questionnaire-derived measures of atopic eczema or asthma in adolescence in a setting where atopic eczema and allergies are rare,” the researchers concluded.
—Christina Vogt
Reference:
Flohr C, Henderson AJ, Kramer MS, et al. Effect of an intervention to promote breastfeeding on asthma, lung function, and atopic eczema at age 16 years: follow-up of the PROBIT randomized trial [Published online November 13, 2017]. JAMA Pediatr. doi:10.1001/jamapediatrics.2017.4064.
