The findings of the study, “Long-term breastfeeding influences disease activity in a low-income juvenile idiopathic arthritis cohort,” were published in Clinical Rheumatology.
JIA encompasses a group of chronic inflammatory conditions that affect the joints, causing swelling, stiffness, and pain in children and adolescents. The prevalence and severity of the condition has been linked to several environmental factors, including smoking status of the parents, and breastfeeding.
“Few studies have proposed that short-term, an ill-defined period, or no breastfeeding increase the risk of developing JIA whereas one study has found otherwise, indicating that breastfeeding
did not protect [children] from developing JIA,” the investigators said.
Despite the debate on breastfeeding’s impact on the onset of JIA, the World Health Organization (WHO) strongly recommends that children, especially those from low-income families, are breastfed until they reach six months of age, and preferably until age 2.
However, studies assessing the impact of breastfeeding on children with JIA from low-income families are scarce.
To learn more, a team of Brazilian researchers investigated the impact of breastfeeding on JIA activity in a group of children from low-income families.
The cross-sectional study involved a total 91 children with JIA, with a mean age of 14.6 years, who were followed at different clinic sites in Brazil from May 2015 to April 2016. The children’s clinical and demographic data were obtained from their medical records, while information on breastfeeding duration was obtained by interviewing their mothers.
Most children had been diagnosed with polyarticular JIA (42.8%), followed by oligoarticular JIA (25.3%) and enthesitis-related JIA (18.7%). More than half of the patients (61.8%) were treated with methotrexate, while approximately a third (32.9%) were treated with biologic disease‐modifying anti‐rheumatic drugs (DMARDs), including etanercept, adalimumab and tocilizumab.
Approximately a fourth of the children had permanent joint deformities (24%).
None of the children participating in the study came from a family with a monthly income higher than US$900; in fact, approximately a third of the participants were from families with a monthly income lower than US$300.
According to the mothers’ testimonials, almost all children participating in the study were breastfed (91%). Among the children who had been breastfed, more than two-thirds received maternal milk for more than three months, the researchers said.
Remarkably, those who had been breastfed for more than six months tended to have fewer joint deformities and lower disease activity, measured using the Juvenile Arthritis Disease Activity Score (JADAS) 27 and the Childhood Health Assessment Questionnaire (CHAQ).
“Our cohort represents the highest breastfeeding prevalence among low-income JIA patients ever reported. Breastfeeding for more than six months had a tendency to be associated with lower disease activity. Replicating this information in other cohorts may help establish a comfortable minimum breastfeeding period,” the researchers said.