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Human milk feeding and wheeze in Black infants born preterm

Abstract

Objectives

To determine the association between human milk exposure at 3 months corrected gestational age and recurrent wheeze in preterm Black infants.

Methods

This is a secondary analysis of data from the D-Wheeze trial (ClinicalTrials.gov identifier NCT01601847). Associations between human milk feeding at 3 months corrected age and wheezing outcomes were examined by generalized linear models.

Results

Exclusively human milk fed infants (n = 13) had significantly fewer wheezing episodes than formula fed infants (n = 230) (IRR (95% CI) = 0.25 (0.07, 0.89), p = 0.03). There were no hospitalizations in infants receiving exclusive human milk. Receiving any human milk was associated with decreased odds of hospitalization by 12 months corrected age (OR (95% CI) = 0.12 (0.02, 0.79), p = 0.03).

Conclusions

Exclusive human milk feeding at three months corrected gestational age is associated with decreased number of wheezing episodes in the first year of life in preterm Black infants.

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Fig. 1: Human milk feeding and recurrent wheeze.
Fig. 2: Human milk feeding and total wheezing episodes per year.

Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Been JV, Lugtenberg MJ, Smets E, van Schayck CP, Kramer BW, Mommers M, et al. Preterm birth and childhood wheezing disorders: a systematic review and meta-analysis. PLoS Med. 2014;11:e1001596.

    Article  Google Scholar 

  2. Fawke J, Lum S, Kirkby J, Hennessy E, Marlow N, Rowell V, et al. Lung function and respiratory symptoms at 11 years in children born extremely preterm: the EPICure study. Am J Respir Crit Care Med. 2010;182:237–45.

    Article  Google Scholar 

  3. Dogaru CM, Nyffenegger D, Pescatore AM, Spycher BD, Kuehni CE. Breastfeeding and childhood asthma: systematic review and meta-analysis. Am J Epidemiol. 2014;179:1153–67.

    Article  Google Scholar 

  4. Quigley MA, Carson C, Kelly Y. Breastfeeding and childhood wheeze: age-specific analyses and longitudinal wheezing phenotypes as complementary approaches to the analysis of Cohort Data. Am J Epidemiol. 2018;187:1651–61.

    Article  Google Scholar 

  5. Azad MB, Vehling L, Lu Z, Dai D, Subbarao P, Becker AB, et al. Breastfeeding, maternal asthma and wheezing in the first year of life: a longitudinal birth cohort study. Eur Respir J. 2017;49.

  6. Kotecha SJ, Watkins WJ, Lowe J, Granell R, Henderson AJ, Kotecha S. Comparison of the Associations of early-life factors on wheezing phenotypes in preterm-born children and term-born children. Am J Epidemiol. 2019;188:527–36.

    Article  Google Scholar 

  7. Meier PP, Johnson TJ, Patel AL, Rossman B. Evidence-based methods that promote human milk feeding of preterm infants: an expert review. Clin Perinatol. 2017;44:1–22.

    Article  Google Scholar 

  8. Teller IC, Embleton ND, Griffin IJ, van Elburg RM. Post-discharge formula feeding in preterm infants: a systematic review mapping evidence about the role of macronutrient enrichment. Clin Nutr Edinb Scotl. 2016;35:791–801.

    CAS  Article  Google Scholar 

  9. Hibbs AM, Babineau DC, Wang X, Redline S. Race differences in the association between multivitamin exposure and wheezing in preterm infants. J Perinatol J Calif Perinat Assoc. 2015;35:192–7.

    CAS  Google Scholar 

  10. Lee HC, Gould JB. Factors influencing breast milk versus formula feeding at discharge for very low birth weight infants in California. J Pediatr. 2009;155:657–62.

    Article  Google Scholar 

  11. Patel AL, Schoeny ME, Hoban R, Johnson TJ, Bigger H, Engstrom JL, et al. Mediators of racial and ethnic disparity in mother’s own milk feeding in very low birth weight infants. Pediatr Res. 2019;85:662–70.

    Article  Google Scholar 

  12. Hibbs AM, Ross K, Kerns LA, Wagner C, Fuloria M, Groh-Wargo S, et al. Effect of vitamin D supplementation on recurrent wheezing in Black infants who were born preterm: The D-Wheeze Randomized Clinical Trial. JAMA 2018;319:2086–94.

    CAS  Article  Google Scholar 

  13. Gardiner JC, Luo Z, Roman LA. Fixed effects, random effects and GEE: what are the differences? Stat Med. 2009;28:221–39.

    Article  Google Scholar 

  14. Hu FB, Goldberg J, Hedeker D, Flay BR, Pentz MA. Comparison of population-averaged and subject-specific approaches for analyzing repeated binary outcomes. Am J Epidemiol. 1998;147:694–703.

    CAS  Article  Google Scholar 

  15. Ballinger GA. Using Generalized Estimating Equations for Longitudinal Data Analysis. Organ Res Methods. 2004;7:127–50.

    Article  Google Scholar 

  16. Ghisletta P, Spini D. An Introduction to Generalized Estimating Equations and an Application to Assess Selectivity Effects in a Longitudinal Study on Very Old Individuals. J Educ Behav Stat. 2004;29:421–37.

    Article  Google Scholar 

  17. Chulada PC, Arbes SJ, Dunson D, Zeldin DC. Breast-feeding and the prevalence of asthma and wheeze in children: analyses from the Third National Health and Nutrition Examination Survey, 1988-1994. J Allergy Clin Immunol. 2003;111:328–36.

    Article  Google Scholar 

  18. Friedman NJ, Zeiger RS. The role of breast-feeding in the development of allergies and asthma. J Allergy Clin Immunol. 2005;115:1238–48.

    Article  Google Scholar 

  19. Oddy WH, Sly PD, de Klerk NH, Landau LI, Kendall GE, Holt PG, et al. Breast feeding and respiratory morbidity in infancy: a birth cohort study. Arch Dis Child. 2003;88:224–8.

    CAS  Article  Google Scholar 

  20. Verduci E, Banderali G, Peroni D, Lassandro C, Radaelli G. Duration of exclusive breastfeeding and wheezing in the first year of life: a longitudinal study. Allergol Immunopathol (Madr). 2017;45:316–24.

    Article  Google Scholar 

  21. Ryan RM, Feng R, Bazacliu C, Ferkol TW, Ren CL, Mariani TJ, et al. Black Race Is Associated with a Lower Risk of Bronchopulmonary Dysplasia. J Pediatr. 2019;207:130–5.

    Article  Google Scholar 

  22. Sisk PM, Lovelady CA, Dillard RG, Gruber KJ, O’Shea TM. Maternal and infant characteristics associated with human milk feeding in very low birth weight infants. J Hum Lact J Int Lact Consult Assoc. 2009;25:412–9.

    Google Scholar 

  23. Centers for Disease Control. Breastfeeding Report Card [Internet]. United States: U.S. Department of Health and Human Services; 2020. Available from: https://www.cdc.gov/breastfeeding/data/reportcard.htm

  24. Bartick MC, Jegier BJ, Green BD, Schwarz EB, Reinhold AG, Stuebe AM. Disparities in Breastfeeding: Impact on Maternal and Child Health Outcomes and Costs. J Pediatr. 2017;181:49–55.

    Article  Google Scholar 

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Acknowledgements

This research was supported by National Heart, Lung, and Blood Institute (NHLBI) and Office of Dietary Supplement of the National Institutes of Health (R01HL109293) and by the NHLBI (K24HL143291). The authors would like to thank the Rainbow Babies and Children’s Foundation Fellow Research Award Program for funding of this study.

Funding

This study was funded by the Rainbow Babies and Children’s Foundation, NHLBI and ODS (R01HL109293) and by the NHLBI (K24HL143291).

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Contributions

ACB was responsible for study design, literature review, creation of tables and figures, and drafting the original manuscript. NM provided database management and data retrieval as well as manuscript review and revisions. ZC and CT performed statistical analysis and interpretation, and contributed to manuscript writing. LF and KR assisted with study design and manuscript review and revisions. AMH assisted with study design, interpretation of results, and manuscript writing and revisions.

Corresponding author

Correspondence to Anna Crist Benson.

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Benson, A.C., Chen, Z., Minich, N.M. et al. Human milk feeding and wheeze in Black infants born preterm. J Perinatol (2022). https://doi.org/10.1038/s41372-022-01471-w

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