Infant feeding patterns and eczema in children in the first 6 years of life

Background: Modes of infant feeding such as direct and indirect breastfeeding, and formula feeding, and their combinations may play a role in child health. Objective: The aim was to investigate which feeding patterns in the first 6 months pose risks of eczema/skin allergy in children up to 6 years compared to direct breastfeeding for at least 3 months. Methods: The Infant Feeding Practices Study II in the United States and its 6-year follow-up provided data on feeding modes in infancy and doctor\u27s diagnosed eczema/skin allergy in the first 6 years of life (1387 infants), based on parental reports. Different feeding patterns were identified. Log-linear models were used to estimate prevalence ratios (PRs) of feeding patterns for doctor\u27s diagnosed eczema/skin allergy in the first 6 years of life, adjusting for confounders. Results: Compared to “direct breastfeeding for at least 3 months” (DBF3m), the combination of “direct feeding at the breast (DBF), pumping and feeding breast milk (BM), and formula (FF) in the first months” (DBF/BM/FF) showed a statistically significant higher risk of eczema/skin allergy in the first 6 years of life (PR = 1.46), adjusting for confounders. DBF combined with BM for the first 3 months followed by mixed feeding also had an increased risk (PR = 1.26), although not statistically significant. Formula feeding introduced since birth had no effect on eczema. Among the confounders, paternal eczema and race/ethnicity (Hispanic vs White) were associated with a higher risk of eczema/skin allergy. Conclusions & Clinical Relevance: Mixed infant feeding may carry a higher risk of eczema/skin allergy compared to direct feeding at the breast. The recent epidemic of pumping and feeding in the United States and the use of mixed infant feeding modes requires additional studies to provide appropriate and renewed assessments of the risks of feeding modes for the future development of allergies