{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T13:33:20Z","timestamp":1776778400585,"version":"3.51.2"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T00:00:00Z","timestamp":1463529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001828","name":"Erasmus Universiteit Rotterdam","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001828","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Breastfeeding is associated with a lower risk of asthma symptoms in early childhood, but its effect at older ages remains unclear. We examined the associations of duration and exclusiveness of breastfeeding with asthma outcomes in children aged 6 years, and whether these associations were explained by atopic or infectious mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a population\u2010based prospective cohort study among 5675 children. Information about breastfeeding was collected by questionnaires. At age 6 years, we measured interrupter resistance (Rint) and fractional exhaled nitric oxide (Fe<jats:styled-content style=\"fixed-case\">NO<\/jats:styled-content>). Information about wheezing patterns (early (\u22643 years only), late (&gt;3 years only), persistent (\u22643 and &gt;3 years)), and current asthma at 6 years was derived from repeated questionnaires.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to children who were ever breastfed, those who were never breastfed had lower Fe<jats:styled-content style=\"fixed-case\">NO<\/jats:styled-content> levels (sympercent (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>): \u201016.0 (\u201024.5, \u20107.5)) and increased risks of late and persistent wheezing (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>(95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>): 1.69 (1.06, 2.69) and 1.44 (1.00, 2.07), respectively). Shorter duration of breastfeeding was associated with early wheezing and current asthma (1.40 (1.14, 1.73) and 2.19 (1.29, 3.71), respectively). Less exclusive breastfeeding was associated with early wheezing (1.28 (1.08, 1.53)). Breastfeeding duration and exclusiveness were not associated with Fe<jats:styled-content style=\"fixed-case\">NO<\/jats:styled-content> or Rint. The associations were not explained by inhalant allergies, partly by lower respiratory tract infections in early life, and to a lesser extent by lower respiratory tract infections in later life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Breastfeeding patterns may influence wheezing and asthma in childhood, which seems to be partly explained by infectious mechanisms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pai.12576","type":"journal-article","created":{"date-parts":[[2016,4,10]],"date-time":"2016-04-10T17:39:13Z","timestamp":1460309953000},"page":"486-492","source":"Crossref","is-referenced-by-count":38,"title":["Breastfeeding and asthma outcomes at the age of 6 years: The Generation R Study"],"prefix":"10.1111","volume":"27","author":[{"given":"Herman T.","family":"den Dekker","sequence":"first","affiliation":[{"name":"The Generation R Study Group Erasmus MC University Medical Center Rotterdam The Netherlands"},{"name":"Department of Pediatrics Division of Respiratory Medicine Erasmus MC University Medical Center Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes M. M.","family":"Sonnenschein\u2010van der Voort","sequence":"additional","affiliation":[{"name":"The Generation R Study Group Erasmus MC University Medical Center Rotterdam The Netherlands"},{"name":"Department of Pediatrics Division of Respiratory Medicine Erasmus MC University Medical Center Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent W. V.","family":"Jaddoe","sequence":"additional","affiliation":[{"name":"The Generation R Study Group Erasmus MC University Medical Center Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands"},{"name":"Department of Pediatrics Erasmus MC University Medical Center Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irwin K.","family":"Reiss","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neonatology Erasmus MC University Medical Center Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan C.","family":"de Jongste","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Respiratory Medicine Erasmus MC University Medical Center Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liesbeth","family":"Duijts","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Respiratory Medicine Erasmus MC University Medical Center Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands"},{"name":"Department of Pediatrics Division of Neonatology Erasmus MC University Medical Center Rotterdam The 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