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Am J Clin Nutr. 2019 Mar 1;109(Supplement_7):757S-771S. doi: 10.1093/ajcn/nqy306.

Infant milk-feeding practices and childhood leukemia: a systematic review.

Author information

1
Panum Group, Bethesda, MD.
2
USDA, Food and Nutrition Service, Alexandria, VA.
3
National Institutes of Health Library, Bethesda, MD.
4
Dell Medical School at the University of Texas, Austin, TX.
5
US Food and Drug Administration, contractor, College Park, MD.
6
US Food and Drug Administration, College Park, MD.
7
University of Rochester Medical Center, Rochester, NY.
8
University of Cincinnati College of Allied Health Sciences, Cincinnati, OH.
9
Division of Nutritional Sciences, Cornell University, Ithaca, NY.
10
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
11
Department of Nutrition, Harvard School of Public Health, Boston, MA.
12
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT.
13
Department of Pediatrics, The University of Iowa, Iowa City, IA.

Abstract

BACKGROUND:

During the Pregnancy and Birth to 24 Months Project, the US Departments of Agriculture and Health and Human Services initiated a review of evidence on diet and health in these populations.

OBJECTIVES:

The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding, and 4) feeding a lower versus higher intensity of human milk to mixed-fed infants with acute childhood leukemia, generally, and acute lymphoblastic leukemia, specifically.

METHODS:

The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January 1980 to March 2016, dual-screened the results using predetermined criteria, extracted data from and assessed risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence.

RESULTS:

We included 24 articles from case-control or retrospective studies. Limited evidence suggests that never feeding human milk versus 1) ever feeding human milk and 2) feeding human milk for durations ≥6 mo are associated with a slightly higher risk of acute childhood leukemia, whereas evidence comparing never feeding human milk with feeding human milk for durations <6 mo is mixed. Limited evidence suggests that, among infants fed human milk, a shorter versus longer duration of human milk feeding is associated with a slightly higher risk of acute childhood leukemia. None of the included articles examined exclusive human milk feeding or the intensity of human milk fed to mixed-fed infants.

CONCLUSIONS:

Feeding human milk for short durations or not at all may be associated with slightly higher acute childhood leukemia risk. The evidence could be strengthened with access to broadly generalizable prospective samples; therefore, we recommend linking surveillance systems that collect infant feeding and childhood cancer data.

KEYWORDS:

breast milk; breastfeeding; child; human milk; infant; leukemia; systematic review; toddler

PMID:
30982871
PMCID:
PMC6500929
[Available on 2020-03-01]
DOI:
10.1093/ajcn/nqy306

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