Breastfeeding Could Provide a Protective Layer in the Prevention of AS


Breastfeeding could serve as a protective layer against ankylosing spondylitis in people with a familial history of the disease.

For people with a familial history of ankylosing spondylitis, breastfeeding can serve as a protective layer against the possibility of developing ankylosing spondylitis later in life, new research shows.

Writing in the Oct. 12 online issue of Annals of the Rheumatic Diseases, French researchers report the results of a retrospective case-controlled study, finding that breastfeeding apparently induces a protective effect on the occurrence of ankylosing spondylitis in people who carry HLA-B27.

Breastfeeding induces a different microbiota from the one induced by bottle feeding, the researchers wrote. “Microbiota acquisition begins at birth and continues throughout the first months of life. Microbes from the mother and the environment colonize the newborn’s skin and gastrointestinal tract. Maternal milk contains up to 109 microbes per liter, and is the first source of microbes to colonize the gastrointestinal tract.”

It is known that the microbial environment might influence the role of an HLA-B27 genetic background. And, other studies have suggested that breastfeeding could possibly prevent the development of rheumatoid arthritis and juvenile idiopathic arthritis, but the theory has never before been explored in ankylosing spondylitis.[[{"type":"media","view_mode":"media_crop","fid":"42615","attributes":{"alt":"©FamVeld/","class":"media-image media-image-right","id":"media_crop_7395786310080","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4631","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"font-size: 13.008px; line-height: 1.538em; float: right;","title":" ","typeof":"foaf:Image"}}]]

More than 90% of individuals with ankylosing spondylitis express HLA-B27. For those with this genetic background, the development of ankylosing spondylitis could be impacted by intestinal microbiota.

The breastfeeding data in the new study is based on data collected from 119 families with ankylosing spondylitis. It includes 203 patients who were positive for HLA-B27 and a control group of 293 healthy siblings. The data gathered for the study included age, gender, number of brothers and sisters, age at the time of onset of disease, type, and the duration of feeding whether it was breast or bottle. For this study, only patients who were breastfed for more than 48 hours were enrolled in the study. 

The findings:  Patients with ankylosing spondylitis were breastfed less often than healthy controls. In families where children were breastfed, patients with ankylosing spondylitis were less often breastfed than their healthy siblings (57% vs 72%).

“Breast feeding reduced familial prevalence of ankylosing spondylitis. The frequency of breast feeding was similar in the ankylosing spondylitis siblings and in the 280 unrelated controls. However, patients with ankylosing spondylitis were less often breast fed compared with the 280 unrelated controls (OR 0.6, 95% CI (0.42 to 0.89), p<0.01),” the researchers wrote.

Researchers also found that breastfeeding did not reduce the risk of developing  rheumatoid arthritis in a cohort of patients who were tested as a control for the data. “The frequency of breast feeding was lower, but not significantly, in patients with RA (73%) compared with their siblings (78%),” they reported.

The researchers wrote that breastfeeding has the potential to provide a protective effect on the development of ankylosing spondylitis, but additional studies are needed to determine if this degree of protection can lead to an understanding of the mechanism  of the observed protection.


Montoya J, Matta NB, et al.

"Patients with ankylosing spondylitis have been breast fed less often than healthy controls: a case-control retrospective study,"

Ann Rheum Dis. 2015 Oct 12. pii: annrheumdis-2015-208187. doi: 10.1136/annrheumdis-2015-208187.  

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