Breastfeeding in Infancy and Adult Health: A Narrative Review

Area of Science:

• Developmental Origins of Health and Disease (DOHaD)
• Epidemiology
• Public Health

Background:

• Breastfeeding is a key modifiable exposure within the DOHaD framework.
• Long-term health associations of breastfeeding are challenging to isolate from confounding factors.
• Understanding breastfeeding's impact on adult health is crucial for public health strategies.

Purpose of the Study:

• To systematically review quantitative associations between infant breastfeeding and adult health outcomes.
• To evaluate evidence across cardiometabolic, cancer, and neurocognitive domains.
• To assess the magnitude and clinical relevance of breastfeeding's long-term effects.

Main Methods:

• Structured literature search of PubMed/MEDLINE and Scopus (Jan 2015-Dec 2025).
• Prioritization of large prospective cohorts and genetic epidemiology studies.
• Inclusion of 18 primary studies reporting on breastfeeding (ever/never, duration, exclusivity) and adult outcomes.

Main Results:

• Breastfeeding associated with modestly lower all-cause and cardiovascular mortality.
• Small reductions observed in cardiovascular disease, type 2 diabetes, and improved cardiometabolic profiles (lower adiposity, higher HDL cholesterol).
• Longer breastfeeding linked to slight advantages in cognitive performance, educational attainment, and psychological outcomes.

Conclusions:

• Breastfeeding is associated with modestly favorable adult cardiometabolic and neurobehavioral profiles.
• Observed effect sizes are generally small, indicating limited individual clinical impact but potential population relevance.
• Breastfeeding's contribution to long-term health should be interpreted cautiously, considering the influence of later-life factors.