Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis
Abstract Background Despite numerous reviews examining the impact of exclusive breastfeeding on preventing childhood pneumonia and asthma, a comprehensive and up-to-date synthesis is lacking. This umbrella review aims to consolidate the current evidence on the link between non-exclusive breastfeedin...
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2025-03-01
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| Series: | International Breastfeeding Journal |
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| Online Access: | https://doi.org/10.1186/s13006-025-00712-w |
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| author | Biruk Beletew Abate Biruk Shalmeno Tusa Ashenafi Kibret Sendekie Freweyni Gebreegziabher Araya Molla Azmeraw Bizuayehu Getachew Tesfaw Walle Tegene Atamenta Kitaw Befkad Derese Tilahun Addis Wondmagegn Alamaw Alemu Birara Zemariam Amare Kassaw Ayelign Mengesha Kassie Gizachew Yilak Fassikaw Kebede Bizuneh Berihun Dachew |
| author_facet | Biruk Beletew Abate Biruk Shalmeno Tusa Ashenafi Kibret Sendekie Freweyni Gebreegziabher Araya Molla Azmeraw Bizuayehu Getachew Tesfaw Walle Tegene Atamenta Kitaw Befkad Derese Tilahun Addis Wondmagegn Alamaw Alemu Birara Zemariam Amare Kassaw Ayelign Mengesha Kassie Gizachew Yilak Fassikaw Kebede Bizuneh Berihun Dachew |
| author_sort | Biruk Beletew Abate |
| collection | DOAJ |
| description | Abstract Background Despite numerous reviews examining the impact of exclusive breastfeeding on preventing childhood pneumonia and asthma, a comprehensive and up-to-date synthesis is lacking. This umbrella review aims to consolidate the current evidence on the link between non-exclusive breastfeeding and the risk of pneumonia and asthma in under-five children. Methods A comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science, the Cochrane Database of Systematic Reviews, and Google Scholar to identify systematic review and meta-analysis (SRM) studies evaluating the effect of exclusive breastfeeding on preventing childhood pneumonia and asthma globally. The latest search was conducted on January 25/2025. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews Two (AMSTAR-2) tool. A weighted inverse variance random-effects model was employed to generate pooled estimates. Summary effect estimates were expressed using odds ratios (OR) with 95% confidence intervals (CI). We evaluated the quality of evidence for each association using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, categorising it as convincing (class I), highly suggestive (class II), suggestive (class III), and weak (class IV). Results Twelve SRMs, including 270 primary studies with over ten million participants, were analysed. The random-effects model revealed a highly suggestive association between non-exclusive breastfeeding and an increase in the risk of pneumonia (OR 2.34; 95% CI 1.89, 2.78, GRADE: highly suggestive). Similarly, there was highly suggestive evidence that non-exclusive breastfeeding was associated with a 29% higher risk of childhood asthma (OR 1.21; 95% CI 1.07, 1.34, GRADE: highly suggestive). Conclusion Our results highlighted that non-exclusive breastfeeding is associated with an increased risk of pneumonia and asthma in under-five children. These findings emphasise the critical role of exclusive breastfeeding in reducing the risk of respiratory health issues, highlighting the need for policies and initiatives that promote breastfeeding as a key strategy for improving children’s health outcomes. |
| format | Article |
| id | doaj-art-e717ab2e3ef54843813639e974dd9d3e |
| institution | DOAJ |
| issn | 1746-4358 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | International Breastfeeding Journal |
| spelling | doaj-art-e717ab2e3ef54843813639e974dd9d3e2025-08-20T02:49:06ZengBMCInternational Breastfeeding Journal1746-43582025-03-012011910.1186/s13006-025-00712-wNon-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysisBiruk Beletew Abate0Biruk Shalmeno Tusa1Ashenafi Kibret Sendekie2Freweyni Gebreegziabher Araya3Molla Azmeraw Bizuayehu4Getachew Tesfaw Walle5Tegene Atamenta Kitaw6Befkad Derese Tilahun7Addis Wondmagegn Alamaw8Alemu Birara Zemariam9Amare Kassaw10Ayelign Mengesha Kassie11Gizachew Yilak12Fassikaw Kebede Bizuneh13Berihun Dachew14School of Population Health, Curtin UniversitySchool of Population Health, Curtin UniversityDepartment of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of GondarDepartment of Nursing, College of Health Science, Woldia UniversityDepartment of Nursing, College of Health Science, Woldia UniversityDepartment of Nursing, College of Health Science, Woldia UniversityDepartment of Nursing, College of Health Science, Woldia UniversityDepartment of Nursing, College of Health Science, Woldia UniversityDepartment of Nursing, College of Health Science, Woldia UniversityDepartment of Nursing, College of Health Science, Woldia UniversityDepartment of Nursing, College of Health Science, Debre Tabor UniversityDepartment of Nursing, College of Health Science, Woldia UniversityDepartment of Nursing, College of Health Science, Woldia UniversityCollege of Health Science, Debre Markos UniversitySchool of Population Health, Curtin UniversityAbstract Background Despite numerous reviews examining the impact of exclusive breastfeeding on preventing childhood pneumonia and asthma, a comprehensive and up-to-date synthesis is lacking. This umbrella review aims to consolidate the current evidence on the link between non-exclusive breastfeeding and the risk of pneumonia and asthma in under-five children. Methods A comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science, the Cochrane Database of Systematic Reviews, and Google Scholar to identify systematic review and meta-analysis (SRM) studies evaluating the effect of exclusive breastfeeding on preventing childhood pneumonia and asthma globally. The latest search was conducted on January 25/2025. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews Two (AMSTAR-2) tool. A weighted inverse variance random-effects model was employed to generate pooled estimates. Summary effect estimates were expressed using odds ratios (OR) with 95% confidence intervals (CI). We evaluated the quality of evidence for each association using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, categorising it as convincing (class I), highly suggestive (class II), suggestive (class III), and weak (class IV). Results Twelve SRMs, including 270 primary studies with over ten million participants, were analysed. The random-effects model revealed a highly suggestive association between non-exclusive breastfeeding and an increase in the risk of pneumonia (OR 2.34; 95% CI 1.89, 2.78, GRADE: highly suggestive). Similarly, there was highly suggestive evidence that non-exclusive breastfeeding was associated with a 29% higher risk of childhood asthma (OR 1.21; 95% CI 1.07, 1.34, GRADE: highly suggestive). Conclusion Our results highlighted that non-exclusive breastfeeding is associated with an increased risk of pneumonia and asthma in under-five children. These findings emphasise the critical role of exclusive breastfeeding in reducing the risk of respiratory health issues, highlighting the need for policies and initiatives that promote breastfeeding as a key strategy for improving children’s health outcomes.https://doi.org/10.1186/s13006-025-00712-wExclusive breastfeedingAsthmaPneumoniaUmbrella reviewUnder-five children |
| spellingShingle | Biruk Beletew Abate Biruk Shalmeno Tusa Ashenafi Kibret Sendekie Freweyni Gebreegziabher Araya Molla Azmeraw Bizuayehu Getachew Tesfaw Walle Tegene Atamenta Kitaw Befkad Derese Tilahun Addis Wondmagegn Alamaw Alemu Birara Zemariam Amare Kassaw Ayelign Mengesha Kassie Gizachew Yilak Fassikaw Kebede Bizuneh Berihun Dachew Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis International Breastfeeding Journal Exclusive breastfeeding Asthma Pneumonia Umbrella review Under-five children |
| title | Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis |
| title_full | Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis |
| title_fullStr | Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis |
| title_full_unstemmed | Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis |
| title_short | Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis |
| title_sort | non exclusive breastfeeding is associated with pneumonia and asthma in under five children an umbrella review of systematic review and meta analysis |
| topic | Exclusive breastfeeding Asthma Pneumonia Umbrella review Under-five children |
| url | https://doi.org/10.1186/s13006-025-00712-w |
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