Breastfeeding and Childhood Leukemia Incidence: A Meta-analysis and Systematic Review
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TLDR
It is indicated that promoting breastfeeding for 6 months or more may help lower childhood leukemia incidence, in addition to its other health benefits for children and mothers.Abstract:
Importance Childhood cancer is a leading cause of mortality among children and adolescents in the developed world and the incidence increases by 0.9% each year. Leukemia accounts for about 30% of all childhood cancer but its etiology is still mostly unknown. Objective To conduct a meta-analysis of available scientific evidence on the association between breastfeeding and childhood leukemia. Data Sources A thorough search for articles published between January 1960 and December 2014 researching the association between breastfeeding and childhood leukemia was conducted on PubMed, the Cochrane Library, and Scopus (performed in July and December 2014), supplemented by manual searches of reference lists. Study Selection To be included in the meta-analyses, studies had to be case control; include breastfeeding as a measured exposure and leukemia as a measured outcome; include data on breastfeeding duration in months; and be published in a peer-reviewed journal with full text available in English. Data Extraction and Synthesis The search identified 24 relevant studies, 17 of which met all inclusion criteria. No publication bias or significant heterogeneity among these 17 studies were detected. The quality of each study that met the inclusion criteria was assessed using the Newcastle-Ottawa Scale. Multiple meta-analyses were conducted using the random effect model on raw data in the StatsDirect statistical program. Main Outcomes and Measures No or short duration of breastfeeding and the incidence of childhood leukemia. Results The meta-analysis of all 17 studies indicated that compared with no or shorter breastfeeding, any breastfeeding for 6 months or longer was associated with a 20% lower risk for childhood leukemia (odds ratio, 0.80; 95% CI, 0.72-0.90). A separate meta-analysis of 15 studies indicated that ever breastfed compared with never breastfed was associated with a 9% lower risk for childhood leukemia (odds ratio, 0.91; 95% CI, 0.80-1.04), although the definition of never breastfed differed between studies. All meta-analyses of subgroups of the 17 studies showed similar associations. Based on current meta-analyses results, 14% to 20% of all childhood leukemia cases may be prevented by breastfeeding for 6 months or more. Conclusions and Relevance Breastfeeding is a highly accessible, low-cost public health measure. This meta-analysis that included studies not featured in previous meta-analyses on the subject indicates that promoting breastfeeding for 6 months or more may help lower childhood leukemia incidence, in addition to its other health benefits for children and mothers.read more
Citations
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Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect
Cesar G. Victora,Rajiv Bahl,Aluísio J D Barros,Giovanny Vinícius Araújo de França,Susan Horton,Julia Krasevec,Simon Murch,Mari Jeeva Sankar,Neff Walker,Nigel Rollins +9 more
TL;DR: The meta-analyses indicate protection against child infections and malocclusion, increases in intelligence, and probable reductions in overweight and diabetes, and an increase in tooth decay with longer periods of breastfeeding.
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A causal mechanism for childhood acute lymphoblastic leukaemia.
TL;DR: Evidence supporting the model that infections early in life reduce the risk of childhood common B cell precursor acute lymphoblastic leukaemia (BCP-ALL) development is described, given this evidence, paediatric BCP-ALL may be a preventable cancer.
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Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs.
Melissa Bartick,Eleanor Bimla Schwarz,Brittany D. Green,Briana J. Jegier,Arnold Reinhold,Tarah T. Colaizy,Debra L. Bogen,Andrew J. Schaefer,Alison M. Stuebe +8 more
TL;DR: Excess cases of pediatric and maternal disease, death, and costs attributable to suboptimal breastfeeding rates in the United States and policies to increase optimal breastfeeding could result in substantial public health gains.
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COSMOS-E: Guidance on conducting systematic reviews and meta-analyses of observational studies of etiology.
Olaf M. Dekkers,Olaf M. Dekkers,Olaf M. Dekkers,Jan P. Vandenbroucke,Jan P. Vandenbroucke,Jan P. Vandenbroucke,M. Cevallos,Andrew G Renehan,Douglas G. Altman,Matthias Egger,Matthias Egger +10 more
TL;DR: As many reviews of observational studies on etiology are being performed, this document may provide researchers with guidance on how to conduct and analyse such reviews.
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Policy Statement: Breastfeeding and the Use of Human Milk.
Joan Younger Meek,Lawrence Noble +1 more
TL;DR: The American Academy of Pediatrics recommends exclusive breastfeeding for approximately 6 months after birth and supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond.
References
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TL;DR: Pediatricians play a critical role in their practices and communities as advocates of breastfeeding and thus should be knowledgeable about the health risks of not breastfeeding, the economic benefits to society of breastfeeding, and the techniques for managing and supporting the breastfeeding dyad.