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This article is part of the supplement: The Lives Saved Tool in 2013: new capabilities and applications

Open Access Highly Accessed Review

Breastfeeding for reducing the risk of pneumonia morbidity and mortality in children under two: a systematic literature review and meta-analysis

Laura M Lamberti1, Irena Zakarija-Grković2, Christa L Fischer Walker1*, Evropi Theodoratou3, Harish Nair34, Harry Campbell3 and Robert E Black1

  • * Corresponding author: Christa L Fischer Walker cfischer@jhsph.edu

  • † Equal contributors

Author affiliations

1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

2 Department of Family Medicine, University of Split School of Medicine, Split, Croatia

3 Centre of Population Health Sciences, University of Edinburgh Medical School, Edinburgh, UK

4 Public Health Foundation of India, New Delhi, India

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Citation and License

BMC Public Health 2013, 13(Suppl 3):S18  doi:10.1186/1471-2458-13-S3-S18

Published: 17 September 2013

Abstract

Background

Suboptimal breastfeeding practices among infants and young children <24 months of age are associated with elevated risk of pneumonia morbidity and mortality. We conducted a systematic review and meta-analysis to quantify the protective effects of breastfeeding exposure against pneumonia incidence, prevalence, hospitalizations and mortality.

Methods

We conducted a systematic literature review of studies assessing the risk of selected pneumonia morbidity and mortality outcomes by varying levels of breastfeeding exposure among infants and young children <24 months of age. We used random effects meta-analyses to generate pooled effect estimates by outcome, age and exposure level.

Results

Suboptimal breastfeeding elevated the risk of pneumonia morbidity and mortality outcomes across age groups. In particular, pneumonia mortality was higher among not breastfed compared to exclusively breastfed infants 0-5 months of age (RR: 14.97; 95% CI: 0.67-332.74) and among not breastfed compared to breastfed infants and young children 6-23 months of age (RR: 1.92; 95% CI: 0.79-4.68).

Conclusions

Our results highlight the importance of breastfeeding during the first 23 months of life as a key intervention for reducing pneumonia morbidity and mortality.