Association between breastfeeding and Kawasaki disease: a case–control study
The association between breastfeeding and Kawasaki disease is not fully understood. We performed a case–control study to examine the association between breastfeeding and Kawasaki disease. In this study, 389 children diagnosed with Kawasaki disease and 426 gender- and age-matched controls were identified at Renmin Hospital of Wuhan University between November 2013 and March 2019. Demographic and clinical data were collected from a structured telephone interview and medical record database. Odds ratio and 95% confidence interval for risk of Kawasaki disease were estimated. Children who were breastfed exclusively had a decrease in developing Kawasaki disease (adjusted odds ratios and 95% confidence intervals 0.53 (0.38–0.74). Although the risk reduction was not statistically different, partial breastfeeding also provided a protective effect (adjusted odds ratios and 95% confidence intervals 0.70 (0.48–1.01). In the stratified analysis, we still observed that exclusive breastfeeding was inversely associated with the development of complete Kawasaki disease (adjusted odds ratios and 95% confidence intervals 0.52 (0.31–0.88) and incomplete Kawasaki disease (adjusted odds ratios and 95% confidence intervals 0.54 (0.38–0.77). However, there was no significant association between exclusive breastfeeding and the intravenous immunoglobulin treatment response (adjusted odds ratios and 95% confidence intervals 0.69 (0.27–1.69) and the risk of coronary artery lesions (adjusted odds ratios and 95% confidence intervals 0.79 (0.49–1.31) in Kawasaki disease.
What is known
• Previous studies have demonstrated that breastfeeding has been shown to potentially confer protection against several autoimmune disorders of childhood.
• The association between breastfeeding and Kawasaki disease is not fully understood.
What is new
The first study to evaluate the association between breastfeeding and the development of Kawasaki disease in China with a large sample size.
• Exclusive breastfeeding was inversely associated with the development of Kawasaki disease and breastfeeding might be a potential protective factor against Kawasaki disease.
KeywordsKawasaki disease Breastfeeding Case-control study Odds ratio
American Heart Association
Coronary artery lesion
World Health Organization
We thank all of the participants of this study. We thank the Department of Medical Records Management, People’s Hospital, Wuhan University for its assistance.
Shun Wang, Dan Xiang, and Baozhen Yao conceptualized this study; Shun Wang and Dan Xiang performed the structured telephone interviews and analyzed the data; Shun Wang, Dan Xiang, and Congcong Fang collected the demographic and clinical data and drafted this manuscript; Congcong Fang and Baozhen Yao critically revised this manuscript.
Supported in part by the Medical Science Advancement Program of Wuhan University (No. TFLC2018001).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent and ethical approval
This study was approved by the Ethical Committee of Renmin Hospital of Wuhan University. Informed consent was obtained from the guardians of all individual participants.
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