Abstract
Objective: The present study was conducted to investigate the impact of breastfeeding on the risk of development of acute leukemia among children Admitted to Alexandria University Children's Hospital.
METHODS: A case control study included 134 ALL&AML cases & 134 matched controls for age & sex from the same family relatives to evaluate socioeconomic & genetic causes of the disease. The mothers were interviewed for the completion of interview format that included: duration & patterns of breastfeeding.
RESULTS: lower proportion of acute leukemia cases 59.7% were exclusively breast-fed babies as compared to 89.6% of the control subjects. However, higher proportions of index children were either predominant breast-fed 19.4% or complementary-fed 10.4%. Nearly 10.4% were bottle-fed babies as compared to none of their controls. The differences between cases & controls as regards pattern of breast feeding were statistically significant where p<0.001. As regards duration of breastfeeding 75.4% of index children were breast-fed for more than 6 months as compared to vast majority of their controls (97.8%). The difference between cases & controls was statistically significant where p <0.001. The association also was statistically significant when 2 groups (standard & high risk) were considered as regards pattern of breastfeeding where x2=13.055, p =0.004. The multivariate logistic regression analysis indicated that bottle feeding had the odds of 7.76 of being at high risk level for acute leukemia (OR=7.76, 95% CI 1.9-33.8).
CONCLUSION: Exclusive breast-feeding and breast-feeding for one year are protective against acute childhood leukemia.
Bivariate and multivariate analysis for pattern & duration of breastfeeding of the studied children with acute leukemia and their controls.
| Pattern and duration of breastfeeding . | Bi variant variable . | Multivariate variable . | ||||||
|---|---|---|---|---|---|---|---|---|
| Type of feeding during the first 6 month of life. | Cases (n=134) | Control (n=134) | Significance | OR | (95% CI) | Significance | ||
| No. | % | No. | % | X2 = 37.6 P>0.0001* | 1 | |||
| Exclusive BF | 80 | 59.7 | 120 | 89.6 | ||||
| Predominant BF | 26 | 19.4 | 13 | 9.7 | 1.67 | (1.26 - 2.2)* | X2 = 9.4 P=0.002* | |
| Complementary feeding | 14 | 10.4 | 1 | 0.7 | 21 | (2.8 - 436.4)* | X2 = 16.13 P>0.0001* | |
| Bottle feeding | 14 | 10.4 | 0 | 0 | 2.5 | (2.1 - 2.9)* | X2 = 19.12 P>0.0001* | |
| Duration of breastfeeding | ||||||||
| 0-≤ 3 month | 2 | 1.7 | 0 | 0 | X2 =15.331 MC P=0.0001* | AN- | FEP=0.18 =13.06 P=0.0003* X2=0.38 P=0.537 | |
| 3-≤ 6 month | 17 | 14.2 | 3 | 2.2 | 7.6 | (2.1 - 33.8)* | ||
| 6-12 month | 16 | 13.3 | 17 | 12.7 | 1.26 | 0.6-2.8 | ||
| More than 12 month | 85 | 70.8 | 114 | 85.1 | 1 | - | ||
| Pattern and duration of breastfeeding . | Bi variant variable . | Multivariate variable . | ||||||
|---|---|---|---|---|---|---|---|---|
| Type of feeding during the first 6 month of life. | Cases (n=134) | Control (n=134) | Significance | OR | (95% CI) | Significance | ||
| No. | % | No. | % | X2 = 37.6 P>0.0001* | 1 | |||
| Exclusive BF | 80 | 59.7 | 120 | 89.6 | ||||
| Predominant BF | 26 | 19.4 | 13 | 9.7 | 1.67 | (1.26 - 2.2)* | X2 = 9.4 P=0.002* | |
| Complementary feeding | 14 | 10.4 | 1 | 0.7 | 21 | (2.8 - 436.4)* | X2 = 16.13 P>0.0001* | |
| Bottle feeding | 14 | 10.4 | 0 | 0 | 2.5 | (2.1 - 2.9)* | X2 = 19.12 P>0.0001* | |
| Duration of breastfeeding | ||||||||
| 0-≤ 3 month | 2 | 1.7 | 0 | 0 | X2 =15.331 MC P=0.0001* | AN- | FEP=0.18 =13.06 P=0.0003* X2=0.38 P=0.537 | |
| 3-≤ 6 month | 17 | 14.2 | 3 | 2.2 | 7.6 | (2.1 - 33.8)* | ||
| 6-12 month | 16 | 13.3 | 17 | 12.7 | 1.26 | 0.6-2.8 | ||
| More than 12 month | 85 | 70.8 | 114 | 85.1 | 1 | - | ||
X2: Chi-Square test FEP: Fisher's Exact test -NA-: Not Applicable *significant at P≤0.0
No relevant conflicts of interest to declare.
Author notes
Asterisk with author names denotes non-ASH members.
