Breastfeeding duration is not associated with offspring inflammatory bowel disease risk in three population-based birth cohorts

Manasi Agrawal; Ketil Størdal; Anne Vinkel Hansen; Malin Östensson; Maiara Brusco De Freitas; Kristine H Allin; Tine Jess; Johnny Ludvigsson; Karl Mårild

doi:10.1016/j.cgh.2024.04.013

Breastfeeding duration is not associated with offspring inflammatory bowel disease risk in three population-based birth cohorts

Clin Gastroenterol Hepatol. 2024 May 8:S1542-3565(24)00416-6. doi: 10.1016/j.cgh.2024.04.013. Online ahead of print.

Authors

Manasi Agrawal¹, Ketil Størdal², Anne Vinkel Hansen³, Malin Östensson⁴, Maiara Brusco De Freitas³, Kristine H Allin⁵, Tine Jess⁵, Johnny Ludvigsson⁶, Karl Mårild⁷

Affiliations

¹ Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark; The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York NY.
² Department of Pediatric Research, Institute of clinical medicine, University of Oslo, Oslo, Norway; Department of Pediatrics, Oslo University Hospital, Oslo, Norway.
³ Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark.
⁴ Department of Pediatrics, Oslo University Hospital, Oslo, Norway.
⁵ Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark; Department of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark.
⁶ Crown Princess Victoria Children's Hospital and Division of Pediatrics, Dept of Biomedical and Clinical Sciences, Linköping university, Linköping, Sweden.
⁷ Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden. Electronic address: karlmarild@gmail.com.

PMID: 38729392
DOI: 10.1016/j.cgh.2024.04.013

Abstract

Background and aims: Breastfeeding is critical for offspring health and development. While many observational studies report a protective effect between breastfeeding and inflammatory bowel disease (IBD), the relationship is not well-understood.

Methods: We used prospectively collected data from three population-based birth cohorts (Danish National Birth Cohort, Norwegian Mother, Father, and Child Cohort, and All Babies in Southeast Sweden) and cross-linked national registers to ascertain the impact of breastfeeding duration on offspring IBD risk in each country, using adjusted Cox proportional regression analyses. We performed meta-analyses to determine pooled estimates.

Results: We included 148,737 offspring and 169,510 offspring in analyses of exclusive and any breastfeeding duration, respectively. During median follow-up of 16.3 to 22.3 years, between 1996 and 2021, 543 offspring were diagnosed with IBD. In each country, there was no association between exclusive breastfeeding duration and offspring IBD risk after adjusting for birth year (Denmark), offspring sex, parental IBD status, maternal education, smoking during pregnancy, age at delivery, mode of delivery, preterm birth, and small for gestational age. The pooled adjusted hazard ratio for IBD was 1.24 (95% CI 0.94, 1.62, Q =0.16, I²= 0.0%) and 1.02 (95% CI 0.85, 1.21, Q=1.45, I²= 0.0%) among offspring breastfed exclusively for ≥6 months and <4 months, respectively, compared to 4-5 months. Similarly, we found null associations in pooled analyses of any breastfeeding duration and IBD, subtypes Crohn's disease and ulcerative colitis, as well as in cohort-specific analyses.

Conclusion: In prospectively collected data from three population-based birth cohorts, the duration of exclusive or any breastfeeding was not associated with offspring IBD risk.

Keywords: Crohn’s disease; Epidemiology; breast feeding; inflammatory bowel disease; ulcerative colitis.