title: Systematic review: the role of breastfeeding in the development of pediatric inflammatory bowel disease.
abstract: OBJECTIVE
  To assess the current evidence for the role of breastfeeding in the development of early onset inflammatory bowel disease (IBD) with a systematic review.
  
  
  METHODS
  An electronic database search was performed (January 1966-January 2008) with keywords related to IBD and breastfeeding, looking specifically for studies that reported outcome in early-onset disease (<16 years of age) and "any exposure" to breast milk as the variables. Meta-analysis of studies included for review was then performed by using a random effects model, and results were expressed as odds ratios (OR) with 95% CIs.
  
  
  RESULTS
  A total of 79 articles were identified, 20 of which were found describing breastfeeding in relation to the development of IBD; 8 of these articles included separate early-onset groups. One study did not describe "any exposure" to breast milk for the early onset group, so 7 studies were included in the meta-analysis. Breast milk exposure had a significant protective effect (OR, 0.69; 95% CI, 0.51-0.94; P = .02) in developing early-onset IBD. A non-significant difference was demonstrated for ulcerative colitis and Crohn's disease individually (OR, 0.72; 95% CI, 0.51-1.02; P = .06; OR, 0.64; 95% CI, 0.38-1.07; P = .09, respectively).
  
  
  CONCLUSIONS
  The current evidence demonstrates a possible protective effect for breast milk in the development of early onset IBD. However, the quality of existing data is generally poor. These findings need to be investigated in well-designed prospective studies.
authors.affiliation: Department of Child Health, University of Glasgow, Glasgow, UK. A.Barclay@clinmed.gla.ac.uk
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Barclay
authors.forename: Richard K
authors.initials: RK
authors.lastname: Russell
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Wilson
authors.forename: W Harper
authors.initials: WH
authors.lastname: Gilmour
authors.forename: Jack
authors.initials: J
authors.lastname: Satsangi
authors.forename: David C
authors.initials: DC
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001942:Breast Feeding / Q000453:epidemiology*; D015984:Causality; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*