Effect of Prolonged and Exclusive Breast Feeding on Risk of Allergy and Asthma: Cluster Randomized Trial
Bibliographic record
Abstract
The question of whether breast-feeding protects against allergy and asthma has yet to be definitively answered. This cluster randomized trial, carried out at 31 maternity centers in Belarus, enrolled 17,046 mother-infant pairs, 81.5% of which were followed up to age 6.5 years. They were randomly assigned to usual practice or to an intervention promoting breast-feeding that is modeled on the WHO/UNICEF baby-friendly hospital initiative. The intervention is designed to promote and support beast feeding, especially in mothers who have elected to begin breast-feeding. The major outcomes were responses to the International Study of Asthma and Allergies in Childhood questionnaire and the results of skin prick tests of 5 inhaled antigens. The randomized groups were similar with regard to baseline sociodemographic and clinical variables. The rate of exclusive breast-feeding at age 3 months was much higher in the intervention group than in control women (44.3% vs. 6.4%). The prevalence of any degree of breast-feeding was significantly higher in the intervention group at all ages up to—and including—12 months. The intervention, however, did not appear to lessen the risk of allergic symptoms or diagnoses, or the frequency of positive skin prick tests. After eliminating 3 experimental and 3 control sites with suspiciously high rates of positive skin prick tests, the rate of positive skin prick tests for 4 of the 5 antigens was significantly increased in the intervention group. These findings fail to support a protective effect of prolonged or exclusive breast-feeding against asthma, hay fever, or eczema at age 6.5 years. The intervention also failed to lower the prevalence of positive skin prick tests. One must look elsewhere to explain the recent “epidemic” of allergy and asthma.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".