Breastfeeding and Lung Function of Children: A Systematic Review and Meta‐Analysis

Abstract

ABSTRACTAimTo evaluate the associations between breastfeeding and lung function among children without known respiratory diseases and to determine the effects of breastfeeding on spirometry.MethodsA systematic search of PubMed, Embase and Cochrane was performed from their inception to 11 Oct 2023 (PROSPERO identifier: CRD42023471664). Observational studies (cohort or cross‐sectional or case–control design) and randomised controlled trials (RCTs) were searched. A random‐effects model meta‐analysis was used to estimate the effect size if significant heterogeneity was detected (p < 0.05 or I2 > 50%); Otherwise, the fixed‐effects model was applied.ResultsIn total, 13 observational studies with 18 152 children were included in the qualitative synthesis, and five studies with 5305 children were included in the meta‐analysis. Compared to children who were never breastfed, those who were breastfed had better FEV1 (β: 19.34 mL; 95% CI: 6.05, 32.64; p = 0.004) and PEF (β: 87.50 mL/s; 95% CI: 27.43, 147.58; p = 0.004). A similar trend was observed for FVC (β: 17.45 mL; 95% CI: −0.43, 35.33; p = 0.06). Furthermore, compared to children breastfed for less than three to four months, those breastfed for three to four 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/s; 95% CI: 24.40, 126.97; p = 0.004).ConclusionThis systematic review and meta‐analysis revealed associations between breastfeeding and improved lung function in children aged 6–16 years. Further high‐quality evidence is needed.