Infant-Feeding Methods and Childhood Sleep-Disordered Breathing

Montgomery‐Downs, Hawley E.; Crabtree, Valerie McLaughlin; Capdevila, Óscar Sans; Gozal, David

doi:10.1542/peds.2007-0722

Cited by 59 publications

(89 citation statements)

References 38 publications

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“…Disorders linked to respiratory control immaturity such as apnea in preterm neonates, or dysfunction in sudden infant death syndrome, remain a major burden (Finer et al, 2006;Halloran and Alexander, 2006). Breastfeeding notably reduces the risk of sudden infant death syndrome (Ford et al, 1993;McVea et al, 2000;Vennemann et al, 2009) and sleep-disordered breathing in 4 -10-yearold infants (Montgomery-Downs et al, 2007). Our study suggests that one of the potential links between these outcomes might be perinatal exposure to progesterone contributing to enhance respiratory chemoreflex and protective responses to hypoxia.…”

Section: Discussionmentioning

confidence: 72%

Antagonism of progesterone receptor suppresses carotid body responses to hypoxia and nicotine in rat pups

2012

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We tested the hypothesis that antagonism of progesterone receptor (PR) in newborn rats alters carotid body and respiratory responses to hypoxia and nicotinic receptor agonists. Rats were treated with the PR antagonist mifepristone (daily oral gavage 40 μg/g/d) or vehicle between postnatal days 3 and 15. In 11-14-day-old rats, we used in vitro carotid body/carotid sinus nerve preparation and whole body plethysmography to assess the carotid body and ventilatory responses to hypoxia (65 mmHg in vitro, 10% O2 in vivo) and to nicotinic receptor agonists (as an excitatory modulator of carotid body activity-nicotine 100 μM for in vitro studies, and epibatidine 5 μg/kg, i.p., which mainly acts on peripheral nicotinic receptors, for in vivo studies). The carotid body responses to hypoxia and nicotine were drastically reduced by mifepristone. Compared with vehicle, mifepristone-treated rats had a reduced body weight. The ventilatory response to epibatidine was attenuated; however, the hypoxic ventilatory response was similar between vehicle and mifepristone-treated pups. Immunohistochemical staining revealed that mifepristone treatment did not change carotid body morphology. We conclude that PR activity is a critical factor ensuring proper carotid body function in newborn rats. Keywordscarotid sinus nerve; whole-body plethysmography; hypoxia; nicotine receptor agonist; progesterone receptor antagonist; newborn Progesterone is a respiratory stimulant that acts both on the central nervous system (CNS) and on peripheral chemoreceptors to enhance resting minute ventilation (Bayliss et al., 1987), the hypoxic ventilatory response (Joseph et al., 2002), and the carotid sinus nerve response to hypoxia (Hannhart et al., 1990). These effects of progesterone are well described in adults and also occur in newborn rats in which chronic progesterone exposure enhances the hypoxic ventilatory response and reduces apnea frequency under normoxia or hypoxia (Lefter et al., 2007(Lefter et al., , 2008. This has potential far-reaching implications because progesterone-based hormone replacement therapy reduces the occurrence of sleep apneas in

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Section: Discussionmentioning

confidence: 72%

Antagonism of progesterone receptor suppresses carotid body responses to hypoxia and nicotine in rat pups

2012

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“…Two epidemiologic studies that coded breastfeeding dichotomously reported similar findings, 13,25 and a study of habitually snoring children found that longer duration of breastfeeding between 2 and 5 months of age was associated with greater protection from obstructive sleep apnea. 28 Authors of the latter study speculated that the act of breastfeeding promoted the development of a healthy upper airway structure and that breast milk provided immunologic protection against infections that promote SDB. Our data confirm that breast milk feeding may protect against persistent snoring during the early preschool years, and further suggest that extending breastfeeding beyond 5 months may result in incremental protection.…”

Section: Figurementioning

confidence: 99%

Persistent Snoring in Preschool Children: Predictors and Behavioral and Developmental Correlates

et al. 2012

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WHAT'S KNOWN ON THIS SUBJECT: Loud snoring, which spikes at ∼2 to 3 years of age, has been associated with behavior problems in school-aged children in cross-sectional studies, but no longitudinal studies have quantified predictors and the behavioral impact of persistent snoring in preschool-aged children.WHAT THIS STUDY ADDS: Persistent loud snoring, which occurs in 9% of children 2 to 3 years of age, is linked with behavior problems. Higher socioeconomic status and a history of breastfeeding were associated with lower rates of transient and persistent snoring in young children. abstract OBJECTIVE: To clarify whether persistent snoring in 2-to 3-year-olds is associated with behavioral and cognitive development, and to identify predictors of transient and persistent snoring. METHODS:Two hundred forty-nine mother/child pairs participated in a prospective birth cohort study. Based upon parental report of loud snoring $2 times weekly at 2 and 3 years of age, children were designated as nonsnorers, transient snorers (snored at 2 or 3 years of age, but not both), or persistent snorers (snored at both ages). We compared groups by using validated measures of behavioral and cognitive functioning. Potential predictors of snoring included child race and gender, socioeconomic status (parent education and income), birth weight, prenatal tobacco exposure (maternal serum cotinine), childhood tobacco exposure (serum cotinine), history and duration of breast milk feeding, and body mass relative to norms. RESULTS:In multivariable analyses, persistent snorers had significantly higher reported overall behavior problems, particularly hyperactivity, depression, and inattention. Nonsnorers had significantly stronger cognitive development than transient and persistent snorers in unadjusted analyses, but not after demographic adjustment. The strongest predictors of the presence and persistence of snoring were lower socioeconomic status and the absence or shorter duration of breast milk feeding. Secondary analyses suggested that race may modify the association of childhood tobacco smoke exposure and snoring.CONCLUSIONS: Persistent, loud snoring was associated with higher rates of problem behaviors. These results support routine screening and tracking of snoring, especially in children from low socioeconomic backgrounds; referral for follow-up care of persistent snoring in young children; and encouragement and facilitation of infant breastfeeding. This manuscript has not been published elsewhere, and all authors approve of its submission for review. Each author made a substantive intellectual contribution to the study. Dr Beebe participated in early conceptualization and design of sleep measurement methodology, conducted preliminary analyses, and collaborated with coauthors on final analyses and data interpretation; he took the lead role with drafting and revising the manuscript. Dr Rausch provided critical contributions to formulating the data analytic plan, conducted final data analyses, assisted with data interpretation, and reviewed ...

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“…The literature identifies the risk of SDB to be associated with socio-economic status (SES) variables, including housing, parental education and employment [37][38][39] maternal smoking [38,39], race [38,40], birthweight and gestational age [41], and breastfeeding via the immunologic protection it confers against early exposures that are themselves associated with chronic upper airway inflammation and adenotonsillar hypertrophy [42,43]. Variables analyzed included the following:…”

Section: Covariate Assessmentmentioning

confidence: 99%

“…Methods: We performed a cluster analysis of SDB's primary symptoms: snoring, mouth-breathing, and apnea. Parents in the Avon Longitudinal Study of Parents and Children (ALSPAC) reported SDB symptoms by questionnaire for their child at 6,18,30,42,57,69, and 81 months of age. Participants were those from the original cohort exclusive of children with congental or other medical conditions predisposing growth aberrations or respiratory problems (i.e.…”

Section: Introductionmentioning

confidence: 99%

Snoring, mouth-breathing, and apnea trajectories in a population-based cohort followed from infancy to 81 months: A cluster analysis

Freeman

Bonuck

2012

International Journal of Pediatric Otorhinolaryngology

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Infant-Feeding Methods and Childhood Sleep-Disordered Breathing

Cited by 59 publications

References 38 publications

Antagonism of progesterone receptor suppresses carotid body responses to hypoxia and nicotine in rat pups

Antagonism of progesterone receptor suppresses carotid body responses to hypoxia and nicotine in rat pups

Persistent Snoring in Preschool Children: Predictors and Behavioral and Developmental Correlates

Snoring, mouth-breathing, and apnea trajectories in a population-based cohort followed from infancy to 81 months: A cluster analysis

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