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Breastfeeding and risk of childhood asthma: a systematic review and meta-analysis

Mike Xue, Emily Dehaas, Nagendra Chaudhary, Paul O'Byrne, Imran Satia, Om P. Kurmi
ERJ Open Research 2021 7: 00504-2021; DOI: 10.1183/23120541.00504-2021
Mike Xue
1Dept of Family Medicine, Queen's University, Kingston, Canada
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Emily Dehaas
2Dept of Medicine, University of Toronto, Toronto, Canada
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Nagendra Chaudhary
3Dept of Pediatrics, Universal College of Medical Sciences, Bhairahawa, Nepal
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  • ORCID record for Nagendra Chaudhary
Paul O'Byrne
4Dept of Medicine, Division of Respirology, McMaster University, Hamilton, Canada
5Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada
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Imran Satia
4Dept of Medicine, Division of Respirology, McMaster University, Hamilton, Canada
5Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada
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Om P. Kurmi
4Dept of Medicine, Division of Respirology, McMaster University, Hamilton, Canada
5Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Canada
6Faculty Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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  • For correspondence: om.kurmi@coventry.ac.uk
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Abstract

Objective To investigate the relationship between breastfeeding and the development of paediatric asthma.

Methods A systematic review and meta-analysis was conducted with MEDLINE, Embase, CINAHL and ProQuest Nursing and Allied Health source databases. Retrospective/prospective cohorts in children aged <18 years with breastfeeding exposure reported were included. The primary outcome was a diagnosis of asthma by a physician or using a guideline-based criterion. A secondary outcome was asthma severity.

Results 42 studies met inclusion criteria. 37 studies reported the primary outcome of physician-/guideline-diagnosed asthma, and five studies reported effects on asthma severity. Children with longer duration/more breastfeeding compared to shorter duration/less breastfeeding have a lower risk of asthma (OR 0.84, 95% CI 0.75–0.93; I2 = 62.4%). Similarly, a lower risk of asthma was found in children who had more exclusive breastfeeding versus less exclusive breastfeeding (OR 0.81, 95% CI 0.72–0.91; I2=44%). Further stratified analysis of different age groups demonstrated a lower risk of asthma in the 0–2-years age group (OR 0.73, 95% CI 0.63–0.83) and the 3–6-years age group (OR 0.69, 95% CI 0.55–0.87); there was no statistically significant effect on the ≥7-years age group.

Conclusion The findings suggest that the duration and exclusivity of breastfeeding are associated with a lower risk of asthma in children aged <7 years.

Abstract

The findings of this systematic review and meta-analysis of cohort studies suggest that duration and exclusivity of breastfeeding are associated with a lower risk of asthma in children aged <7 years https://bit.ly/3p804PG

Footnotes

  • Author contributions: M. Xue and E. Dehaas share joint first authorship. M. Xue, E. Dehaas and O.P. Kurmi designed the review. Database search, article identification, data extraction and risk-of-bias assessment were conducted by M. Xue and E. Dehaas. M. Xue and O.P. Kurmi analysed the data. M. Xue, E. Dehaas and O.P. Kurmi drafted the manuscript. O.P. Kurmi provided advice at multiple different stages. All authors critically reviewed the manuscript and approved the final manuscript submission. The corresponding author attests that all listed authors meet authorship criteria and that no others have been omitted.

  • Provenance: Submitted article, peer reviewed.

  • This article has supplementary material available from openres.ersjournals.com

  • This review is registered in PROSPERO with identifier number CRD42018099831.

  • Data sharing: Full datasets can be obtained from the corresponding author.

  • Conflict of interest: M. Xue has nothing to disclose.

  • Conflict of interest: E. Dehaas has nothing to disclose.

  • Conflict of interest: N. Chaudhary has nothing to disclose.

  • Conflict of interest: P. O'Byrne has nothing to disclose.

  • Conflict of interest: I. Satia has nothing to disclose.

  • Conflict of interest: O.P. Kurmi has nothing to disclose.

  • Received August 12, 2021.
  • Accepted August 15, 2021.
  • Copyright ©The authors 2021
http://creativecommons.org/licenses/by-nc/4.0/

This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org

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Breastfeeding and risk of childhood asthma: a systematic review and meta-analysis
Mike Xue, Emily Dehaas, Nagendra Chaudhary, Paul O'Byrne, Imran Satia, Om P. Kurmi
ERJ Open Research Oct 2021, 7 (4) 00504-2021; DOI: 10.1183/23120541.00504-2021

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Breastfeeding and risk of childhood asthma: a systematic review and meta-analysis
Mike Xue, Emily Dehaas, Nagendra Chaudhary, Paul O'Byrne, Imran Satia, Om P. Kurmi
ERJ Open Research Oct 2021, 7 (4) 00504-2021; DOI: 10.1183/23120541.00504-2021
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