Journal Article

The Role of Breast-Feeding in the Prevention of <i>Helicobacter pylori</i> Infection: A Systematic Review

Eric Chak, George W. Rutherford and Craig Steinmaus

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 48, issue 4, pages 430-437
Published in print February 2009 | ISSN: 1058-4838
Published online February 2009 | e-ISSN: 1537-6591 | DOI:
The Role of Breast-Feeding in the Prevention of Helicobacter pylori Infection: A Systematic Review

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Background. The benefits of breast-feeding for the prevention of infection in infants and young children have been widely recognized, but epidemiologic studies regarding the role of breast-feeding in protecting against Helicobacter pylori infection have produced conflicting results.

Methods. We performed a systematic review of relevant epidemiologic studies conducted during the period 1984–2007 after abstracting data from articles that met our inclusion criteria. Study quality was assessed using the Newcastle-Ottawa scale. With use of the random effects model, we calculated the summary odds ratios (ORs) and 95% confidence intervals (CIs) for H. pylori infection according to history of breast-feeding.

Results. For the 14 studies that met inclusion criteria, the summary OR for H. pylori infection was 0.78 (95% CI, 0.61–0.99; 1-sided P=.02). Nine of the 14 studies reported ORs of <1.0, and 6 of these studies reported statistically significant protective effects. Only 1 study reported a statistically significant OR of >1.0. In studies in which the subjects resided in middle- or low-income nations, the summary OR was 0.55 (95% CI, 0.33–0.93; P=.01), compared with 0.93 (95% CI, 0.73–1.19; P=.28) in studies in which subjects resided in high-income nations. The summary OR for studies that use the >13C-urea breath test was 0.67 (95% CI, 0.32–1.39), compared with 0.91 (95% CI, 0.74–1.11) for studies that used the H. pylori IgG serologic test. We found no statistically significant dose-dependent protective effect against H. pylori associated with increasing duration of breast-feeding.

Conclusions. Breast-feeding is protective against H. pylori infection, especially in middle- and low-income nations.

Journal Article.  4379 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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