There is no clear evidence showing that exclusive breastfeeding for at least four months reduces the chances of a baby eventually developing eczema, researchers reported in the British Journal of Dermatology. The authors, from King’s College London, say that in view of their findings, the UK’s breastfeeding guidelines with regards to eczema should be reviewed.

This study was a joint collaboration between researchers from King’s College London, the University of Ulm, Germany, and the University of Nottingham, England. They gathered data on 51,119 children aged 8 to 12 years from 21 nations.

The investigators collected data on breastfeeding, when the baby was weaned, and eczema. Parents had to fill in questionnaires. The children were given a skin examination for eczema, as well as a skin prick test to determine whether they had any allergies.

Previous studies had indicated that breastfeeding might protect from eczema. WHO (World Health Organization) and the UK Department of Health recommend six months of exclusive breastfeeding to reduce eczema risk.

However, in keeping with the findings in this present study, the researchers reviewed more recent articles and found no evidence showing that exclusive breastfeeding for four months or more reduced the risk of developing eczema.

Moreover, there is growing evidence that introducing potentially allergenic food proteins, such as peanut early on in life helps improve tolerance, rather than causing allergies. The authors point out that further intervention studies are required to confirm this.

Dr. Carsten Flohr and team set out to determine whether breastfeeding protects from eczema, and if so, to what extent. They focused on children who had been exclusively breastfed for at least four months. They found that these children had the same risk of eventually developing eczema as the children who had been weaned earlier.

The study formed part of Phase II of ISAAC (The International Study of Asthma and Allergies in Childhood) – the largest epidemiological research project ever done.

Dr Carsten Flohr, who works at the Asthma, Allergy and Lung Biology Division, King’s College, said:

“Although there was a small protective effect of breastfeeding per se on severe eczema in affluent countries, we found no evidence that exclusive breastfeeding for four months or longer protects against eczema in either developed or developing nations.

We feel that the UK breastfeeding guidelines with regard to eczema should therefore be reviewed. Further studies are now required to explore how and when solids should be introduced alongside breastfeeding to aid protection against eczema and other allergic diseases.

It is widely accepted that breast milk is the most important and appropriate nutrition in early life. Especially in the context of developing countries it is also important to keep in mind that exclusive breastfeeding reduces the risk of gastrointestinal infections compared to mixed or bottle feeding. Our study does not change this notion.

Nina Goad of the British Association of Dermatologists said:

“The size of this study means that its findings are very significant, although the authors recognise that further studies are required. Following these further studies we may need to review the UK’s advice on how long mothers should breastfeed exclusively for, and at what age we should be weaning our infants, in relation to eczema prevention.

This study isn’t about the benefits of infant formula milk versus breast milk, nor is it questioning other benefits of breast feeding, but it is about whether breastfeeding exclusively for prolonged periods and weaning after six months, as opposed to after four months, has any impact on eczema risk.

Written by Christian Nordqvist