(New analysis - published November 2004)

Breastfeeding and risk of inflammatory bowel disease: a systematic review
with meta-analysis
http://www.ajcn.org/cgi/content/abstract/80/5/1342

American Journal of Clinical Nutrition, Vol. 80, No. 5, 1342-1352, November
2004
© 2004 American Society for Clinical Nutrition


Background: It has long been believed that breastfeeding provides protection
against ulcerative colitis and Crohn disease. Studies designated to test
this hypothesis were conducted without reaching conclusive results.

Objective: The aim of this meta-analysis was to examine the role of
breastfeeding in preventing inflammatory bowel disease and to summarize the
evidence gathered about this subject.

Design: A meta-analysis was performed on 17 relevant articles that were
found by using MEDLINE, EMBASE, the Internet, and articles' references. The
publications were fully reviewed and divided, on the basis of their quality,
into 3 groups.

Results: Studies showed heterogeneous results. The pooled odds ratios of all
the 17 reviewed studies, calculated according to the random-effects model,
were 0.67 (95% CI: 0.52, 0.86) for Crohn disease and 0.77 (0.61, 0.96) for
ulcerative colitis. However, only 4 studies for Crohn disease and 4 for
ulcerative colitis were eventually included in the highest quality group. In
this group, the pooled odds ratio was 0.45 (0.26, 0.79) for Crohn disease
and 0.56 (0.38, 0.81) for ulcerative colitis.

Conclusions: The results of this meta-analysis support the hypothesis that
breastfeeding is associated with lower risks of Crohn disease and ulcerative
colitis. However, because only a few studies were graded to be of high
quality, we suggest that further research, conducted with good methodology
and large sample sizes, should be carried out to strengthen the validity of
these observations.

Janice Reynolds

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