Breastfeeding and risk of childhood asthma: a systematic review and meta-analysis

Mike Xue; Emily Dehaas; Nagendra Chaudhary; Paul O'Byrne; Imran Satia; Om P Kurmi

doi:10.1183/23120541.00504-2021

Breastfeeding and risk of childhood asthma: a systematic review and meta-analysis

Mike Xue, Emily Dehaas, Nagendra Chaudhary, Paul O'Byrne, Imran Satia, Om P Kurmi

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Abstract

Objective: To investigate the relationship between breastfeeding and the development of paediatric asthma.

Methods: A systematic review and meta-analysis was conducted with MEDLINE, Embase, CINAHL and ProQuest Nursing and Allied Health source databases. Retrospective/prospective cohorts in children aged <18 years with breastfeeding exposure reported were included. The primary outcome was a diagnosis of asthma by a physician or using a guideline-based criterion. A secondary outcome was asthma severity.

Results: 42 studies met inclusion criteria. 37 studies reported the primary outcome of physician-/guideline-diagnosed asthma, and five studies reported effects on asthma severity. Children with longer duration/more breastfeeding compared to shorter duration/less breastfeeding have a lower risk of asthma (OR 0.84, 95% CI 0.75-0.93; I2 = 62.4%). Similarly, a lower risk of asthma was found in children who had more exclusive breastfeeding versus less exclusive breastfeeding (OR 0.81, 95% CI 0.72-0.91; I2=44%). Further stratified analysis of different age groups demonstrated a lower risk of asthma in the 0-2-years age group (OR 0.73, 95% CI 0.63-0.83) and the 3-6-years age group (OR 0.69, 95% CI 0.55-0.87); there was no statistically significant effect on the ≥7-years age group.

Conclusion: The findings suggest that the duration and exclusivity of breastfeeding are associated with a lower risk of asthma in children aged <7 years.

Original language	English
Number of pages	13
Journal	ERJ Open Research
Volume	7
Issue number	4
Early online date	13 Dec 2021
DOIs	https://doi.org/10.1183/23120541.00504-2021
Publication status	Published - Dec 2021

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This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

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abstract = "Objective: To investigate the relationship between breastfeeding and the development of paediatric asthma.Methods: A systematic review and meta-analysis was conducted with MEDLINE, Embase, CINAHL and ProQuest Nursing and Allied Health source databases. Retrospective/prospective cohorts in children aged <18 years with breastfeeding exposure reported were included. The primary outcome was a diagnosis of asthma by a physician or using a guideline-based criterion. A secondary outcome was asthma severity.Results: 42 studies met inclusion criteria. 37 studies reported the primary outcome of physician-/guideline-diagnosed asthma, and five studies reported effects on asthma severity. Children with longer duration/more breastfeeding compared to shorter duration/less breastfeeding have a lower risk of asthma (OR 0.84, 95% CI 0.75-0.93; I2 = 62.4%). Similarly, a lower risk of asthma was found in children who had more exclusive breastfeeding versus less exclusive breastfeeding (OR 0.81, 95% CI 0.72-0.91; I2=44%). Further stratified analysis of different age groups demonstrated a lower risk of asthma in the 0-2-years age group (OR 0.73, 95% CI 0.63-0.83) and the 3-6-years age group (OR 0.69, 95% CI 0.55-0.87); there was no statistically significant effect on the ≥7-years age group.Conclusion: The findings suggest that the duration and exclusivity of breastfeeding are associated with a lower risk of asthma in children aged <7 years.",

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AU - Dehaas, Emily

AU - Chaudhary, Nagendra

AU - O'Byrne, Paul

AU - Satia, Imran

AU - Kurmi, Om P

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N2 - Objective: To investigate the relationship between breastfeeding and the development of paediatric asthma.Methods: A systematic review and meta-analysis was conducted with MEDLINE, Embase, CINAHL and ProQuest Nursing and Allied Health source databases. Retrospective/prospective cohorts in children aged <18 years with breastfeeding exposure reported were included. The primary outcome was a diagnosis of asthma by a physician or using a guideline-based criterion. A secondary outcome was asthma severity.Results: 42 studies met inclusion criteria. 37 studies reported the primary outcome of physician-/guideline-diagnosed asthma, and five studies reported effects on asthma severity. Children with longer duration/more breastfeeding compared to shorter duration/less breastfeeding have a lower risk of asthma (OR 0.84, 95% CI 0.75-0.93; I2 = 62.4%). Similarly, a lower risk of asthma was found in children who had more exclusive breastfeeding versus less exclusive breastfeeding (OR 0.81, 95% CI 0.72-0.91; I2=44%). Further stratified analysis of different age groups demonstrated a lower risk of asthma in the 0-2-years age group (OR 0.73, 95% CI 0.63-0.83) and the 3-6-years age group (OR 0.69, 95% CI 0.55-0.87); there was no statistically significant effect on the ≥7-years age group.Conclusion: The findings suggest that the duration and exclusivity of breastfeeding are associated with a lower risk of asthma in children aged <7 years.

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Breastfeeding and risk of childhood asthma: a systematic review and meta-analysis

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