Systematic review and meta-analysis investigating breast feeding and childhood wheezing illness
Version of Record online: 25 AUG 2011
© 2011 Blackwell Publishing Ltd.
Paediatric and Perinatal Epidemiology
Volume 25, Issue 6, pages 507–518, November 2011
How to Cite
Brew, B. K., Allen, C. W., Toelle, B. G. and Marks, G. B. (2011), Systematic review and meta-analysis investigating breast feeding and childhood wheezing illness. Paediatric and Perinatal Epidemiology, 25: 507–518. doi: 10.1111/j.1365-3016.2011.01233.x
- Issue online: 10 OCT 2011
- Version of Record online: 25 AUG 2011
- breast feeding;
Brew BK, Allen CW, Toelle BG, Marks GB. Systematic review and meta-analysis investigating breast feeding and childhood wheezing illness. Paediatric and Perinatal Epidemiology 2011; 25: 507–518.
There is conflicting evidence concerning the relationship between breast feeding and wheezing illness. The objective of this study was to investigate whether there is any association between breast feeding and wheezing in children aged over 5 years and to discover possible sources of heterogeneity. An electronic search of MEDLINE and EMBASE databases was conducted from January 2000 to June 2010. In addition, reference lists from relevant publications were searched. Birth cohort, cross-sectional and case–control studies were included if they measured any breast feeding or exclusive breast feeding for 3 or 4 months. Wheezing illness, including asthma, was identified based on symptoms, reported diagnosis or objective criteria. Thirty-one publications were identified for meta-analysis. There was no association found between any or exclusive breast feeding and wheezing illness, although there was a high level of heterogeneity between the studies. Subgroup analysis revealed that any breast feeding slightly lowers the odds of wheeze (pooled odds ratio 0.92 [0.86, 0.98]) but slightly increases the odds of asthma defined by specific criteria (pooled odds ratio 1.10 [1.00, 1.22]). This meta-analysis does not provide evidence that breast feeding is protective against wheezing illness in children aged 5 years and over. The difference in the effects of breast feeding according to the nature of the wheezing illness highlights the importance of the heterogeneity of illness phenotypes.