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Copyright (c) 2022 Claudia Paola Acevedo Villafañe
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Influence of breastfeeding in the development of allergic rhinitis in children
Corresponding Author(s) : Claudia Paola Acevedo Villafañe
Ciencia e Innovación en Salud,
2022
Abstract
Introduction: There is controversy about the duration of exclusive breastfeeding and the prevention of rhinitis, so the study aimed to assess the role of exclusive breastfeeding in developing chronic allergic rhinitis in children.
Materials and Methods: This is a case-control study with 500 children (18 months to 7 years), 250 children with allergic rhinitis and 250 controls without rhinitis. All patients received informed consent and a survey of parents or caregivers on the history of exclusive breastfeeding, initiation of complementary feeding, sociodemographic characteristics, family history of allergic diseases, and personal exposure to various allergens in the first year of life.
Results: The proportion of patients with allergic rhinitis who received exclusive breastfeeding is lower than that of controls (32.0% vs. 24.4%, p = 0.059). The median time of breastfeeding in patients with rhinitis was 12 (IQR 6 to 22) months and 16 (IQR 8 to 24) months in controls (p = 0.026). Exclusive breastfeeding for six months or more is a protective factor for allergic rhinitis.
Conclusions: Exclusive breastfeeding for more than six months is a protective factor for allergic rhinitis development in children. The risk of allergic rhinitis was lower in children with prolonged breastfeeding (>6 months)
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- Langley-Evans SC. Nutrition in early life and the programming of adult disease: A review. Vol. 28, J Hum Nutr Diet. 2015. p. 1–14. Doi: 10.1111/jhn.12212
- Moreno JM. Los mil primeros días de vida y la prevención de la enfermedad en el adulto. Nutr Hosp. 2016;33 (Suppl 4):8–11. Doi: 10.20960/nh.337
- Koletzko B, Godfrey KM, Poston L, Szajewska H, van Goudoever JB, de Waard M, et al. Nutrition During Pregnancy, Lactation and Early Childhood and its Implications for Maternal and Long-Term Child Health: The Early Nutrition Project Recommendations. Ann Nutr Metab. 2019;74(2):93–106. Doi: 10.1159/000496471
- Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016 Jan;387(10017):475–90. Doi: 10.1016/s0140-6736(15)01024-7
- Section on Breastfeeding. Breastfeeding and the Use of Human Milk. Pediatrics. 2012 Mar 1;129(3): e827-41. Doi: 10.1542/peds.2011-3552
- Amarasekera M, Prescott SL, Palmer DJ. Nutrition in early life, immune-programming and allergies: The role of Epigenetics, Asian Pac J Allergy Immunol. 2013; Vol. 31 p. 175–82. https://pubmed.ncbi.nlm.nih.gov/24053699/
- Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines—2016 revision. J Allergy Clin Immunol. 2017 oct;140(4):950–8. Doi: 10.1016/j.jaci.2017.03.050
- Greiner AN. Allergic Rhinitis: Impact of the Disease and Considerations for Management. Med Clin North Am. 2006 Jan;90(1):17–38. Doi: 10.1016/j.mcna.2005.08.011
- Dennis RJ, Caraballo L, García E, Rojas MX, Rondon MA, Pérez A, et al. Prevalence of asthma and other allergic conditions in Colombia 2009–2010: a cross-sectional study. BMC Pulm Med. 2012 Dec 2;12(1):12–7. Doi: 10.1186/1471-2466-12-17
- Acevedo Villafañe C, Latorre Latorre F, Cifuentes Cifuentes L, Díaz-Martínez LA, Garza Acosta O. Influencia de la lactancia materna y la alimentación en el desarrollo de alergias en los niños. Aten Primaria. 2009 Dec;41(12):675–80. Doi: 10.1016/j.aprim.2009.04.005
- di Mauro G, Bernardini R, Barberi S, Capuano A, Correra A, de’ Angelis GL, et al. Prevention of food and airway allergy: consensus of the Italian Society of Preventive and Social Paediatrics, the Italian Society of Paediatric Allergy and Immunology, and Italian Society of Pediatrics. World Allergy Organ J. 2016;9:1–28. Doi: 10.1186/s40413-016-0111-6
- Zou Q-Y, Shen Y, Ke X, Hong S-L, Kang H-Y. Exposure to air pollution and risk of prevalence of childhood allergic rhinitis: A meta-analysis. Int J Pediatr Otorhinolaryngology. 2018 Sep;112:82–90. Doi: 10.1016/j.ijporl.2018.06.039
- Otsuka H, Otsuka K, Matsune S, Okubo K. Assessing the Onset of Allergic Rhinitis by Nasal Cytology and Immunoglobulin E Antibody Levels in Children. Am J Rhinol Allergy. 2018 Jan 1;32(1):16–22. Doi: 10.2500/ajra.2018.32.4503
- Greiner AN, Hellings PW, Rotiroti G, Scadding GK. Allergic rhinitis. Lancet. 2011 Dec;378(9809):2112–22. Doi: 10.1016/s0140-6736(11)60130-x
- Testa D, di Bari M, Nunziata M, Cristofaro G de, Massaro G, Marcuccio G, et al. Allergic rhinitis and asthma assessment of risk factors in pediatric patients: A systematic review. Intl J Pediatr Otorhinolaryngology. 2020;129:undefined-109759. Doi: 10.1016/j.ijporl.2019.109759
- Boguniewicz M. Allergic disorders. In: Hay W LM, Sondheimer J, Deterding R, editors. Current Pediatric Diagnosis & Treatment. 17th Edition. Denver: McGraw-Hill; 2005. p. 1080–109.
- Egea Bermejo E, Reyes AJ, García Gómez E, et al. Consenso Colombiano sobre rinitis alérgica. . Bogotá: Ediciones Médicas Latinoamericanas; 2000. 7–32.
- Organization WH. Indicators for assessing infant and young child feeding practices: part 1: definitions: conclusions of a consensus meeting held 6-8 November 2007 in Washington D.C., USA [Internet]. Geneva: World Health Organization; 2008. Available from: https://apps.who.int/iris/handle/10665/43895
- Organization WH, (UNICEF) UNCF. Estrategia Mundial para la Alimentación del Lactante y del Niño Pequeño [Internet]. WHA55 A55/15, párrafo 10. Ginebra: Organización Mundial de la Salud; 2003. Available from: https://apps.who.in t/iris/handle/10665/42695
- Ministerio de la Protección Social Profamilia. Encuesta Nacional de Demografia y Salud – ENDS 2010. Capítulo XI - Lactancia Materna y Estado Nutricional. [Internet]. 2010 [cited 2021 Nov 1]. p. 269–83. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/Base%20de%20datos%20ENDS%202010%20informe.pdf
- Rojas Montenegro C. Alimentación complementaria. In: Guerrero R, editor. 1ra ed. Bogotá: Editorial Panamericana; 1999. p. 74–8.
- Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*. Allergy. 2008 Apr;63(Suppl 86):8–160. https://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2007.01620.x
- Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J. The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies. Allergy. 2002 Feb;57(2):107–14. Doi: 10.1034/j.1398-9995.2002.1o3170.x
- Greenland S. Modeling and variable selection in epidemiologic analysis. Am J Public Health. 1989 Mar;79(3):340–9. Doi: 10.2105/ajph.79.3.340
- Shanahan F, van Sinderen D, O’Toole PW, Stanton C. Feeding the microbiota: transducer of nutrient signals for the host. Gut. 2017 Sep;66(9):1709–17. Doi: 10.1136/gutjnl-2017-313872
- Instituto Colombiano de Bienestar Familiar (ICBF) M de S y PSIN de S (INS), DA para la PS y la UN de Colombia. ENSIN: Encuesta Nacional de Situación Nutricional | Portal ICBF - Instituto Colombiano de Bienestar Familiar ICBF [Internet]. Primera infancia 0 a 4 años: Lactancia Materna Exclusiva en menores de 6 meses de edad. . 2015 [cited 2021 Nov 1]. Available from: https://www.icbf.gov.co/bienestar/nutricion/encuesta-nacional-situacion-nutricional#ensin3
- du Toit G, Lack G. Can Food Allergy Be Prevented? The Current Evidence. Pediatric Clinics of North America. 2011 Apr;58(2):481–509. Doi: 10.1016/j.pcl.2011.02.002
- Bion V, Lockett GA, Soto-Ramírez N, Zhang H, Venter C, Karmaus W, et al. Evaluating the efficacy of breastfeeding guidelines on long-term outcomes for allergic disease. Allergy. 2016 May;71(5):661–70. Doi: 10.1111/all.12833
- Codispoti CD, Levin L, LeMasters GK, Ryan P, Reponen T, Villareal M, et al. Breast-feeding, aeroallergen sensitization, and environmental exposures during infancy are determinants of childhood allergic rhinitis. J Allergy Clin Immunol. 2010 May;125(5):1054–60. Doi: 10.1016/j.jaci.2010.02.004
- Fleischer DM, Spergel JM, Assa’ad AH, Pongracic JA. Primary Prevention of Allergic Disease Through Nutritional Interventions. J Allergy Clin Immunol Pract. 2013 Jan;1(1):29–36. Doi: 10.1016/j.jaip.2012.09.003
- Güngör D, Nadaud P, LaPergola CC, Dreibelbis C, Wong YP, Terry N, et al. Infant milk-feeding practices and food allergies, allergic rhinitis, atopic dermatitis, and asthma throughout the life span: a systematic review. Am J Clin Nutr. 2019 Mar 1;109(Supplement_7):772S-799S. Doi: 10.1093/ajcn/nqy283
- Alduraywish SA, Lodge CJ, Campbell B, Allen KJ, Erbas B, Lowe AJ, et al. The march from early life food sensitization to allergic disease: a systematic review and meta-analyses of birth cohort studies. Allergy. 2016 Jan;71(1):77–89. Doi: 10.1111/all.12784
- Ehlayel MS, Bener A. Duration of breast-feeding and the risk of childhood allergic diseases in a developing country. Allergy Asthma Proc. 2008 Jul 1;29(4):386–91. Doi:10.2500/aap.2008.29.3138
- Lodge C, Tan D, Lau M, Dai X, Tham R, Lowe A, et al. Breastfeeding and asthma and allergies: a systematic review and meta-analysis. Acta Paediatri. 2015 Dec; 104:38–53. Doi: 10.1111/apa.13132
- Waidyatillake NT, Stoney R, Thien F, Lodge CJ, Simpson JA, Allen KJ, et al. Breast milk polyunsaturated fatty acids: associations with adolescent allergic disease and lung function. Allergy. 2017 Aug;72(8):1193–1201.Doi: 10.1111/all.13114
- Jelding-Dannemand E, Malby Schoos A-M, Bisgaard H. Breast-feeding does not protect against allergic sensitization in early childhood and allergy-associated disease at age 7 years. J Allergy Clin Immunol. 2015 Nov;136(5):1302-8. e-1–13. Doi: 10.1016/j.jaci.2015.02.023
- Halken S. Prevention of allergic disease in childhood: clinical and epidemiological aspects of primary and secondary allergy prevention. Pediatric Allergy Immunol. 2004 Jun;15(Suppl 16):4–32. Doi: 10.1111/j.1399-3038.2004.0148b.x
- Saarinen UM, Kajosaari M. Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet. 1995 Oct;346(8982):1065-69. Doi:10.1016/s0140-6736(95)91742-x
- Oddy WH, Peat JK. Breastfeeding, Asthma, and Atopic Disease: An Epidemiological Review of the Literature. J Hum Lact. 2003 Aug 25;19(3):250–61. Doi: 10.1177/0890334403255516
- Liccardi G, Salzillo A, Calzetta L, Piccolo A, Menna G, Rogliani P. Can the presence of cat/dog at home be considered the only criterion of exposure to cat/dog allergens? A likely underestimated bias in clinical practice and in large epidemiological studies. Eur Ann Allergy Clin Immunol. 2016;48(2):61–4. https://pubmed.ncbi.nlm.nih.gov/26934742/
References
Langley-Evans SC. Nutrition in early life and the programming of adult disease: A review. Vol. 28, J Hum Nutr Diet. 2015. p. 1–14. Doi: 10.1111/jhn.12212
Moreno JM. Los mil primeros días de vida y la prevención de la enfermedad en el adulto. Nutr Hosp. 2016;33 (Suppl 4):8–11. Doi: 10.20960/nh.337
Koletzko B, Godfrey KM, Poston L, Szajewska H, van Goudoever JB, de Waard M, et al. Nutrition During Pregnancy, Lactation and Early Childhood and its Implications for Maternal and Long-Term Child Health: The Early Nutrition Project Recommendations. Ann Nutr Metab. 2019;74(2):93–106. Doi: 10.1159/000496471
Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016 Jan;387(10017):475–90. Doi: 10.1016/s0140-6736(15)01024-7
Section on Breastfeeding. Breastfeeding and the Use of Human Milk. Pediatrics. 2012 Mar 1;129(3): e827-41. Doi: 10.1542/peds.2011-3552
Amarasekera M, Prescott SL, Palmer DJ. Nutrition in early life, immune-programming and allergies: The role of Epigenetics, Asian Pac J Allergy Immunol. 2013; Vol. 31 p. 175–82. https://pubmed.ncbi.nlm.nih.gov/24053699/
Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines—2016 revision. J Allergy Clin Immunol. 2017 oct;140(4):950–8. Doi: 10.1016/j.jaci.2017.03.050
Greiner AN. Allergic Rhinitis: Impact of the Disease and Considerations for Management. Med Clin North Am. 2006 Jan;90(1):17–38. Doi: 10.1016/j.mcna.2005.08.011
Dennis RJ, Caraballo L, García E, Rojas MX, Rondon MA, Pérez A, et al. Prevalence of asthma and other allergic conditions in Colombia 2009–2010: a cross-sectional study. BMC Pulm Med. 2012 Dec 2;12(1):12–7. Doi: 10.1186/1471-2466-12-17
Acevedo Villafañe C, Latorre Latorre F, Cifuentes Cifuentes L, Díaz-Martínez LA, Garza Acosta O. Influencia de la lactancia materna y la alimentación en el desarrollo de alergias en los niños. Aten Primaria. 2009 Dec;41(12):675–80. Doi: 10.1016/j.aprim.2009.04.005
di Mauro G, Bernardini R, Barberi S, Capuano A, Correra A, de’ Angelis GL, et al. Prevention of food and airway allergy: consensus of the Italian Society of Preventive and Social Paediatrics, the Italian Society of Paediatric Allergy and Immunology, and Italian Society of Pediatrics. World Allergy Organ J. 2016;9:1–28. Doi: 10.1186/s40413-016-0111-6
Zou Q-Y, Shen Y, Ke X, Hong S-L, Kang H-Y. Exposure to air pollution and risk of prevalence of childhood allergic rhinitis: A meta-analysis. Int J Pediatr Otorhinolaryngology. 2018 Sep;112:82–90. Doi: 10.1016/j.ijporl.2018.06.039
Otsuka H, Otsuka K, Matsune S, Okubo K. Assessing the Onset of Allergic Rhinitis by Nasal Cytology and Immunoglobulin E Antibody Levels in Children. Am J Rhinol Allergy. 2018 Jan 1;32(1):16–22. Doi: 10.2500/ajra.2018.32.4503
Greiner AN, Hellings PW, Rotiroti G, Scadding GK. Allergic rhinitis. Lancet. 2011 Dec;378(9809):2112–22. Doi: 10.1016/s0140-6736(11)60130-x
Testa D, di Bari M, Nunziata M, Cristofaro G de, Massaro G, Marcuccio G, et al. Allergic rhinitis and asthma assessment of risk factors in pediatric patients: A systematic review. Intl J Pediatr Otorhinolaryngology. 2020;129:undefined-109759. Doi: 10.1016/j.ijporl.2019.109759
Boguniewicz M. Allergic disorders. In: Hay W LM, Sondheimer J, Deterding R, editors. Current Pediatric Diagnosis & Treatment. 17th Edition. Denver: McGraw-Hill; 2005. p. 1080–109.
Egea Bermejo E, Reyes AJ, García Gómez E, et al. Consenso Colombiano sobre rinitis alérgica. . Bogotá: Ediciones Médicas Latinoamericanas; 2000. 7–32.
Organization WH. Indicators for assessing infant and young child feeding practices: part 1: definitions: conclusions of a consensus meeting held 6-8 November 2007 in Washington D.C., USA [Internet]. Geneva: World Health Organization; 2008. Available from: https://apps.who.int/iris/handle/10665/43895
Organization WH, (UNICEF) UNCF. Estrategia Mundial para la Alimentación del Lactante y del Niño Pequeño [Internet]. WHA55 A55/15, párrafo 10. Ginebra: Organización Mundial de la Salud; 2003. Available from: https://apps.who.in t/iris/handle/10665/42695
Ministerio de la Protección Social Profamilia. Encuesta Nacional de Demografia y Salud – ENDS 2010. Capítulo XI - Lactancia Materna y Estado Nutricional. [Internet]. 2010 [cited 2021 Nov 1]. p. 269–83. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/Base%20de%20datos%20ENDS%202010%20informe.pdf
Rojas Montenegro C. Alimentación complementaria. In: Guerrero R, editor. 1ra ed. Bogotá: Editorial Panamericana; 1999. p. 74–8.
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*. Allergy. 2008 Apr;63(Suppl 86):8–160. https://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2007.01620.x
Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J. The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies. Allergy. 2002 Feb;57(2):107–14. Doi: 10.1034/j.1398-9995.2002.1o3170.x
Greenland S. Modeling and variable selection in epidemiologic analysis. Am J Public Health. 1989 Mar;79(3):340–9. Doi: 10.2105/ajph.79.3.340
Shanahan F, van Sinderen D, O’Toole PW, Stanton C. Feeding the microbiota: transducer of nutrient signals for the host. Gut. 2017 Sep;66(9):1709–17. Doi: 10.1136/gutjnl-2017-313872
Instituto Colombiano de Bienestar Familiar (ICBF) M de S y PSIN de S (INS), DA para la PS y la UN de Colombia. ENSIN: Encuesta Nacional de Situación Nutricional | Portal ICBF - Instituto Colombiano de Bienestar Familiar ICBF [Internet]. Primera infancia 0 a 4 años: Lactancia Materna Exclusiva en menores de 6 meses de edad. . 2015 [cited 2021 Nov 1]. Available from: https://www.icbf.gov.co/bienestar/nutricion/encuesta-nacional-situacion-nutricional#ensin3
du Toit G, Lack G. Can Food Allergy Be Prevented? The Current Evidence. Pediatric Clinics of North America. 2011 Apr;58(2):481–509. Doi: 10.1016/j.pcl.2011.02.002
Bion V, Lockett GA, Soto-Ramírez N, Zhang H, Venter C, Karmaus W, et al. Evaluating the efficacy of breastfeeding guidelines on long-term outcomes for allergic disease. Allergy. 2016 May;71(5):661–70. Doi: 10.1111/all.12833
Codispoti CD, Levin L, LeMasters GK, Ryan P, Reponen T, Villareal M, et al. Breast-feeding, aeroallergen sensitization, and environmental exposures during infancy are determinants of childhood allergic rhinitis. J Allergy Clin Immunol. 2010 May;125(5):1054–60. Doi: 10.1016/j.jaci.2010.02.004
Fleischer DM, Spergel JM, Assa’ad AH, Pongracic JA. Primary Prevention of Allergic Disease Through Nutritional Interventions. J Allergy Clin Immunol Pract. 2013 Jan;1(1):29–36. Doi: 10.1016/j.jaip.2012.09.003
Güngör D, Nadaud P, LaPergola CC, Dreibelbis C, Wong YP, Terry N, et al. Infant milk-feeding practices and food allergies, allergic rhinitis, atopic dermatitis, and asthma throughout the life span: a systematic review. Am J Clin Nutr. 2019 Mar 1;109(Supplement_7):772S-799S. Doi: 10.1093/ajcn/nqy283
Alduraywish SA, Lodge CJ, Campbell B, Allen KJ, Erbas B, Lowe AJ, et al. The march from early life food sensitization to allergic disease: a systematic review and meta-analyses of birth cohort studies. Allergy. 2016 Jan;71(1):77–89. Doi: 10.1111/all.12784
Ehlayel MS, Bener A. Duration of breast-feeding and the risk of childhood allergic diseases in a developing country. Allergy Asthma Proc. 2008 Jul 1;29(4):386–91. Doi:10.2500/aap.2008.29.3138
Lodge C, Tan D, Lau M, Dai X, Tham R, Lowe A, et al. Breastfeeding and asthma and allergies: a systematic review and meta-analysis. Acta Paediatri. 2015 Dec; 104:38–53. Doi: 10.1111/apa.13132
Waidyatillake NT, Stoney R, Thien F, Lodge CJ, Simpson JA, Allen KJ, et al. Breast milk polyunsaturated fatty acids: associations with adolescent allergic disease and lung function. Allergy. 2017 Aug;72(8):1193–1201.Doi: 10.1111/all.13114
Jelding-Dannemand E, Malby Schoos A-M, Bisgaard H. Breast-feeding does not protect against allergic sensitization in early childhood and allergy-associated disease at age 7 years. J Allergy Clin Immunol. 2015 Nov;136(5):1302-8. e-1–13. Doi: 10.1016/j.jaci.2015.02.023
Halken S. Prevention of allergic disease in childhood: clinical and epidemiological aspects of primary and secondary allergy prevention. Pediatric Allergy Immunol. 2004 Jun;15(Suppl 16):4–32. Doi: 10.1111/j.1399-3038.2004.0148b.x
Saarinen UM, Kajosaari M. Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet. 1995 Oct;346(8982):1065-69. Doi:10.1016/s0140-6736(95)91742-x
Oddy WH, Peat JK. Breastfeeding, Asthma, and Atopic Disease: An Epidemiological Review of the Literature. J Hum Lact. 2003 Aug 25;19(3):250–61. Doi: 10.1177/0890334403255516
Liccardi G, Salzillo A, Calzetta L, Piccolo A, Menna G, Rogliani P. Can the presence of cat/dog at home be considered the only criterion of exposure to cat/dog allergens? A likely underestimated bias in clinical practice and in large epidemiological studies. Eur Ann Allergy Clin Immunol. 2016;48(2):61–4. https://pubmed.ncbi.nlm.nih.gov/26934742/