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.

Table 1.

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*  
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 0.7 21 (2.8 - 436.4)* X2 = 16.13 P>0.0001* 
Bottle feeding 14 10.4 2.5 (2.1 - 2.9)* X2 = 19.12 P>0.0001* 
Duration of breastfeeding         
0-≤ 3 month 1.7 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 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 
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*  
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 0.7 21 (2.8 - 436.4)* X2 = 16.13 P>0.0001* 
Bottle feeding 14 10.4 2.5 (2.1 - 2.9)* X2 = 19.12 P>0.0001* 
Duration of breastfeeding         
0-≤ 3 month 1.7 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 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 

X2: Chi-Square test FEP: Fisher's Exact test -NA-: Not Applicable *significant at P≤0.0

Disclosures

No relevant conflicts of interest to declare.

Author notes

*

Asterisk with author names denotes non-ASH members.