Breastfeeding, maternal smoking, and child health in a secondhand smoke exposed sample

Introduction: Breastfeeding may attenuate illness risk in children of maternal smokers despite exposure to nicotine through breast milk. However, many studies do not account for exposure through expired secondhand smoke [SHS], and re-aerosolized SHS from contaminated surfaces. This study compared child illness indicators across breastfeeding groups in a sample of SHS-exposed children.

Methods: Pre-treatment data were obtained from 298 maternal smokers (children 0-36 months old) enrolled in a SHS intervention trial. Children were "not breastfed" if mothers reported never breastfeeding, mixed feeding, or breastfeeding for <5 weeks; and were "breastfed" if exclusively breastfed for ≥5 weeks. Mothers reported symptoms and utilization of SHS-related healthcare visits.

Results: Mothers (83.9% African American) smoked 11.69 (sd=6.40) cigarettes and exposed their children to 5.02 (sd=4.13) cigarettes per day. "Breastfed" group mothers were less likely to be married, smoked less cigarettes, and exposed their babies to about 2 fewer cigarettes per day (p=0.02). (Pending baby cotinine comparisons will be presented.) "Breastfed" children had fewer wheezing days (p=0.04); however, all other symptoms did not differ between groups. Both groups rated children's overall health similarly. "Not breastfed" children had more doctor visits for colds (p=0.03).

Conclusions: Results suggest inconsistent illness attenuating benefits of breastfeeding in this sample of SHS-exposed children. Future research should examine the influence of breastfeeding-SHS interactions on child health across different modes of SHS exposure. Understanding these effects will guide best practices and education efforts to improve SHS-exposure reduction during breastfeeding months for maternal smokers unable to quit smoking.