Cristian M Dogaru¹, Marie-Pierre F Strippoli², Ben D Spycher³, Urs Frey⁴, Caroline S Beardsmore⁵, Michael Silverman⁶ and Claudia E Kuehni⁷

Author Affiliations

¹ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
² Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
³ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
⁴ Department of Paediatrics, University Children's Hospital of Basel, Basel, Switzerland
⁵ Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
⁶ Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
⁷ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland

Correspondence: Claudia Kuehni, Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Rationale: The evidence for an effect of breastfeeding on lung function is conflicting, in particular whether the effect is modified by maternal asthma.

Objectives: To explore the association between breastfeeding and school-age lung function.

Methods: In the Leicestershire Cohort Studies we assessed duration of breastfeeding (not breastfed, = 3 months, 4-6 months, and > 6 months), other exposures and respiratory symptoms by repeated questionnaires. Post-bronchodilator FVC, FEV1, PEF, FEF50 and skin prick tests were measured at age 12 years. We performed multivariable linear regression and tested potential causal pathways (N=1458).

Measurements and Main Results: In the entire sample, FEF50 was higher by 130 and 164 ml in children breastfed for 4-6 and >6 months respectively, compared to those not breastfed (p=0.048 and 0.041), with larger effects if the mother had asthma. FVC and FEV1 were associated with breastfeeding only in children of asthmatic mothers (p for interaction 0.018 and 0.008): FVC was increased by 123 and 164 ml for those breastfed 4-6 or >6 months respectively (p=0.177 and 0.040) and FEV1 was increased by 148 and 167 ml respectively (p=0.050 and 0.016). Results were unchanged after adjustment for respiratory infections in infancy and asthma and atopy in the child.

Conclusions: In this cohort, breastfeeding for over 4 months was associated with increased FEF50 and, in children of asthmatic mothers, with increased FEV1 and FVC. It seems that the effect is not mediated via avoidance of early infections or atopy, but rather through a direct effect on lung growth.

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