Literature review for - Flourish Paediatrics

Sufficient evidence was found to make body of evidence statements for breastfeeding benefits and
risks for mothers and infants, as detailed below. There were no recent good quality reviews of
supplements. The majority of studies were excluded because they were not reviews.
A summary of non-systematic reviews that were recent have been included as an appendix. There
was some overlap between this question and the searches for question U1.7 What nutritional factors
are important in optimising breastfeeding outcoumes? and consequently some reviews from U1.7
have been used to inform the body of evidence statements in this review.
BREASTFEEDING AND ADULT DISEASE OUTCOMES
What are the benefits of breastfeeding (partial and exclusive) and the risks of not
breastfeeding (any and exclusive), to infants and mothers, both in the short term and long
term?
Evidence statement
Grade
Evidence statement
Grade
Component Rating Notes
Being breastfed initially, particularly exclusively breastfed
is associated with lower blood cholesterol concentrations in
adult life.
C
Being breastfed in infancy is associated with lower systolic
and diastolic blood pressure up to adolescence.
B
Evidence Base Good 2 Systematic reviews (2P) comparing adult chronic disease
outcomes for infants who were breastfed versus formula fed,
with both showing protecting. The review on adult
cholesterol levels included 13 cohort and 4 cross-sectional
studies. The review on blood pressure included 2 RCTs, 9
cohorts and 4 cross-sectional studies.
Consistency Good Majority of studies consistent for both outcomes. In some
studies the infant feeding group definitions of breastfeeding
versus formula feedings were not completely exclusive.
Clinical impact Good Important at the population level. Meaningful reduction in
plasma cholesterol level in adults after 17 to >50 years
follow-up, of approx. 0.4mmol/L reduction for those
breastfed, up to 0.15mmol/L reduction for those exclusively
breastfed compared to those formula fed in infancy. From
the meta-analysis, mean reduction was found in systolic (1.4
mmHg) and diastolic blood pressure (0.5 mmHg reduction)
in breastfed versus bottle fed infants at up to 17 years.
Generalisability Excellent Breastfeeding definitions and rates are applicable to
Australian women
495