Evidence mapPaperPMID 40134007Full record

SynthesisInternational breastfeeding journal2025

Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis.

Biruk Beletew Abate, Biruk Shalmeno Tusa, Ashenafi Kibret Sendekie, Freweyni Gebreegziabher Araya, Molla Azmeraw Bizuayehu, Getachew Tesfaw Walle, Tegene Atamenta Kitaw, Befkad Derese Tilahun, Addis Wondmagegn Alamaw, Alemu Birara Zemariam and 5 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in International breastfeeding journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Biruk Beletew AbateSchool of Population Health, Curtin University, Perth, WA, Australia. birukkelemb@gmail.com.
Biruk Shalmeno TusaSchool of Population Health, Curtin University, Perth, WA, Australia.
Ashenafi Kibret SendekieDepartment of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Freweyni Gebreegziabher ArayaDepartment of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Molla Azmeraw BizuayehuDepartment of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Getachew Tesfaw WalleDepartment of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Tegene Atamenta KitawDepartment of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Befkad Derese TilahunDepartment of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Addis Wondmagegn AlamawDepartment of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Alemu Birara ZemariamDepartment of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Amare KassawDepartment of Nursing, College of Health Science, Debre Tabor University, Debra Tabor, Ethiopia.
Ayelign Mengesha KassieDepartment of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Gizachew YilakDepartment of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Fassikaw Kebede BizunehCollege of Health Science, Debre Markos University, Debre Makros, Northwest, Ethiopia.
Berihun DachewSchool of Population Health, Curtin University, Perth, WA, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite numerous reviews examining the impact of exclusive breastfeeding on preventing childhood pneumonia and asthma, a comprehensive and up-to-date synthesis is lacking. This umbrella review aims to consolidate the current evidence on the link between non-exclusive breastfeeding and the risk of pneumonia and asthma in under-five children.

methodsA comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science, the Cochrane Database of Systematic Reviews, and Google Scholar to identify systematic review and meta-analysis (SRM) studies evaluating the effect of exclusive breastfeeding on preventing childhood pneumonia and asthma globally. The latest search was conducted on January 25/2025. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews Two (AMSTAR-2) tool. A weighted inverse variance random-effects model was employed to generate pooled estimates. Summary effect estimates were expressed using odds ratios (OR) with 95% confidence intervals (CI). We evaluated the quality of evidence for each association using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, categorising it as convincing (class I), highly suggestive (class II), suggestive (class III), and weak (class IV).

resultsTwelve SRMs, including 270 primary studies with over ten million participants, were analysed. The random-effects model revealed a highly suggestive association between non-exclusive breastfeeding and an increase in the risk of pneumonia (OR 2.34; 95% CI 1.89, 2.78, GRADE: highly suggestive). Similarly, there was highly suggestive evidence that non-exclusive breastfeeding was associated with a 29% higher risk of childhood asthma (OR 1.21; 95% CI 1.07, 1.34, GRADE: highly suggestive).

conclusionOur results highlighted that non-exclusive breastfeeding is associated with an increased risk of pneumonia and asthma in under-five children. These findings emphasise the critical role of exclusive breastfeeding in reducing the risk of respiratory health issues, highlighting the need for policies and initiatives that promote breastfeeding as a key strategy for improving children's health outcomes.

Indexed as

AsthmaBreast FeedingPneumoniaChild, PreschoolFemaleHumansInfantInfant, NewbornMaleRisk FactorsAsthmaExclusive breastfeedingPneumoniaUmbrella reviewUnder-five children

Identifiers

PMID40134007
PMCPMC11938590

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.