The Impact of Breastfeeding on the Childhood Acute Leukemia Risk Among Children Attending Alexandria University Children's Hospital

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*	1
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	1	0.7		21	(2.8 – 436.4)*	X2 = 16.13    P>0.0001*
Bottle feeding	14	10.4	0	0		2.5	(2.1 – 2.9)*	X2 = 19.12    P>0.0001*
Duration of breastfeeding
0-≤ 3 month	2	1.7	0	0	X2=15.331 MCP=0.0001*	AN-		FEP=0.18 =13.06  P=0.0003*   X2=0.38  P=0.537
3-≤ 6 month	17	14.2	3	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		1		-

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