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Eur Child Adolesc Psychiatry. 2019 Jan;28(1):19-30. doi: 10.1007/s00787-018-1182-4. Epub 2018 Jun 15.

Maternal breastfeeding and attention-deficit/hyperactivity disorder in children: a meta-analysis.

Author information

1
Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Kaohsiung, Taiwan.
2
WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan.
3
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
4
Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
5
Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung, Taiwan.
6
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.
7
Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, UK.
8
Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK.
9
Translational Psychiatry Research Group and Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
10
Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Rua Prof. Costa Mendes, 1608, 4o Andar, Fortaleza, CE, 60430-040, Brazil.
11
ESPA Research, 2A Hylton Park Road, Sunderland, SR5 3HD, UK.
12
Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
13
Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
14
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
15
Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
16
Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
17
Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.
18
Department of Child Psychiatry, Chang Gung Memorial Hospital at Taoyuan and Chang Gung University, Taoyuan, Taiwan.
19
Department of Pediatrics, DA-AN Women and Children Hospital, Tainan, Taiwan.
20
Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. py1029@adm.cgmh.org.tw.
21
Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. py1029@adm.cgmh.org.tw.

Abstract

Previous studies have suggested environmental factors may contribute to the risk of attention-deficit/hyperactivity disorder (ADHD). The current meta-analysis examined (1) the difference in the duration of maternal breastfeeding between children with and without ADHD, and (2) the association between maternal breastfeeding and ADHD in children. The data of individual studies were synthesized with a random-effects model. Eleven articles were included in this meta-analysis. Children with ADHD had significantly less breastfeeding duration than controls (Hedges' g = - 0.36, 95% confidence intervals (CIs) = - 0.61 to - 0.11, p = 0.005; difference in means: - 2.44 months, 95% CIs = - 3.17 to - 1.71, p < 0.001). In addition, the rates of non-exclusive breastfeeding in children with ADHD is significantly higher in "under 3 months" (odds ratio (OR) = 1.90, 95% CIs = 1.45 to 2.48, p < 0.001) but lower in "6 to 12 months" (OR = 0.69, 95% CIs = 0.49 to 0.98, p = 0.039) and "over 12 months" (OR = 0.58, 95% CIs = 0.35 to 0.97, p = 0.038) than controls. Children with ADHD received significantly higher rate of exclusive breastfeeding duration "under 3 months" (OR = 1.51, 95% CIs = 1.20 to 1.89, p < 0.001) but lower in "over 3 months" (OR = 0.52, 95% CIs = 0.29 to 0.95, p = 0.033) than controls. Furthermore, an association was found between non-breastfeeding and ADHD children (adjusted OR = 3.71, 95% CI = 1.94 to 7.11, p < 0.001). Our results suggest maternal breastfeeding is associated with a lower risk of ADHD in children. Future longitudinal research is required to confirm/refute these findings and to explore possible mechanisms underlying this association.

KEYWORDS:

Attention-deficit/hyperactivity disorder; Breastfeeding; Meta-analysis; Nutrition; Risk

PMID:
29907910
DOI:
10.1007/s00787-018-1182-4
[Indexed for MEDLINE]

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