Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis.

IF 2.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

International Breastfeeding Journal Pub Date : 2025-03-25 DOI:10.1186/s13006-025-00712-w

Biruk Beletew Abate, Biruk Shalmeno Tusa, Ashenafi Kibret Sendekie, Freweyni Gebreegziabher Araya, Molla Azmeraw Bizuayehu, Getachew Tesfaw Walle, Tegene Atamenta Kitaw, Befkad Derese Tilahun, Addis Wondmagegn Alamaw, Alemu Birara Zemariam, Amare Kassaw, Ayelign Mengesha Kassie, Gizachew Yilak, Fassikaw Kebede Bizuneh, Berihun Dachew

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引用次数: 0

Abstract

Background: Despite numerous reviews examining the impact of exclusive breastfeeding on preventing childhood pneumonia and asthma, a comprehensive and up-to-date synthesis is lacking. This umbrella review aims to consolidate the current evidence on the link between non-exclusive breastfeeding and the risk of pneumonia and asthma in under-five children.

Methods: A comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science, the Cochrane Database of Systematic Reviews, and Google Scholar to identify systematic review and meta-analysis (SRM) studies evaluating the effect of exclusive breastfeeding on preventing childhood pneumonia and asthma globally. The latest search was conducted on January 25/2025. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews Two (AMSTAR-2) tool. A weighted inverse variance random-effects model was employed to generate pooled estimates. Summary effect estimates were expressed using odds ratios (OR) with 95% confidence intervals (CI). We evaluated the quality of evidence for each association using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, categorising it as convincing (class I), highly suggestive (class II), suggestive (class III), and weak (class IV).

Results: Twelve SRMs, including 270 primary studies with over ten million participants, were analysed. The random-effects model revealed a highly suggestive association between non-exclusive breastfeeding and an increase in the risk of pneumonia (OR 2.34; 95% CI 1.89, 2.78, GRADE: highly suggestive). Similarly, there was highly suggestive evidence that non-exclusive breastfeeding was associated with a 29% higher risk of childhood asthma (OR 1.21; 95% CI 1.07, 1.34, GRADE: highly suggestive).

Conclusion: Our results highlighted that non-exclusive breastfeeding is associated with an increased risk of pneumonia and asthma in under-five children. These findings emphasise the critical role of exclusive breastfeeding in reducing the risk of respiratory health issues, highlighting the need for policies and initiatives that promote breastfeeding as a key strategy for improving children's health outcomes.

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非纯母乳喂养与五岁以下儿童肺炎和哮喘相关：系统评价和荟萃分析的综合综述

背景：尽管许多综述研究了纯母乳喂养对预防儿童肺炎和哮喘的影响，但缺乏全面和最新的综合。这项总括性审查旨在巩固目前关于非纯母乳喂养与五岁以下儿童肺炎和哮喘风险之间联系的证据。方法：综合检索PubMed、Embase、Scopus、Web of Science、Cochrane系统评价数据库和谷歌Scholar，确定全球范围内评价纯母乳喂养对预防儿童肺炎和哮喘效果的系统评价和荟萃分析（SRM）研究。最近一次搜索是在2025年1月25日进行的。使用多重系统评价2 （AMSTAR-2）工具评估纳入研究的质量。采用加权逆方差随机效应模型生成汇总估计。总效应估计用比值比（OR）和95%置信区间（CI）表示。我们使用推荐、评估、发展和评估分级（GRADE）框架评估每个关联的证据质量，将其分类为令人信服（I类）、高度提示（II类）、提示（III类）和弱（IV类）。结果：分析了12个srm，包括270个主要研究，参与者超过1000万。随机效应模型显示，非纯母乳喂养与肺炎风险增加之间存在高度暗含的关联(OR 2.34；95% CI 1.89, 2.78， GRADE：高度提示)。同样，有高度暗含性的证据表明，非纯母乳喂养与儿童哮喘风险增加29%相关(OR 1.21；95% CI 1.07, 1.34， GRADE：高度提示)。结论：我们的研究结果强调，非纯母乳喂养与五岁以下儿童肺炎和哮喘风险增加有关。这些发现强调了纯母乳喂养在降低呼吸道健康问题风险方面的关键作用，强调需要制定政策和举措，将促进母乳喂养作为改善儿童健康结果的关键战略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Breastfeeding Journal Medicine-Obstetrics and Gynecology

CiteScore

6.30

自引率

11.40%

发文量

审稿时长

32 weeks

期刊介绍： Breastfeeding is recognized as an important public health issue with enormous social and economic implications. Infants who do not receive breast milk are likely to experience poorer health outcomes than breastfed infants; mothers who do not breastfeed increase their own health risks. Publications on the topic of breastfeeding are wide ranging. Articles about breastfeeding are currently published journals focused on nursing, midwifery, paediatric, obstetric, family medicine, public health, immunology, physiology, sociology and many other topics. In addition, electronic publishing allows fast publication time for authors and Open Access ensures the journal is easily accessible to readers.