Interactions between breast-feeding, specific parental atopy, and sex on development of asthma and atopy

J Allergy Clin Immunol. 2007 Jun;119(6):1359-66. doi: 10.1016/j.jaci.2007.01.043. Epub 2007 Mar 13.


Background: The influence of breast-feeding on the risk of developing atopy and asthma remains controversial.

Objective: To examine asthma and atopy outcomes by sex, reported specific parental history of atopy, and breast-feeding.

Methods: In a birth cohort, we examined childhood asthma and atopy (positive skin prick tests) by sex and breast-feeding in relation to maternal and paternal atopy. Interactions were explored in logistic regression models.

Results: For boys, breast-feeding (odds ratio [OR], 1.63; 95% CI, 0.93-2.87; P = .09) and maternal atopy (OR, 1.95; 95% CI, 0.93-4.08; P = .08) were each associated with atopy at age 13 years. Breast-feeding increased the risk for atopy among boys with paternal atopy (OR, 7.39; 95% CI, 2.21-24.66) compared with non-breast-fed boys with paternal atopy, but did not significantly further increase risk among subjects with maternal atopy. For girls, breast-feeding (OR, 0.74; 95% CI, 0.41-1.31) and maternal and paternal atopy were not independent risk factors for atopy at age 13 years. However, breast-feeding increased the risk for atopy in girls with maternal atopy (OR, 3.13; 95% CI, 1.20-8.14) compared with non-breast-fed girls with maternal atopy. There was no such effect among subjects with paternal atopy. Results for the outcome of asthma followed a similar pattern.

Conclusion: The influence of breast-feeding on development of atopy and asthma differs by sex and by maternal and paternal atopy, and is most significant among subjects at lower baseline risk.

Clinical implications: Analyses of environmental risk factors for asthma and atopy should be stratified by specific parental atopy and sex.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Asthma / epidemiology
  • Asthma / etiology*
  • Breast Feeding*
  • Bronchial Hyperreactivity / epidemiology
  • Bronchial Hyperreactivity / etiology
  • Child
  • Female
  • Humans
  • Hypersensitivity, Immediate / epidemiology
  • Hypersensitivity, Immediate / etiology*
  • Logistic Models
  • Male
  • New Zealand
  • Parents*
  • Prospective Studies
  • Risk Factors
  • Sex Factors