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Meta-Analysis
. 2023 Oct 16;21(1):393.
doi: 10.1186/s12916-023-03071-7.

Association of breastfeeding with mental disorders in mother and child: a systematic review and meta-analysis

Polina Bugaeva #  1 , Inna Arkusha #  2   3 , Rinat Bikaev #  3 , Igor Kamenskiy  4 , Aleksandra Pokrovskaya  5 , Yasmin El-Taravi  6 , Valeria Caso  7 , Alla Avedisova  2 , Derek K Chu  8 , Jon Genuneit  9   10 , Gabriel Torbahn  11   12 , Timothy R Nicholson  13 , Dina Baimukhambetova  14 , Aigun Mursalova  14 , Anastasia Kolotilina  14 , Svetlana Gadetskaya  14 , Elena Kondrikova  14 , Mikhail Zinchuk  3 , Renat Akzhigitov  3 , Robert J Boyle  15 , Alla Guekht  3 , Daniel Munblit  16   17   18   19
Affiliations
Meta-Analysis

Association of breastfeeding with mental disorders in mother and child: a systematic review and meta-analysis

Polina Bugaeva et al. BMC Med. .

Abstract

Background: Breastfeeding has long been associated with numerous benefits for both mothers and infants. While some observational studies have explored the relationship between breastfeeding and mental health outcomes in mothers and children, a systematic review of the available evidence is lacking. The purpose of this study is to systematically evaluate the association between breastfeeding and mental health disorders in mothers and children.

Methods: We systematically searched MEDLINE and EMBASE from inception to June 2, 2023. The inclusion criteria consisted of all studies evaluating links between breastfeeding and development of mental health disorders in children and mothers. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) while grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the certainty of evidence. A random-effects meta-analysis was used if possible, to estimate the odds ratio for the association between breastfeeding and mental health outcomes. The Mantel-Haenszel method was utilised for pooling ORs across studies. Study heterogeneity was assessed using the I2 statistic.

Results: Our review identified twenty-one original study. Of these, 18 focused on the association between breastfeeding and child health, assessing depressive disorders, schizophrenia, anxiety disorders, eating disorders and borderline personality disorder. Three studies evaluated the associations between breastfeeding and maternal mental health disorders. Three studies looking at outcomes in children showed no significant association between breastfeeding and occurrence of schizophrenia later in life (OR 0.98; 95% CI 0.57-1.71; I2 = 29%). For depressive disorders (5 studies) and anxiety disorders (3 studies), we found conflicting evidence with some studies showing a small protective effect while others found no effect. The GRADE certainty for all these findings was very low due to multiple limitations. Three studies looking at association between breastfeeding and maternal mental health, were too heterogeneous to draw any firm conclusions.

Conclusions: We found limited evidence to support a protective association between breastfeeding and the development of mental health disorders in children later in life. The data regarding the association between breastfeeding and maternal mental health beyond the postnatal period is also limited. The methodological limitations of the published literature prevent definitive conclusions, and further research is needed to better understand the relationship between breastfeeding and mental health in mothers and children.

Keywords: Anxiety disorders; Breastfeeding; Child health; Depressive disorders; Maternal health; Mental health; Schizophrenia; Systematic review.

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Conflict of interest statement

The authors declare no support from any organisation for the submitted work. Outside of the submitted work, JG benefit from unrestricted research grants from Danone Nutricia Research to Leipzig University for research into human milk composition within the Ulm Birth Cohort Studies—this work is not related to the present publication; author RJB declares consultancy payment from Cochrane, Wiley and the British Society for Allergy and Clinical Immunology for editorial work and payment for expert witness work in cases involving food anaphylaxis and a disputed infant formula health claim.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram
Fig. 2
Fig. 2
Meta-analysis of case–control studies. Breastfeeding (ever vs. never) and risk of schizophrenia. 1.1.1. Primary analysis, which includes studies using non-family related subjects as a control group. 1.1.2. Sensitivity analysis, which included McCreadi et al. study, which used siblings as a control group
See this image and copyright information in PMC

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