Abstract
To systematically review the association between breastfeeding and childhood allergic disease. Predetermined inclusion/exclusion criteria identified 89 articles from PubMed, CINAHL and EMBASE databases. Meta-analyses performed for categories of breastfeeding and allergic outcomes. Meta-regression explored heterogeneity. More vs. less breastfeeding (duration) was associated with reduced risk of asthma for children (5-18 years), particularly in medium-/low-income countries and with reduced risk of allergic rhinitis ≤5 years, but this estimate had high heterogeneity and low quality. Exclusive breastfeeding for 3-4 months was associated with reduced risk of eczema ≤2 years (estimate principally from cross-sectional studies of low methodological quality). No association found between breastfeeding and food allergy (estimate had high heterogeneity and low quality). Meta-regression found differences between study outcomes may be attributable to length of breastfeeding recall, study design, country income and date of study inception. Some of the protective effect of breastfeeding for asthma may be related to recall bias in studies of lesser methodological quality. There is some evidence that breastfeeding is protective for asthma (5-18 years). There is weaker evidence for a protective effect for eczema ≤2 years and allergic rhinitis ≤5 years of age, with greater protection for asthma and eczema in low-income countries.
Highlights
Allergic diseases are common in childhood and a significant cause of morbidity [1]
There has been a dramatic rise in prevalence of these conditions [2,3], which include asthma, eczema and allergic rhinitis, and a similar, delayed increase has been observed for food allergy in the last 10–15 years [4]
The complexity and severity of allergic disease continues to Abbreviations CINAHL, Cumulative Index of Nursing and Allied Health Literature; EMBASE, Excerpta Medica database; GRADE/ Grade, the Grading of Recommendations Assessment, Development and Evaluation system; ISAAC, International study of Asthma and Allergies in Childhood; Newcastle–Ottawa scale (NOS), Newcastle–Ottawa Scale; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-analyses
Summary
Allergic diseases are common in childhood and a significant cause of morbidity [1]. There has been a dramatic rise in prevalence of these conditions [2,3], which include asthma, eczema and allergic rhinitis, and a similar, delayed increase has been observed for food allergy in the last 10–15 years [4]. Allergic rhinitis is estimated to affect between 10 and 30% of the global population [3]. The complexity and severity of allergic disease continues to Abbreviations CINAHL, Cumulative Index of Nursing and Allied Health Literature; EMBASE, Excerpta Medica database; GRADE/ Grade, the Grading of Recommendations Assessment, Development and Evaluation system; ISAAC, International study of Asthma and Allergies in Childhood; NOS, Newcastle–Ottawa Scale; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-analyses.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
