Association of breast-feeding and maternal smoking during pregnancy with children's general health status later in life

Background: Maternal smoking during pregnancy is associated with a variety of risks on foetus health while breast-feeding is beneficial to the health development of infants and protects them from diseases. Little has been reported regarding their possible long-term influence on children's health status later in life. Methods: Parent-rated general health status was investigated among 17461 children and adolescents aged 0–17 years, who participated in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) in 2003–2006. Information on breast-feeding, exposure to maternal smoking during pregnancy and health parameters at birth was obtained by standardised, parent-administered questionnaires. Results: In all age groups, children who had been breast-fed over 6 months had a significantly better health status later in life than children who had never been breast-fed: 0–2 (p=0.036), 3–6 (p<0.001), 7–10 (p<0.001), 11–13 (p<0.001) and 14–17 (p=0.002) years. Children whose mother had not smoked during pregnancy had a better health status later in life than children whose mother had smoked regularly during pregnancy in age groups 3–6 (p=0.001) and 14–17 (p<0.001). After adjusting for age, sex, body mass index, sports activities, region of residence, migration background, parental socio-economic status, children's body weight and height at birth and medicals problems after birth, breast-feeding remained significantly associated with better health status later in life in the regression models for children in age groups 7–10 (odds ratio 1.28, 95% confidence intervals 1.04–1.58), 11–13 (1.39, 1.08–1.80) and 14–17 years (1.26, 1.01–1.57), while non-smoking during pregnancy significantly associated with better health status later in life for children in age groups 11–13 (1.71, 1.06–2,76) and 14–17 years (1.58, 1.05–2.36). Conclusions: Although of cross-sectional nature, our data suggest that breast-feeding and maternal smoking during pregnancy may have a substantial influence on children's general health status later in life. Further studies are required to elucidate these possible associations.