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. 2021 Jul 1;114(1):134-142.
doi: 10.1093/ajcn/nqab065.

Associations of breastfeeding with childhood autoimmunity, allergies, and overweight: The Environmental Determinants of Diabetes in the Young (TEDDY) study

Sandra Hummel  1 , Andreas Weiß  1 , Ezio Bonifacio  2 , Daniel Agardh  3 , Beena Akolkar  4 , Carin A Aronsson  3 , William A Hagopian  5 , Sibylle Koletzko  6   7 , Jeffrey P Krischer  8 , Åke Lernmark  3 , Kristian Lynch  8 , Jill M Norris  9 , Marian J Rewers  10 , Jin-Xiong She  11 , Jorma Toppari  12   13 , Ulla Uusitalo  8 , Kendra Vehik  8 , Suvi M Virtanen  14   15   16   17 , Andreas Beyerlein  1 , Anette-G Ziegler  1 ; TEDDY Study Group
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Free PMC article

Associations of breastfeeding with childhood autoimmunity, allergies, and overweight: The Environmental Determinants of Diabetes in the Young (TEDDY) study

Sandra Hummel et al. Am J Clin Nutr. .
Free PMC article

Abstract

Background: Breastfeeding has beneficial effects on numerous health outcomes.

Objectives: We investigated whether breastfeeding duration is associated with the development of early childhood autoimmunity, allergies, or obesity in a multinational prospective birth cohort.

Methods: Infants with genetic susceptibility for type 1 diabetes (n = 8676) were followed for the development of autoantibodies to islet autoantigens or transglutaminase, allergies, and for anthropometric measurements to a median age of 8.3 y (IQR: 2.8-10.2 y). Information on breastfeeding was collected at 3 mo of age and prospectively thereafter. A propensity score for longer breastfeeding was calculated from the variables that were likely to influence any or exclusive breastfeeding. The risks of developing autoimmunity or allergy were assessed using Cox proportional hazards models, and the risk of obesity at 5.5 y of age was assessed using logistic regression with adjustment by the propensity score.

Results: Breastfeeding duration was not associated with a lower risk of either islet or transglutaminase autoimmunity (any breastfeeding >6 mo, adjusted HR: 1.07; 95% CI: 0.96, 1.19; exclusive breastfeeding >3 mo, adjusted HR: 1.03; 95% CI: 0.92, 1.15). Exclusive breastfeeding >3 mo was associated with a decreased risk of seasonal allergic rhinitis (adjusted HR: 0.70; 95% CI: 0.53, 0.92; P < 0.01). Any breastfeeding >6 mo and exclusive breastfeeding >3 mo were associated with decreased risk of obesity (adjusted OR: 0.62; 95% CI: 0.47, 0.81; P < 0.001; and adjusted OR: 0.68; 95% CI: 0.47, 0.95; P < 0.05, respectively).

Conclusions: Longer breastfeeding was not associated with a lower risk of childhood (islet or transglutaminase) autoimmunity in genetically at-risk children but was associated with decreased risk of seasonal allergic rhinitis and obesity at 5.5 y of age.

Keywords: allergic disease; breastfeeding; celiac disease; islet autoimmunity; obesity.

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Figures

FIGURE 1
FIGURE 1
Flowchart of the study population. *For the outcome autoimmunity, information on tTG autoantibodies was not available for 842 of 6810 children. TEDDY, The Environmental Determinants of Diabetes in the Young; tTG, tissue transglutaminase.
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