Bottle Feeding in the Bed or Crib Before Sleep Time and Wheezing in Early
Childhood
Juan C. Celedón, MD, DrPH*,,,
Augusto A. Litonjua, MD, MPH*,,,
Louise Ryan, PhD||,¶, Scott T. Weiss, MD, MS*,,
and Diane R. Gold, MD, MPH*,,
* Channing Laboratory, Department of Medicine, Brigham and Womens
Hospital, Boston, Massachusetts Division of
Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center,
Boston, Massachusetts Harvard Medical School,
Boston, Massachusetts || Harvard School of Public Health, Boston, Massachusetts ¶ Dana-Farber Cancer Institute, Boston, Massachusetts
Objective. Bottle feeding in the bed or crib before sleep
timehas been associated with an increased risk of wheezing in thefirst year of life. We examined whether bottle feeding in the
bed or crib before sleep time in the first year of life is associated
with wheezing in the first 5 years of life.
Methods. In a prospective cohort study of 448 children with
parental history of atopy followed from birth, we examined the
relation between the number of bimonthly parental reports ofbottle
feeding in the bed or crib before sleep time in the firstyear of
life (range: 06 reports) and parental reportof wheezing in the
first 5 years of life. Additional outcomemeasures included recurrent
wheezing (2 episodes of wheezingin the previous year) and asthma (physician-diagnosed asthma
and 1 episode of wheezing in the
previous year) at the age of5 years.
Results. The risk of recurrent wheezing and asthma at 5 yearsof age increased significantly with each additional report of
bottle feeding in the bed or crib before sleep time in the firstyear
of life. The risk of wheezing between the ages of 1 and5 years
increased with each additional report of bottle feedingin the bed or
crib before sleep time in the first year of life.As an example, a
child whose parents reported bottle feedingin the bed or crib before
sleep time on 3 occasions in the firstyear of life had 1.5 times
higher risk of wheezing between theages of 1 and 5 years than a
child whose parents did not reportbottle feeding in the bed or crib
before sleep time in the firstyear of life (95% confidence interval
for relative risk: 1.122.12).
Conclusions. Among children with parental history of atopy,
bottle feeding in the bed or crib before sleep time in the firstyear
of life is a risk factor for recurrent wheezing and asthmaat 5 years
of age and a risk factor for wheezing between theages of 1 and 5
years.
Key Words: bottle feeding sleep time wheezing
Abbreviations: IgE, immunoglobulin E OR, odds ratio CI,
confidence interval GER, gastroesophageal reflux
Received for publication May 16, 2002; accepted Aug 26, 2002.
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