Long-term effects of breastfeeding – A systematic review

Breastfeeding has well-established short-term benefits, particularly the reduction of morbidity and mortality due to infectious diseases in childhood. A pooled analysis of studies carried out in middle/ low income countries showed that breastfeeding substantially lowers the risk of death from infectious diseases in the first two years of life.

Based on data from the United Kingdom Millennium Cohort, Quigley et al estimated that optimal breastfeeding practices could prevent a substantial proportion of hospital admissions due to diarrhea and lower respiratory tract infection. A systematic review by Kramer et al confirmed that exclusive breastfeeding in the first 6 months decreases morbidity from gastrointestinal and allergic diseases, without any negative effects on growth. Given such evidence, it has been recommended that in the first six months of life, every child should be exclusively breastfed, with partial breastfeeding continued until two years of age.

Building upon the strong evidence on the short-term effects of breastfeeding, the present review addresses its long-term consequences. Current evidence, mostly from high income countries, suggests that occurrence of non-communicable diseases may be programmed by exposures occurring during gestation or in the first years of life. Early diets, including the type of milk received, is one of the key exposures that may influence the development of adult diseases.

In 2007, we carried out a systematic review and meta-analysis on the long-term consequences of breastfeeding. The Department of Maternal, Newborn, Child and Adolescent Health of the World Health Organization has now commissioned an update of this review. The following long-term outcomes were reviewed: blood pressure, type-2 diabetes, serum cholesterol, overweight and obesity, and intellectual performance. These outcomes are of great interest to researchers, as made evident by the number of publications identified: 60 new publications were identified since 2006. This report describes the methods, results and conclusions of this updated review.

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