Breastfeeding and lung function of children: a systematic review and meta-analysis

Abstract

Abstract There are many benefits of breastfeeding for children, women and society but robust evidence that breastfeeding is favorable for the lung function of children is lacking. To evaluate the associations of breastfeeding with the lung function of children with no known respiratory disease and to determine which lung function parameters are related to breastfeeding, the PubMed, Embase and Cochrane Library were searched from their inception to 11 Oct 2023. Observational studies (cohort, cross-sectional or case-control designs) were included. A random-effects model was used to estimate the combined β if significant heterogeneity was detected(P < 0.05 or I2 > 50%); otherwise, the fixed-effects model was applied. The outcomes measured were forced expiratory volume in one second(FEV1), forced vital capacity(FVC), forced expiratory volume in one second to forced vital capacity(FEV1/FVC), peak expiratory flow(PEF) and other relevant lung function parameters. Compared with children with never-breastfeeding, children with ever-breastfeeding had better FEV1(β:19.34 ml; 95%CI:6.05,32.64; P = 0.004) and FVC(β:75.68 ml; 95%CI:24.40,126.97; P = 0.004). Additionally there was a slight statistical significance for FVC(β:17.45 ml; 95%CI:-0.43,35.33; P = 0.06). Furthermore, compared with the breastfed for less than 3 to 4 months, Children who had been breastfed for 3 to 4 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; 95%CI:24.40,126.97; P = 0.004). No significant difference was detected in FEV1/FVC between breastfed and non-breastfed children(β:-0.28; 95%CI:-0.99,0.44; P = 0.44) or between those breastfed for less than 3 to 4 months and those breastfed for more than 3 to 4 months(β:-0.48; 95%CI:-1.45,0.48; P = 0.33). This systematic review and meta-analysis revealed that being breastfed or breastfed for more than 3 to 4 months seemed to be favorable for the improvement of lung function in children aged 6–16 years. And additional high-quality evidence is needed.