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Libuda, L.* ; Filipiak-Pittroff, B.* ; Standl, M. ; Schikowski, T.* ; von Berg, A.* ; Koletzko, S.* ; Bauer, C.P.* ; Heinrich, J.* ; Berdel, D.* ; Gappa, M.*

Full breastfeeding and allergic diseases—long-term protection or rebound effects?

Nutrients 15:15 (2023)

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A previous follow-up of the GINIplus study showed that breastfeeding could protect against early eczema. However, effects diminished in adolescence, possibly indicating a “rebound effect” in breastfed children after initial protection. We evaluated the role of early eczema until three years of age on allergies until young adulthood and assessed whether early eczema modifies the association between breastfeeding and allergies. Data from GINIplus until 20-years of age (N = 4058) were considered. Information on atopic eczema, asthma, and rhinitis was based on reported physician’s diagnoses. Adjusted Odds Ratios (aOR) were modelled by using generalized estimating equations. Early eczema was associated with eczema (aORs = 3.2–14.4), asthma (aORs = 2.2–2.7), and rhinitis (aORs = 1.2–2.7) until young adulthood. For eczema, this association decreased with age (p-for-interaction = 0.002–0.006). Longitudinal models did not show associations between breastfeeding and the respective allergies from 5 to 20 years of age. Moreover, early eczema generally did not modify the association between milk feeding and allergies except for rhinitis in participants without family history of atopy. Early eczema strongly predicts allergies until young adulthood. While preventive effects of full breastfeeding on eczema in infants with family history of atopy does not persist until young adulthood, the hypothesis of a rebound effect after initial protection cannot be confirmed.

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