The Association Between Breastfeeding and Atopic Dermatitis: An Epidemiological Analysis of Global and National Datasets

Background and objective The association between breastfeeding and the risk of atopic dermatitis (AD) in children is a subject of ongoing debate. While a broad consensus suggests a protective effect, several regional cohort studies have reported null or even risk-associated outcomes, creating clinical uncertainty. This study aimed to clarify this relationship by evaluating the association between breastfeeding practices and AD prevalence by using large-scale, population-level data. Methods We conducted a cross-sectional analysis using two independent, publicly available datasets. First, we used the Global Burden of Disease (GBD) 2019 study to analyze the correlation between AD prevalence in children aged one to four years and various risk factors across 204 countries using linear regression. Second, we analyzed data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2005-2006 for 1,605 children aged one to six years, using logistic regression to assess the link between breastfeeding duration and doctor-diagnosed AD. Results The GBD analysis revealed that discontinuous breastfeeding was a highly significant risk factor for childhood AD (R² = 0.21, p<0.001) and remained a key independent predictor in the final multivariate model (p = 0.016). The NHANES analysis corroborated this finding, showing that children with AD had a significantly shorter median breastfeeding duration than healthy children (5.1 vs. 6.1 months, p = 0.03). Furthermore, each additional month of breastfeeding was associated with a 3% reduction in the odds of having AD (odds ratio (OR): 0.97, 95% confidence interval (CI): 0.95-0.999, p = 0.04). Conclusions Our findings from two large, independent, and geographically diverse datasets consistently demonstrate a protective association between breastfeeding and childhood AD. This evidence reinforces global public health recommendations and suggests that while local factors may modulate risk in specific cohorts, the overall benefit of breastfeeding for AD prevention is robust at the population level.