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Aliment Pharmacol Ther. 2017 Nov;46(9):780-789. doi: 10.1111/apt.14291. Epub 2017 Sep 11.

Systematic review with meta-analysis: breastfeeding and the risk of Crohn's disease and ulcerative colitis.

Author information

1
Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
2
Harvard Medical School, Boston, MA, USA.
3
Gastroenterology and Liver Services, Concord Hospital, Sydney, NSW, Australia.
4
Cardiac Imaging Core Laboratory and Clinical Trials Endpoints Center, Brigham and Women's Hospital, Boston, MA, USA.

Abstract

BACKGROUND:

Breastfeeding is a modifiable factor that may influence development of inflammatory bowel diseases. However, literature on this has been inconsistent and not accounted for heterogeneity in populations and exposure.

AIM:

To conduct a meta-analysis to examine the association between breastfeeding in infancy and risk of Crohn's disease (CD) and ulcerative colitis (UC).

METHODS:

A systematic search of Medline/PubMed and Embase was performed for full text, English-language literature through November 2016. Studies were included if they described breastfeeding in infancy in patients with CD or UC, and healthy controls. Data were pooled using a random effects model for analysis.

RESULTS:

A total of 35 studies were included in the final analysis, comprising 7536 individuals with CD, 7353 with UC and 330 222 controls. Ever being breastfed was associated with a lower risk of CD (OR 0.71, 95% CI 0.59-0.85) and UC (OR 0.78, 95% CI 0.67-0.91). While this inverse association was observed in all ethnicity groups, the magnitude of protection was significantly greater among Asians (OR 0.31, 95% CI 0.20-0.48) compared to Caucasians (OR 0.78, 95% CI 0.66-0.93; P = .0001) in CD. Breastfeeding duration showed a dose-dependent association, with strongest decrease in risk when breastfed for at least 12 months for CD (OR 0.20, 95% CI 0.08-0.50) and UC (OR 0.21, 95% CI 0.10-0.43) as compared to 3 or 6 months.

CONCLUSION:

Breastfeeding in infancy protects against the development of CD and ulcerative colitis.

PMID:
28892171
PMCID:
PMC5688338
DOI:
10.1111/apt.14291
[Indexed for MEDLINE]
Free PMC Article

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