Breastfeeding and sleep-disordered breathing in children: systematic review and proposal of underlying interaction
M Storari1, F Yanez-Regonesi2, G Denotti3
1Department of Surgical Science, Institute of Dentistry, Division of Orthodontics, University of Cagliari, Cagliari, Italy.
Insights
Breastfeeding offers significant protection against paediatric sleep-disordered breathing, including habitual snoring, by mitigating risk factors. Further research is needed to confirm these protective effects in children and adolescents.
Area of Science:
- Pediatric Health
- Sleep Medicine
- Public Health
Background:
- Paediatric sleep breathing disorders are an increasing concern.
- Protective factors against these disorders are not well-established.
- Evidence on breastfeeding's role in preventing childhood sleep issues is limited.
Purpose of the Study:
- To systematically review evidence on breastfeeding's effect on childhood snoring and obstructive sleep apnea.
- To describe the mechanisms through which breastfeeding may protect against sleep-disordered breathing.
- To identify gaps in current research regarding protective factors.
Main Methods:
- Systematic literature search of PubMed, ScienceDirect, Medline, and Scopus up to October 2020.
- Inclusion of diverse study designs (prospective, retrospective, cohort, etc.) without language or publication date restrictions.
- PRISMA guidelines followed for study selection and data extraction; supplementary search for interaction mechanisms.
Main Results:
- Breastfeeding demonstrates a protective effect against paediatric sleep-disordered breathing.
- This protection is particularly noted for habitual snoring.
- Breastfeeding appears to prevent associated risk factors contributing to sleep-disordered breathing.
Conclusions:
- Breastfeeding is a viable protective factor for children and adolescents against sleep-disordered breathing.
- Further high-quality prospective studies are necessary to validate these findings.
- Understanding the mechanisms of interaction can inform preventative strategies.
Aim:
Paediatric sleep breathing disorders represent an emerging paediatric health concern. Despite risk factors are widely discussed in literature, evidences about protective factors are lacking. The aim of this systematic review was to examine the available evidence about the effect of breastfeeding on snoring and obstructive sleep apnea in childhood, and to methodically describe the underlying mechanism of interaction.
Methods:
The study protocol was registered in advance in PROSPERO (CRD42020212529). Electronic search of the literature was performed up to October 10th, 2020 using four databases: PubMed, ScienceDirect, Medline and Scopus. Two authors independently retrieved potentially relevant articles to meet eligibility criteria. PRISMA guidelines were followed. Prospective, retrospective, case-control, cohort, clinical trial and cross-sectional studies investigating the association between breastfeeding and paediatric sleep-disordered breathing were included and data were extracted. No restrictions on language or date of publication were set. Subsequently, a search in the literature was further done to investigate underlying mechanisms of interaction.
Conclusion:
This review suggests that breastfeeding can effectively protect children and adolescents from sleep-disordered breathing, especially from habitual snoring, by preventing the associated risk factors. Future prospective studies with more efficient design are required.
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