Meta-analysisindependent cross-checkabstract only checked I-INTC-14 standard review
Benefits of breastfeeding
Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect.
Overview
Victora CG et al.. Lancet 2016 · PMID 26869575 · DOI 10.1016/S0140-6736(15)01024-7
Breastfeeding protects children against infections and has other benefits; it is not shown here to prevent tonsil or appendix surgery.
Does the study support the specific claim? Partly · Methodological quality: high
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Summarise effects of breastfeeding
- How was the study done?
Systematic reviews and meta-analyses
- How many people, animals or samples were studied?
Global
- What was actually found?
Fewer infections, other benefits
- How large was the observed effect?
823,000 deaths preventable per year (modelled)
- What do the results mean in everyday life?
Breastfeeding is beneficial; formula is not shown to cause surgery.
- What are the study's limitations?
Observational evidence; surgery outcomes not covered
- What does it say about Elawady's specific claim?
Supports only the general importance of infant feeding
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Tonsil/adenoid/appendix outcomes
Scientific in-depth review
1. Full reference
- Authors
- Victora CG et al.
- Journal
- Lancet
- Year
- 2016
- Identifier
- PMID 26869575 DOI 10.1016/S0140-6736(15)01024-7
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract (PubMed lists non-US government support)
2. Research question
What are the short- and long-term effects of breastfeeding for children and women?
3. Study design and population
- Study design
- Meta-analysis – Series paper with systematic reviews and meta-analyses
- Population
Children and mothers worldwide
- Country
Global
- Period
Literature to about 2015
- Sample size
Multiple meta-analyses
- Inclusion and exclusion criteria
not detailed in abstract
4. Methods and endpoints
- Exposure / intervention
Breastfeeding
- Comparator
Less or no breastfeeding
- Endpoints
Infections, malocclusion, intelligence, overweight, diabetes, allergy, maternal cancers
- Statistical methods
Meta-analyses
5. Actual results
- Results
Abstract: meta-analyses indicate protection against child infections and malocclusion, increases in intelligence, and probable reductions in overweight and diabetes; no associations with allergic disorders such as asthma or with blood pressure or cholesterol; increased tooth decay with longer breastfeeding. Scaling up breastfeeding could prevent 823,000 annual deaths in children under 5.
- Absolute risks
823,000 child deaths per year modelled
- Authors' conclusion
Breastfeeding has important benefits for children and women in rich and poor countries.
6. Strengths
- Large synthesis
- High-impact series
7. Weaknesses
- Observational evidence for many outcomes
- Tonsil, adenoid and appendicitis outcomes not mentioned in abstract
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Informal judgement.
9. Assessment of the statistical interpretation
Effect sizes per outcome not in abstract.
10. Relevance to the specific claim
Supports that breastfeeding protects against childhood infections (the kernel: infant feeding matters), but does not address tonsillectomy, adenoidectomy or appendicitis, and gives no basis for 'all children' needing surgery because of formula.
11. Independent contrary findings
None.
12. Transferability to Germany and Europe
Applicable.
13. Overall methodological judgement
Context on infant feeding; indirect for the specific claim.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | high |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | indirect |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Effects on adenotonsillar hypertrophy and appendicitis.