Literature review for - Flourish Paediatrics

Table 26.1 Summary of studies to make evidence statements for alcohol, caffeine and breastfeeding outcomes
STUDY DETAILS Giglia & Binns 2006 Haber et al. 2005
(Review)
Affiliation/source of Curtin University of Technology Australia, National Royal Hospital for Women, Australian Catholic University Sydney
funds
Health and Medical Research Council
Study design Systematic Review Systematic Review
Level of evidence III-1 Evidence obtained from well-designed
pseudorandomised controlled trials (alternate allocation or
some other method).
III-2 Evidence obtained from comparative studies (including
systematic reviews of such studies) with concurrent controls and
allocation not randomised, cohort studies, case-control studies, or
interrupted time series with a control group.
Date of search 1990-2005 1966-2004
Number of studies 24 (14 human & 10 rat studies) Not reported but 33 references cited
Total number of NS
NS
participants
Population
Lactating human and rat mothers, age not reported Lactating mothers; no other details provided
characteristics
Range of exposure
Maternal alcohol intake of 2 g / kg body weight
(human studies only)
Length of follow-up NS NS
Outcome(s)
measured
INTERNAL
VALIDITY
Time taken for alcohol to reach human milk, effect of
alcohol intake on milk ejection reflex, infant milk and
alcohol consumption, oxytocin and prolactin levels, milk
yield, breastfeeding initiation and duration, infant motor
development
Not always reported but ranges from 1-3 standard drinks of wine
(120 mL = I standard) to as much alcohol as the mothers could
manage; whereas for caffeine ranges are from 36 to 750 mg
Alcohol Studies: 1. Alcohol content of breastmilk; 2. Transfer of
alcohol in breastmilk; 3. Alcohol infrared absorption and
electrochemical reaction; 4. Oxytocin response; 5. Breastmilk
production and consumption; 6. Infant feeding pattern; 7. Infant
motor development; 8. Infants sleep-wake patterns; 9. Breastmilk
flavour
Caffeine Studies: 1. Excretion of caffeine in breastmilk; 2. Iron
concentrations in milk and infant iron status at 1 month of age; 3.
Breastmilk composition
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