Breastfeeding and Maternal and Infant Health Outcomes In Developed Countries

In this 400-page report, prepared for the Agency for Healthcare Research and Quality, the authors evaluate studies of the effects or associations of breastfeeding on various child and maternal outcomes. In a screening of over 9,000 abstracts, researchers from the Tufts-New England Medical Center Evidence-Based Practice Center identified 43 primary studies on infant health outcomes, 43 primary studies on maternal health outcomes, and 29 systematic reviews or meta-analyses to be included in the review. The primary studies were observational, randomized controlled trials, and comparative studies. The systematic reviews were included since it was not deemed feasible for all of the primary studies to be reviewed. The authors relied on the recommendations of the technical expert panel and the Office on Women’s Health to develop an approach to grade the reviews. This approach graded the meta-analyses and the primary studies included in the review as A for good, B for fair to moderate, and C for poor. “A” studies presented the least bias and the most valid results. “B” studies were susceptible to some bias but were still considered valid, and the “C” studies had significant biases that may have resulted in invalid results. In addition, screening for the meta-analyses and systematic reviews included standards for reporting for meta-analysis in observational studies in epidemiology and a checklist developed specifically for this review to evaluate the quality of the reviews of observational studies. The checklist included such questions as …