Cardwell C.R.Stene L.C.Ludvigsson J.Rosenbauer J.Cinek O.Svensson J.Perez-Bravo F.Memon A.Gimeno S.G.Wadsworth E.J.K.Strotmeyer E.S.Goldacre M.J.Radon K.LEE-MING CHUANGParslow R.C.Chetwynd A.Karavanaki K.Brigis G.Pozzilli P.Urbonaite B.Schober E.Devoti G.Sipetic S.Joner G.Ionescu-Tirgoviste C.De Beaufort C.E.Harrild K.Benson V.Savilahti E.Ponsonby A.-L.Salem M.Rabiei S.Patterson C.C.2020-06-012020-06-0120120149-5992https://www.scopus.com/inward/record.uri?eid=2-s2.0-84868121007&doi=10.2337%2fdc12-0438&partnerID=40&md5=e571014b42bbd5a04d7f936deb1f0db5https://scholars.lib.ntu.edu.tw/handle/123456789/495577OBJECTIVE - To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders. RESEARCH DESIGN AND METHODS - Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies. RESULTS - Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64- 0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies;OR = 0.87, 95%CI 0.75 -1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81-1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78-1.00). These associations were all subject to marked heterogeneity (I 2 = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75-0.99), and heterogeneity was reduced (I 2 = 0%). Adjustments for potential confounders altered these estimates very little. CONCLUSIONS - The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies. ? 2012 by the American Diabetes Association.[SDGs]SDG3adolescent; adult; article; birth weight; breast feeding; child; child health care; clinical assessment; controlled study; data analysis; disease association; human; infant; insulin dependent diabetes mellitus; major clinical study; maternal age; maternal diabetes mellitus; observational study; onset age; preschool child; risk assessment; risk factor; risk reduction; school child; Adolescent; Breast Feeding; Child; Child, Preschool; Diabetes Mellitus, Type 1; Female; Humans; Malejournal article10.2337/dc12-0438228373712-s2.0-84868121007