Breastfeeding and asthma and allergies: A systematic review and meta-analysis

Journal article


Lodge, Caroline J., Tan, D. J., Lau, M. X. Z., Dai, Xiaochen, Tham, Rachel, Lowe, Adrian J., Bowatte, Gayan, Allen, K. J. and Dharmage, Shyamali Chandrika. (2015) Breastfeeding and asthma and allergies: A systematic review and meta-analysis. Acta Paediatrica. 104(467), pp. 38 - 53. https://doi.org/10.1111/apa.13132
AuthorsLodge, Caroline J., Tan, D. J., Lau, M. X. Z., Dai, Xiaochen, Tham, Rachel, Lowe, Adrian J., Bowatte, Gayan, Allen, K. J. and Dharmage, Shyamali Chandrika
Abstract

Aim
To systematically review the association between breastfeeding and childhood allergic disease.
Methods
Predetermined inclusion/exclusion criteria identified 89 articles from PubMed, CINAHL and EMBASE databases. Meta‐analyses performed for categories of breastfeeding and allergic outcomes. Meta‐regression explored heterogeneity.
Results
More vs. less breastfeeding (duration) was associated with reduced risk of asthma for children (5–18 years), particularly in medium‐/low‐income countries and with reduced risk of allergic rhinitis ≤5 years, but this estimate had high heterogeneity and low quality. Exclusive breastfeeding for 3–4 months was associated with reduced risk of eczema ≤2 years (estimate principally from cross‐sectional studies of low methodological quality). No association found between breastfeeding and food allergy (estimate had high heterogeneity and low quality). Meta‐regression found differences between study outcomes may be attributable to length of breastfeeding recall, study design, country income and date of study inception. Some of the protective effect of breastfeeding for asthma may be related to recall bias in studies of lesser methodological quality.
Conclusion
There is some evidence that breastfeeding is protective for asthma (5–18 years). There is weaker evidence for a protective effect for eczema ≤2 years and allergic rhinitis ≤5 years of age, with greater protection for asthma and eczema in low‐income countries.

KeywordsAllergic disease; asthma; meta‐analysis; systematic review
Year2015
JournalActa Paediatrica
Journal citation104 (467), pp. 38 - 53
PublisherWiley-Blackwell
ISSN0803-5253
Digital Object Identifier (DOI)https://doi.org/10.1111/apa.13132
Scopus EID2-s2.0-84947290052
Open accessOpen access
Page range38 - 53
Research GroupMary MacKillop Institute for Health Research
Publisher's version
License
Place of publicationUnited Kingdom
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