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Breastfeeding and Lung Function of Children: A Systematic Review and Meta-Analysis
Ming Li1, Chao Wang2, Jiamin Wang1
1School of Public Health, China Medical University, Shenyang, Liaoning, China.
Insights
Breastfeeding is associated with improved lung function in children aged 6-16 years. Children breastfed for three to four months or longer showed better results in forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF).
Area of Science:
- Pediatric Pulmonology
- Public Health Nutrition
- Epidemiology
Background:
- Lung function development is crucial for long-term respiratory health.
- Breastfeeding is recognized for its numerous health benefits, but its specific impact on lung function requires further elucidation.
- Understanding the relationship between early-life nutrition and respiratory outcomes is vital for public health initiatives.
Purpose of the Study:
- To systematically review and evaluate the association between breastfeeding and lung function in children without pre-existing respiratory conditions.
- To determine the specific effects of breastfeeding duration and exclusivity on spirometric measures.
- To synthesize evidence from observational studies and randomized controlled trials.
Main Methods:
- A comprehensive systematic search of PubMed, Embase, and Cochrane databases was conducted up to October 11, 2023.
- Included studies were observational (cohort, cross-sectional, case-control) and randomized controlled trials (RCTs).
- Meta-analysis using random-effects or fixed-effects models was employed based on heterogeneity assessment.
Main Results:
- Thirteen observational studies (18,152 children) and five meta-analyzed studies (5,305 children) were included.
- Breastfed children demonstrated significantly better forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) compared to never-breastfed children.
- Children breastfed for three to four months or longer exhibited enhanced FEV1, forced vital capacity (FVC), and PEF compared to those breastfed for shorter durations.
Conclusions:
- This systematic review and meta-analysis indicates a positive association between breastfeeding and improved lung function in children aged 6-16 years.
- Longer duration of breastfeeding (≥3-4 months) appears to confer greater benefits to lung function parameters.
- Further high-quality research is warranted to strengthen these findings and explore underlying mechanisms.
Aim:
To evaluate the associations between breastfeeding and lung function among children without known respiratory diseases and to determine the effects of breastfeeding on spirometry.
Methods:
A systematic search of PubMed, Embase and Cochrane was performed from their inception to 11 Oct 2023 (PROSPERO identifier: CRD42023471664). Observational studies (cohort or cross-sectional or case-control design) and randomised controlled trials (RCTs) were searched. A random-effects model meta-analysis was used to estimate the effect size if significant heterogeneity was detected (p < 0.05 or I2 > 50%); Otherwise, the fixed-effects model was applied.
Results:
In total, 13 observational studies with 18 152 children were included in the qualitative synthesis, and five studies with 5305 children were included in the meta-analysis. Compared to children who were never breastfed, those who were breastfed had better FEV1 (β: 19.34 mL; 95% CI: 6.05, 32.64; p = 0.004) and PEF (β: 87.50 mL/s; 95% CI: 27.43, 147.58; p = 0.004). A similar trend was observed for FVC (β: 17.45 mL; 95% CI: -0.43, 35.33; p = 0.06). Furthermore, compared to children breastfed for less than three to four months, those breastfed for three to four months or more had better FEV1 (β: 19.86 mL; 95% CI: 4.21, 35.51; p = 0.01), FVC (β: 31.90 mL; 95% CI: 7.87, 55.93; p = 0.009) and PEF (β: 75.68 mL/s; 95% CI: 24.40, 126.97; p = 0.004).
Conclusion:
This systematic review and meta-analysis revealed associations between breastfeeding and improved lung function in children aged 6-16 years. Further high-quality evidence is needed.
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