Feather Bedding and Childhood Asthma Associated With House Dust Mite Sensitisation: A Randomised Controlled Trial

Arch Dis Child. 2011 Jun;96(6):541-7. doi: 10.1136/adc.2010.189696. Epub 2011 Mar 30.


Introduction: Observational studies report inverse associations between the use of feather upper bedding (pillow and/or quilt) and asthma symptoms but there is no randomised controlled trial (RCT) evidence assessing the role of feather upper bedding as a secondary prevention measure.

Objective: To determine whether, among children not using feather upper bedding, a new feather pillow and feather quilt reduces asthma severity among house dust mite (HDM) sensitised children with asthma over a 1-year period compared with standard dust mite avoidance advice, and giving children a new mite-occlusive mattress cover.

Design: RCT.

Setting: The Calvary Hospital in the Australian Capital Territory and the Children's Hospital at Westmead, Sydney, New South Wales.

Patients: 197 children with HDM sensitisation and moderate to severe asthma. Intervention New upper bedding duck feather pillow and quilt and a mite-occlusive mattress cover (feather) versus standard care and a mite-occlusive mattress cover (standard).

Main outcome measures: The proportion of children reporting four or more episodes of wheeze in the past year; an episode of speech-limiting wheeze; or one or more episodes of sleep disturbance caused by wheezing; and spirometry with challenge testing. Statistical analysis included multiple logistic and linear regression.

Results: No differences between groups were found for primary end points--frequent wheeze (OR 1.51, 95% CI 0.83 to 2.76, p=0.17), speech-limiting wheeze (OR 0.70, 95% CI 0.32 to 1.48, p=0.35), sleep disturbed because of wheezing (OR 1.17, 95% CI 0.64 to 2.13, p=0.61) or for any secondary end points. Secondary analyses indicated the intervention reduced the risk of sleep being disturbed because of wheezing and severe wheeze to a greater extent for children who slept supine.

Conclusion: No differences in respiratory symptoms or lung function were observed 1 year after children with moderate-severe asthma and HDM sensitisation were given a mite-occlusive mattress cover and then received either feather upper bedding (pillow and quilt) or standard bedding care.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Allergens / adverse effects
  • Animals
  • Asthma / etiology
  • Asthma / prevention & control*
  • Bedding and Linens* / adverse effects
  • Child
  • Dust / immunology
  • Feathers*
  • Female
  • Humans
  • Male
  • Posture
  • Pyroglyphidae / immunology*
  • Respiratory Sounds / etiology
  • Skin Tests / methods
  • Sleep


  • Allergens
  • Dust