Literature review for - Flourish Paediatrics

BREASTFEEDING AND SUDDEN INFANT DEATH SYNDROME
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
Not breastfeeding is associated with an increased risk of
Sudden Infant Death Syndrome
Grade
C
Component Rating Notes
Evidence Base Satisfactory 1 Systematic review (23 studies, 18 case-controls, 4 nested
case-controls, 1 cohort) of excellent quality with metaanalysis
with low risk of bias showing an increased risk of
SIDs with "bottle" feeding
Consistency Good 19 studies had a protective effect for breastfeeding, 1 had no
effect and 3 showed a negative effect. Sensitivity analysis
conducted in the meta-analysis and similar ORs for bottle
feeding shown for studies rated "good" (10 studies, OR
range 0.56 to 5.95) or published in last 10 years
Clinical impact Excellent Pooled OR for 23 studies was 2.11 (95%CI: 1.66 - 2.68).
For higher quality studies only OR = 2.24 ("good" studies)
and 2.32 (studies in last 10 years)
Generalisability Excellent Generalisable to Australian women and the review includes
Australian data
Applicability Excellent Directly applicable to Australia
This body of evidence statement had to be stated as “not breastfeeding…” because breastfeeding
could not be demonstrated to be protective, possibly due to confounding, whereas not breastfeeding
could be shown to increase the risk of sudden infant death syndrome.
The studies included in the body of evidence statement are shown in Table 24.4.
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