Systematic reviewindependent cross-checkabstract checked I-ORG-119 standard review
Breastfeeding and snoring in children
Breastfeeding and sleep-disordered breathing in children: systematic review and proposal of underlying interaction models.
Overview
Storari M et al.. Eur J Paediatr Dent 2021 · PMID 35034467 · DOI 10.23804/ejpd.2021.22.04.10
A review suggests breastfed children snore less, but the studies are observational and no numbers were pooled.
Does the study support the specific claim? Partly · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Review breastfeeding and childhood sleep-disordered breathing
- How was the study done?
Systematic review
- How many people, animals or samples were studied?
Not stated
- What was actually found?
Breastfeeding linked to less habitual snoring
- How large was the observed effect?
Not reported
- What do the results mean in everyday life?
Breastfeeding has benefits; it is not proven to prevent tonsil surgery
- What are the study's limitations?
Observational, no meta-analysis
- What does it say about Elawady's specific claim?
Weak partial support; does not show formula causes surgery
- Do the results apply to Germany and Europe?
Moderate
- What can explicitly not be concluded from this study?
Cannot show causation
Scientific in-depth review
1. Full reference
- Authors
- Storari M et al.
- Journal
- Eur J Paediatr Dent
- Year
- 2021
- Identifier
- PMID 35034467 DOI 10.23804/ejpd.2021.22.04.10
- Verification
- verified – PubMed efetch 2026-10-26; Crossref lookup returned 404 for this DOI (not registered with Crossref)
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Not stated in abstract.
2. Research question
Does breastfeeding protect against snoring and obstructive sleep apnoea in children?
3. Study design and population
- Study design
- Systematic review – Systematic review (PROSPERO CRD42020212529) without meta-analysis
- Population
Children and adolescents
- Country
Multinational
- Period
Search to 10 October 2020
- Sample size
Not stated in abstract
- Inclusion and exclusion criteria
Observational and clinical studies on breastfeeding and paediatric SDB
4. Methods and endpoints
- Exposure / intervention
Breastfeeding
- Comparator
Shorter or no breastfeeding
- Endpoints
Snoring, OSA
- Statistical methods
Narrative synthesis
5. Actual results
- Results
The review suggests that breastfeeding can protect children and adolescents from sleep-disordered breathing, especially habitual snoring, by preventing associated risk factors (abstract; no pooled estimates reported).
- Absolute risks
Not reported
- Authors' conclusion
Breastfeeding can effectively protect from SDB, especially habitual snoring; better prospective studies needed.
6. Strengths
- Registered protocol
7. Weaknesses
- No pooled estimates in abstract
- Observational, confounded studies
- Mechanism section speculative
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- high
- Rationale
Narrative synthesis of observational studies; strength of conclusion not matched by quantitative data in the abstract.
9. Assessment of the statistical interpretation
No effect sizes reported in the abstract.
10. Relevance to the specific claim
Closest available evidence on infant feeding and airway problems that lead to adenotonsillectomy.
11. Independent contrary findings
Xu 2020 (I-INTC-13) found breastfeeding associated with more OSAS in a clinical sample; Zwierz 2023 (I-ORG-120) found no effect on adenoid size.
12. Transferability to Germany and Europe
Mixed populations.
13. Overall methodological judgement
Weak, indirect support that breastfeeding is linked to less snoring; says nothing about formula 'causing' tonsil or adenoid surgery.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | high |
| Precision of results | not applicable |
| Directness | indirect |
| Reproducibility | unknown |
| Consistency with the overall evidence | mixed |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Effect on surgery rates.