A new study, which is published today in the Journal of the American Medical Association (JAMA) Pediatrics, and was led by researchers from King’s College London, Harvard University, University of Bristol and McGill University, examined more than 13,000 Belarussian teenagers enrolled in the PROmotion of Breastfeeding Intervention Trial (PROBIT) and found a 54% reduction in cases of eczema amongst teenagers whose mothers had received support to breastfeed exclusively.
Eczema causes the skin to become itchy, dry, cracked, sore and red. It affects around one in 5 children and one in 10 adults in the developed world.
The paper’s lead author, Dr Carsten Flohr, King’s College London, whose work is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ and King’s College London, said: “The WHO recommends between four and six months of exclusive breastfeeding to aid prevention of allergy and associated illnesses. Our findings add further weight to the importance of campaigns like the Baby-Friendly Hospital Initiative (BFHI), which is tackling low rates of breastfeeding globally.”
The PROBIT study recruited a total of 17,046 mothers and their new-born babies between June 1996 and December 1997. Half of the maternity hospitals and paediatric clinics involved in the study provided additional support modelled on the recommendations of the WHO and United Nations Children's Fund’s BFHI, while the other half continued their usual practices.
"PROBIT, the largest randomized trial ever carried out in the area of human lactation, continues to yield scientifically and clinically important information more than two decades after its inception," says Dr. Michael Kramer, from McGill’s Faculty of Medicine and the Research Institute of the McGill University Health Centre (RI-MUHC), the Principal Investigator on the PROBIT study.
The UK has one of the lowest rates of breastfeeding in the world. Only one in three (34%) UK-born babies have received any breast milk, compared with 49% in the United States and 71% in Norway. Only 1% of babies in the UK are exclusively breastfed to six months.
While the study found that the breastfeeding promotion intervention provided protection against eczema there was no reduction in risk of asthma with 1.5% of the intervention group (108/7064) reporting asthma symptoms compared with 1.7% (110/6493) in the control group.
The paper ‘The effect of an intervention to promote breastfeeding on asthma, lung function and atopic eczema at age 16 years’ was published today in JAMA Pediatrics: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2661823
The Promotion of Breastfeeding Intervention Trial (PROBIT) is the largest cluster-randomised controlled trial ever conducted in the area of human lactation during infancy. The trial’s directors are: Professor Michael Kramer (McGill University), Professor Richard Martin (University of Bristol) and Dr Emily Oken (Harvard University).
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Note to editors:
· Breastfeeding statistics from the WHO National Implementation of the Baby-friendly Hospital Initiative report for 2017: http://apps.who.int/iris/bitstream/10665/255197/1/9789241512381-eng.pdf?...
Funding and support
This study was supported by the European Union, Early Nutrition Programming Long-term Efficacy and Safety, the Canadian Institutes of Health Research, the USA National Institutes of Health (R01 HD050758, K24 HD069408). G.D.S. and R.M.M. work in the Integrative Epidemiology Unit (IEU) supported by the United Kingdom Medical Research Council (MRC) and the University of Bristol (Grant Code: MC_UU_12013/1-9).
The NIHR Bristol Nutrition Biomedical Research Centre is funded by the National Institute for Health Research (NIHR) and is a partnership between the University Hospitals Bristol NHS Foundation Trust and the University of Bristol.
CF is funded through a NIHR Career Development Fellowship (CDF-2014-07-037) and also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NIH, the EU, the Canadian Institutes of Health Research, the UK National Health Service, the UK NIHR, MRC or the UK Department of Health. The funders had no role in the conduct or reporting of the study.
· The Baby-friendly Hospital Initiative (BFHI) was launched in 1991 as a global programme to incentivize maternity facilities throughout the world to adhere to the Ten Steps to Successful Breastfeeding and comply with the International Code of Marketing of Breast-milk Substitutes.
About the PROBIT study
The Promotion of Breastfeeding Intervention Trial (PROBIT) is the largest cluster-randomised controlled trial ever conducted in the area of human lactation during infancy.
The trial is based on the long-term follow-up of 17,046 healthy mothers and infants who were originally enrolled into the trial in the Republic of Belarus (PROBIT I, Principal Investigator: Professor Michael Kramer, McGill University, Canada).
31 maternity hospitals and one each of their affiliated polyclinics (where children are followed for routine health care) were randomised either to the experimental intervention of breastfeeding promotion or the control arm of continuing the prevailing breastfeeding practices at the time of randomisation.
The intervention produced two randomised cohorts with substantially different exposure to breastfeeding, providing a unique opportunity to test, in an intention to treat analysis, the effects of breastfeeding on health outcomes.
For further information, see the project's website: www.bristol.ac.uk/social-community-medicine/projects/probit
· Professor Michael Kramer (McGill University)
· Professor Richard Martin (University of Bristol)
· Dr Emily Oken (Harvard University)