Association of breastfeeding with mental disorders in mother and child: a systematic review and meta-analysis

Table 4 Characteristics of the included studies investigating associations between breastfeeding and anxiety disorders

Study^b	Country	Sample size (cases)	Outcome criteria	Age at outcome assessment, years	Exposure	Reference	Crude OR (95% CI)	Adjusted OR (95% CI)	Adjusted variables	NOS score^a
Cohort studies
De Mola 2016 [45]	Brazil	3657 (438; 127)	MINI GAD	30	1–2.9 months	< 1 month	0.88 (0.69–1.13)	0.86 (0.64–1.16)	Sex, ancestry, birth weight, maternal age, maternal education, marital status, previous gestations, income at birth, smoking during pregnancy, type of delivery, assets index, mother nerve problems, father living together and father history of psychiatric illness	4
De Mola 2016 [45]	Brazil	3657 (438; 127)	MINI GAD		3–5.9 months	< 1 month	0.91 (0.71–1.18)	1.02 (0.77–1.37)
					≥ 6 months	< 1 month	0.81 (0.63–1.03)	0.79 (0.59–1.06)
			SAD		1–2.9 months	< 1 month	0.72 (0.44–1.17)	0.61 (0.35–1.08)
					3–5.9 months	< 1 month	0.79 (0.49–1.29)	0.90 (0.52–1.55)
					≥ 6 months	< 1 month	0.75 (0.48–1.20)	0.66 (0.38–1.15)
Case–control/cross-sectional
Orengul 2018 [31]	Turkey	450 (195)	K-SADS	Cases: 11.50 ± 2.50; controls: ± 11.27–2.33	Ever	Never	0.17 (0.05–0.60)	NR	NR	8
Liu 2023 [47]	United Kingdom	98,702 (19,729)	GAD-7	> 50	Ever	Never	0.77 (0.75–0.80)	MSDP 0.87 (0.82–0.93) NMSDP 0.83 (0.79–0.87)	Sex, age, 10 principle components of population structure, smoking, alcohol use, and Townsend deprivation index	6

K-SADS Schedule for Affective Disorders and Schizophrenia for School-Age Children, MINI Mini International Neuropsychiatric Interview for Children and Adolescents, MSDP maternal smoking during pregnancy, NMSDP no maternal smoking during pregnancy, NR not reported
^aNewcastle Ottawa (NOS) Score: very good = 9–10, good = 7–8, satisfactory = 5–6, unsatisfactory = 0–4
^bHayatbakhsh et al. (n = 4502, NOS = 6) did not report odds/risk ratios, providing comparisons of continuous variables within each subscale of The Youth Self Report (YSR) of the Child Behavior Check List (CBCL) only. Authors reported statistically significant association between breastfeeding and “Anxiety/depression” domain for ≥ 4 months vs. “never” regression coefficient (95% CI) − 0.43 (− 0.78, − 0.09) and − 0.36 (− 0.70, − 0.01), respectively in adjusted models; Oddy et al. (n = 2366, NOS = 8) used a composite outcome “internalising complaints” that includes withdrawn, somatic complaints, anxiety, and depression. BF < 6 months vs. ≥ 6 months OR 1.21 (95% CI 1.0–1.46)

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