BMJ  2007;335:1061-1062 (24 November), doi:10.1136/bmj.39395.414144.80

Letters

Allergy after breast feeding

Testing hypotheses: reply

The first 150 words of the full text of this article appear below.

Silvers et al say that our recent paper was written as if the study's main aim was to test the association between prolonged exclusive breast feeding and asthma and allergy.1 Every randomised controlled trial has a primary outcome that serves as the basis for estimating sample size requirements and for obtaining funding. But we also examined secondary outcomes in the first year of life and sought support for follow-up of the PROBIT cohort to assess important health outcomes at older ages that observational studies had associated with infant feeding. Cluster randomised allocation of the breastfeeding promotion intervention yielded two groups that differed greatly in the duration and exclusivity of breast feeding. This created a unique opportunity to study longer term child health outcomes, including growth, adiposity, neurocognitive development, behaviour, and dental caries, as well as asthma and allergy.2 3

In our recent BMJ paper reporting on the last two outcomes, my . . . [Full text of this article]

Michael S Kramer, professor

McGill University Faculty of Medicine, Montreal, Quebec, Canada H3H 1P3

michael.kramer@mcgill.ca


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Study was not designed to test the hypothesis
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