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Am J Clin Nutr. 2019 Mar 1;109(Supplement_7):800S-816S. doi: 10.1093/ajcn/nqy332.

Infant milk-feeding practices and cardiovascular disease outcomes in offspring: 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 and Department of Nutrition, Harvard School of Public Health, Boston, MA.
11
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT.
12
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) lower versus higher intensities of human milk fed to mixed-fed infants with intermediate and endpoint cardiovascular disease (CVD) outcomes in offspring.

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-March 2016, dual-screened the results using predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence.

RESULTS:

The 4 systematic reviews included 13, 24, 6, and 0 articles, respectively. The evidence was insufficient to draw conclusions about endpoint CVD outcomes across all 4 systematic reviews. Limited evidence suggests that never versus ever being fed human milk is associated with higher blood pressure within a normal range at 6-7 y of age. Moderate evidence suggests there is no association between the duration of any human milk feeding and childhood blood pressure. Limited evidence suggests there is no association between the duration of exclusive human milk feeding and blood pressure or metabolic syndrome in childhood. Additional evidence about intermediate outcomes for the 4 systematic reviews was scant or inconclusive.

CONCLUSIONS:

There is insufficient evidence to draw conclusions about the relationships between infant milk-feeding practices and endpoint CVD outcomes; however, some evidence suggests that feeding less or no human milk is not associated with childhood hypertension.

KEYWORDS:

blood pressure; breastfeeding; cardiovascular disease; cholesterol; human milk; hypertension; infant nutrition; metabolic syndrome; systematic review

PMID:
30982872
PMCID:
PMC6500930
[Available on 2020-03-01]
DOI:
10.1093/ajcn/nqy332

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