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Acta Paediatr. 2015 Dec;104(467):38-53. doi: 10.1111/apa.13132.

Breastfeeding and asthma and allergies: a systematic review and meta-analysis.

Author information

1
Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia.
2
Murdoch Childrens Research Institute and University of Melbourne Department of Paediatrics, Royal Children's Hospital, Parkville, Victoria, Australia.
3
NHMRC Centre of Research Excellence for Chronic Respiratory Disease, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
4
Institute of Inflammation and Repair, University of Manchester, UK.

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.

KEYWORDS:

Allergic disease; asthma; meta-analysis; systematic review

PMID:
26192405
DOI:
10.1111/apa.13132
[Indexed for MEDLINE]

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