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Am J Clin Nutr. 2019 Mar 1;109(Supplement_7):838S-851S. doi: 10.1093/ajcn/nqy371.

Infant milk-feeding practices and diagnosed celiac disease and inflammatory bowel disease in offspring: a systematic review.

Author information

1
Panum Group, Bethesda, MD.
2
Food and Nutrition Service, USDA, 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 USDA and US Department of Health and Human Services initiated an evidence review on diet and health in these populations.

OBJECTIVE:

The aim of these systematic reviews was to examine the relationships of never versus ever feeding human milk, shorter versus longer durations of any and exclusive human milk feeding, and feeding a lower versus a higher intensity of human milk to mixed-fed infants with diagnosed celiac disease and inflammatory bowel disease (IBD).

METHODS:

The Nutrition Evidence Systematic Review team (formerly called the Nutrition Evidence Library) 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 9 celiac disease and 17 IBD articles. Limited case-control evidence suggests never versus ever being fed human milk is associated with higher risk of celiac disease, but concerns about reverse causality precluded a conclusion about the relationship of shorter versus longer durations of any human milk feeding with celiac disease. Evidence examining never versus ever feeding human milk and IBD was inconclusive, and limited, but consistent, case-control evidence suggests that, among infants fed human milk, shorter versus longer durations of any human milk feeding are associated with higher risk of IBD. For both outcomes, evidence examining the duration of exclusive human milk feeding was scant and no articles examined the intensity of human milk fed to mixed-fed infants.

CONCLUSION:

Limited case-control evidence suggests that feeding human milk for short durations or not at all associates with higher risk of diagnosed IBD and celiac disease, respectively. The small number of studies and concern about reverse causality and recall bias prevent stronger conclusions.

KEYWORDS:

Crohn disease; breast milk; breastfeeding; celiac disease; human milk; inflammatory bowel disease; systematic review; ulcerative colitis

PMID:
30982875
PMCID:
PMC6500925
[Available on 2020-03-01]
DOI:
10.1093/ajcn/nqy371

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