Yan Zeng1,2, Ying Tang1,2, Jun Tang1,2, Jing Shi1,2, Li Zhang1,2, Tingting Zhu1,2, Dongqiong Xiao1,2, Yi Qu1,2, Dezhi Mu1,2. 1. Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China. 2. Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects, Ministry of Education, Sichuan University, Chengdu, People's Republic of China.
Abstract
Objectives: To summarize the current evidence on the association between maternal breastfeeding and the occurrence of attention deficit/hyperactivity disorder (ADHD) in offspring. Methods: We searched for studies published in English before May 2018 using the PubMed, EMBASE, Cochrane, and Web of Science databases. We included cohort studies, case-control studies, and cross-sectional studies, that focused on the association between maternal breastfeeding and the occurrence of ADHD in offspring. Random effects models were used for combined analyses. Results: Two cohort studies, 7 case-control studies and 3 cross-sectional studies, with 3,686 cases and 106,907 participants, were included. Children with any maternal breastfeeding had a lower incidence of ADHD than children who were never breastfed (odds ratio [OR]: 0.70; 95% confidence interval [CI]:0.52-0.93). Further analyses also showed associations between reduced ADHD incidence and duration of breastfeeding. Children breastfed for over 1 month, over 3 months, over 6 months, and over 12 months had a lower incidence of ADHD than children breastfed for less than 1 month (OR: 0.20; 95% CI: 0.11-0.38), less than 3 months (OR: 0.33; 95% CI: 0.23-0.47), less than 6 months (OR: 0.50; 95% CI: 0.41-0.61), and less than 12 months (OR: 0.55; 95% CI: 0.37-0.81), respectively. These results were stable in the 1-month, 3-month, and 6-month breastfeeding groups. Conclusion: With our meta-analysis, we provide evidence that maternal breastfeeding may reduce the risk of ADHD in children. The causality of this relationship and underlying mechanisms need to be explored in future prospective studies.
Objectives: To summarize the current evidence on the association between maternal breastfeeding and the occurrence of attention deficit/hyperactivity disorder (ADHD) in offspring. Methods: We searched for studies published in English before May 2018 using the PubMed, EMBASE, Cochrane, and Web of Science databases. We included cohort studies, case-control studies, and cross-sectional studies, that focused on the association between maternal breastfeeding and the occurrence of ADHD in offspring. Random effects models were used for combined analyses. Results: Two cohort studies, 7 case-control studies and 3 cross-sectional studies, with 3,686 cases and 106,907 participants, were included. Children with any maternal breastfeeding had a lower incidence of ADHD than children who were never breastfed (odds ratio [OR]: 0.70; 95% confidence interval [CI]:0.52-0.93). Further analyses also showed associations between reduced ADHD incidence and duration of breastfeeding. Children breastfed for over 1 month, over 3 months, over 6 months, and over 12 months had a lower incidence of ADHD than children breastfed for less than 1 month (OR: 0.20; 95% CI: 0.11-0.38), less than 3 months (OR: 0.33; 95% CI: 0.23-0.47), less than 6 months (OR: 0.50; 95% CI: 0.41-0.61), and less than 12 months (OR: 0.55; 95% CI: 0.37-0.81), respectively. These results were stable in the 1-month, 3-month, and 6-month breastfeeding groups. Conclusion: With our meta-analysis, we provide evidence that maternal breastfeeding may reduce the risk of ADHD in children. The causality of this relationship and underlying mechanisms need to be explored in future prospective studies.