Association between Breast Feeding and Paediatric Sleep Disordered Breathing: a Systematic Review

• Published in: Paediatric and perinatal epidemiology Vol. 31; no. 4; pp. 348 - 362
• Main Authors: Ponce‐Garcia, Cecilia, Hernandez, Ivonne Angelica, Major, Paul, Flores‐Mir, Carlos
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-07-2017
• Subjects: Baby foods; Breast; Breast feeding; Breast Feeding - statistics & numerical data; Breastfeeding & lactation; Breathing; Child; Child, Preschool; Children; Criteria; Data collection; Diagnostic software; Diagnostic systems; Feeding; Health risk assessment; Heterogeneity; Humans; Infant; infant feeding; Infant, Newborn; Measurement methods; obstructive sleep apnea; Population studies; Respiration; Reviews; Risk; Risk reduction; Sleep; Sleep Apnea Syndromes - epidemiology; Sleep Apnea Syndromes - etiology; sleep disordered breathing; Sleep disorders; snoring; Statistical analysis; Studies; obstructive sleep apnea; infant feeding; sleep disordered breathing; breast feeding; snoring
• ISSN: 0269-5022; 1365-3016
• DOI: 10.1111/ppe.12372

Background
Breast feeding has been suggested as a potential protective factor against childhood snoring and sleep disordered breathing (SDB). SDB can have major health consequences. The objective of this systematic review is to synthesise the available literature concerning any potential association between infant feeding methods and SDB in young children.
Methods
Five electronic databases were searched. All searches were inclusive until August 5, 2016. Two authors independently reviewed potentially relevant articles for eligibility. Any prospective or retrospective study, case‐control study, cohort study, clinical trial, and cross‐sectional study that evaluated the association between infant feeding methods and SDB were included. Data on study design, aim of study, sample size, study population, assessment tool, infant feeding methods, and outcome measures were extracted.
Results
Nine studies fulfilled the criteria to be finally included in this review, only cohorts and cross‐sectional studies were identified. While seven of the selected studies reported a statistically significant association between breast feeding and reduced risk of SDB, the remaining two studies did not report any association. The main methodological limitation was high heterogeneity in the diagnostic criteria and assessment tools to identify SDB and limited data collection on infant feeding methods.
Conclusions
The current evidence may point to a protective association, however, as uncertainty is moderate, any suggestion that breast feeding may or may not decrease the risk of SDB is currently unwarranted. More research on the topic is required to resolve some of the contradictions between included studies.