Never versus ever feeding human milk and inflammatory bowel disease a systematic review
Infant formula was defined as commercially-prepared infant formula meeting FDA and/or Codex Alimentarius international food standards.4. This systematic review examines diagnosed inflammatory bowel disease (including Crohn's disease and ulcerative colitis), only, to ensure that it addresses the...
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| Corporate Authors: | , |
| Format: | eBook |
| Language: | English |
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Washington, DC
United States Department of Agriculture
April 2019, 2019
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| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | Infant formula was defined as commercially-prepared infant formula meeting FDA and/or Codex Alimentarius international food standards.4. This systematic review examines diagnosed inflammatory bowel disease (including Crohn's disease and ulcerative colitis), only, to ensure that it addresses the relationship of never versus ever feeding human milk with inflammatory bowel disease and not the relationship of never versus ever feeding human milk with the many other diseases and conditions with similar symptoms. CONCLUSION STATEMENT AND GRADE: 1. Evidence about the relationship between never versus ever being fed human milk and inflammatory bowel disease in offspring is inconclusive. Grade: Grade not assignable METHODS: 1. The systematic review was conducted by a team of staff from the Nutrition Evidence Systematic Review in collaboration with a Technical Expert Collaborative.2. Thirteen articles met the inclusion criteria for this systematic review, which presented evidence from 1 nested case-control study and 11 independent case-control studies (1 research group presented evidence about Crohn's disease and ulcerative colitis in the same population in separate articles).2. The evidence was inconclusive. Three case-control studies found never versus ever feeding human milk is associated with higher risk of Crohn's disease and of ulcerative colitis, 1 case-control study found that never versus ever feeding human milk is associated with a lower risk of Crohn's disease. BACKGROUND: 1. This systematic review was conducted as part of the U.S. Department of Agriculture and Department of Health and Human Services Pregnancy and Birth to 24 Months Project.2. The goal of this systematic review was to examine the following question: What is the relationship between never versus ever feeding human milk and inflammatory bowel disease?3. This systematic review examines comparisons of infants who were never fed human milk with infants who were ever fed human milk (i.e., any amount of human milk feeding). Human milk feeding was defined as feeding human milk alone or in combination with infant formula and/or complementary foods or beverages such as cow's milk. Human milk was defined as mother's own milk provided at the breast (i.e., nursing) or expressed and fed fresh or after refrigeration or freezing. Donor milk (e.g., banked milk) was not examined in this review. A single literature search was conducted to identify literature for several related systematic reviews that examined infant milk-feeding practices and different outcomes. The search was conducted in CINAHL, Cochrane, Embase, and PubMed, and used a search date range of January 1980 to March 2016. A manual search was done to identify articles that may not have been included in the electronic databases searched.3. Articles were screened independently by 2 NESR analysts to determine which articles met predetermined criteria for inclusion.4. Data from each included article were extracted, risks of bias were assessed, and both were checked for accuracy.5. The body of evidence was qualitatively synthesized, a conclusion statement was developed, and the strength of the evidence (grade) was assessed using pre-established criteria including evaluation of the internal validity/risk of bias, adequacy, consistency, impact, and generalizability of available evidence. SUMMARY OF EVIDENCE: 1. Among the remaining studies, there were some nonsignificant associations with wide confidence intervals (indicative of suboptimal statistical power), most of which were in the direction of never versus ever feeding human milk being associated with higher risk of IBD outcomes, and there were some nonsignificant associations with reasonably narrow confidence intervals (indicative of sufficient statistical power).3. The evidence had several limitations, including the inconsistency of the findings, insufficient sample sizes for some studies, the potential for confounding, and the retrospective collection of exposure data, which increases the risk of misclassification of the exposure |
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| Physical Description: | 1 PDF file (205 pages) illustrations |