title: Breastfeeding for reducing the risk of pneumonia morbidity and mortality in children under two: a systematic literature review and meta-analysis.
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.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Lamberti
authors.forename: Irena
authors.initials: I
authors.lastname: Zakarija-Grković
authors.forename: Christa L
authors.initials: CL
authors.lastname: Fischer Walker
authors.forename: Evropi
authors.initials: E
authors.lastname: Theodoratou
authors.forename: Harish
authors.initials: H
authors.lastname: Nair
authors.forename: Harry
authors.initials: H
authors.lastname: Campbell
authors.forename: Robert E
authors.initials: RE
authors.lastname: Black
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data*; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007229:Infant Welfare / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D011014:Pneumonia / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control*; D012307:Risk Factors