The impact of breastfeeding on lung development and function: a systematic review

Abstract

With the global trend of increasing asthma and allergic disorders there is strong interest regarding early life nutrition as a potentially modifiable risk factor for lung disease. This systematic review includes 10 studies that assessed the effect of breastfeeding on lung growth and function. The review found breastfeeding to be beneficial for lung function, with the most consistent effect on increased forced vital capacity. There was no clear evidence that the relationship between breastfeeding and lung function was mediated through other factors. Furthermore, the findings from the few studies that investigated if maternal asthma modified the effect of breastfeeding on lung function were inconsistent. Further research is needed to determine the specific details such as duration and type (exclusive vs partial) of breastfeeding that leads to improved lung function.

Keywords::

• bioactive substances
• breastfeeding
• exclusive breastfeeding
• forced expiratory volume in one second
• forced vital capacity
• immune mediation
• immunoglobulin A
• lung function
• lung growth
• total duration of breastfeeding

Acknowledgement

The authors thank Brittany Campbell (BC) for assisting with selection of studies for inclusion, and for verifying data extraction.

Financial & competing interests disclosure

NT Waidyatillake is supported by the Melbourne International Research Scholarship (MIRS). AJ Lowe SC Dharmage and CJ Lodge all receive fellowships from the National Health and Medical Research Council (NHMRC). K Allen receives a fellowship from the Charles and Sylvia Vitrtel Medical Research Foundation. MJ Abramson has previously received grant funding from Pfizer for unrelated research. All authors do not have any conflict of interest with the material in the manuscript.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Breastfeeding is the first dietary exposure and has a range of beneficial effects for both the mother and the child.

• • It has been proposed that breastfeeding may improve lung function by a number of mechanisms, including by: reducing the number of respiratory tract infections; protecting against childhood asthma; decreasing sensitization; increasing attained height and reducing risk of obesity.

• • It has also been proposed that maternal asthma may modify the effect of breastfeeding on lung function.

• • This review, which systematically identified the existing literature on the association between breastfeeding and lung growth and function, found that most studies demonstrate an association of breastfeeding with improved lung function.

• • However, studies vary in terms of the lung function parameter that breastfeeding is associated with improvement for, with forced vital capacity showing the most consistent improvement.

• • Little evidence exists concerning the factors that mediate the association between breastfeeding and improvement in lung function, and the current literature does not support the proposed indirect effect of breastfeeding on lung function.

• • The evidence that maternal asthma modifies the effect of breastfeeding on lung function is conflicting.

• • Further research is required to identify the exact type and the duration of breastfeeding that improves lung growth and function.