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Shorter Versus Longer Durations of Exclusive Human Milk Feeding and Celiac Disease: A Systematic Review
Darcy Güngör, MS, Perrine Nadaud, PhD, Carol Dreibelbis, MPH, Concetta LaPergola, Nancy Terry, MLS, Yat Ping Wong, MLS, MPH, Steve A. Abrams, MD, Leila Beker, PhD, RD, Tova Jacobovits, MS, RD, Kirsi M Järvinen, MD, PhD, Laurie A. Nommsen-Rivers, PhD, RD, IBCLC, Kimberly O. O’Brien, PhD, Emily Oken, MD, MPH, Rafael Pérez-Escamilla, PhD, Ekhard Ziegler, MD, Kellie O. Casavale, PhD, RD, Joanne M. Spahn, MS, RDN, and Eve Stoody, PhD.
Author Information and AffiliationsAlexandria (VA): USDA Nutrition Evidence Systematic Review; 2019 Apr.
TECHNICAL ABSTRACT
Background
- 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.
- The goal of this systematic review was to examine the following question: What is the relationship between shorter versus longer durations of exclusive human milk feeding and celiac disease?
- This systematic review examines comparisons of infants who were fed human milk exclusively for shorter durations with infants who were fed human milk exclusively for longer durations.
- Exclusive human milk feeding was defined as feeding human milk alone and not in combination with infant formula and/or complementary foods or beverages such as cow’s milk. This definition is inclusive of the World Health Organization definitions of exclusive and predominant breastfeeding, which permit limited quantities of (a) drops or syrups containing vitamins, minerals, or medicines, (b) water and water-based drinks such as sweetened water and teas, (c) fruit juice, (d) oral rehydration salts solution, and (e) ritual fluids4. 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.
- This systematic review examines diagnosed celiac disease, only, to ensure that it addresses the relationship of shorter versus longer durations of exclusive human milk feeding with celiac disease and not the relationship of shorter versus longer durations of exclusive human milk feeding with the many other diseases and conditions with similar symptoms.
Conclusion statement and grade
- There is insufficient evidence to determine whether or not there is a relationship between shorter versus longer durations of exclusive human milk feeding and celiac disease in offspring.Grade: Grade Not Assignable
Methods
- The systematic review was conducted by a team of staff from the Nutrition Evidence Systematic Review in collaboration with a Technical Expert Collaborative.
- 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.
- Articles were screened independently by 2 NESR analysts to determine which articles met predetermined criteria for inclusion.
- Data from the included article were extracted, risks of bias were assessed, and both were checked for accuracy.
- 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
- This review includes 2 articles, which provided insufficient evidence to draw any conclusions about the relationship between the duration of exclusive human milk feeding and celiac disease.
- 4
World Health Organization. Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6–8 November 2007 in Washington D.C. WHO. 2008.
Contents
Funding source: United States Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Alexandria, VA
Suggested citation:
Güngör D, Nadaud P, Dreibelbis C, LaPergola C, Terry N, Wong YP, Abrams SA, Beker L, Jacobovits T, Järvinen KM, Nommsen-Rivers LA, O’Brien KO, Oken E, Pérez-Escamilla R, Ziegler, EE, Casavale KO, Spahn JM, Stoody E. Shorter Versus Longer Durations of Exclusive Human Milk Feeding and Celiac Disease: A Systematic Review. April 2019. U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Nutrition Evidence Systematic Review. Available at: https://doi.org/10.52570/NESR.PB242018.SR0220
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Related citations:
This systematic review has also been published in the American Journal of Clinical Nutrition: Güngör D, Nadaud P, Dreibelbis C, LaPergola CC, Wong YP, Terry N, Abrams SA, Beker L, Jacobovits T, Järvinen KM, Nommsen-Rivers LA, O’Brien KO, Oken E, Pérez-Escamilla R, Ziegler, EE, Spahn JM. Infant milk-feeding practices and diagnosed celiac disease and inflammatory bowel disease in offspring: a systematic review. Am J Clin Nutr. 2019;109(7):838S-851S. Available at: https://doi.org/10.1093/ajcn/nqy371 [PMC free article: PMC6500925] [PubMed: 30982875].
Related citations are published in the American Journal of Clinical Nutrition:
- P/B-24 Project overview: Stoody EE, Spahn JM, Casavale KO. The Pregnancy and Birth to 24 Months Project: a series of systematic reviews on diet and health. Am J Clin Nutr. 2019;109(7):685S–97S. Available at: https://doi.org/10.1093/ajcn/nqy372 [PubMed: 30982878].
- P/B-24 Project systematic review methodology: Obbagy JE, Spahn JM, Wong YP, Psota TL, Spill MK, Dreibelbis C, Gungor DE, Nadaud P, Raghavan R, Callahan EH, English LK, Kingshipp BL, LaPergola CC, Shapiro MJ, Stoody EE. Systematic review methodols used in the Pregnancy and Birth to 24 Months Project. Am J Clin Nutr. 2019;109(7):698S–704S. Available at https://doi.org/10.1093/ajcn/nqy226 [PubMed: 30445449].
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