The role of breast-feeding in the prevention of Helicobacter pylori infection: A systematic review

Eric W Chak, George W. Rutherford, Craig Steinmaus

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Background. The benefits of breast-feeding for the prevention of infection in infants and young children have been widely recognized, but epidemiologic studies regarding the role of breast-feeding in protecting against Helicobacter pylori infection have produced conflicting results. Methods. We performed a systematic review of relevant epidemiologic studies conducted during the period 1984-2007 after abstracting data from articles that met our inclusion criteria. Study quality was assessed using the Newcastle-Ottawa scale. With use of the random effects model, we calculated the summary odds ratios (ORs) and 95% confidence intervals (CIs) for H. pylori infection according to history of breast-feeding. Results. For the 14 studies that met inclusion criteria, the summary OR for H. pylori infection was 0.78 (95% CI, 0.61-0.99; 1-sided P = .02). Nine of the 14 studies reported ORs of <1.0, and 6 of these studies reported statistically significant protective effects. Only 1 study reported a statistically significant OR of >1.0. In studies in which the subjects resided in middle- or low-income nations, the summary OR was 0.55 (95% CI, 0.33-0.93; P = .01), compared with 0.93 (95% CI, 0.73-1.19; P = .28) in studies in which subjects resided in high-income nations. The summary OR for studies that use the 13C-urea breath test was 0.67 (95% CI, 0.32-1.39), compared with 0.91 (95% CI, 0.74-1.11) for studies that used the H. pylori IgG serologic test. We found no statistically significant dose-dependent protective effect against H. pylori associated with increasing duration of breast-feeding. Conclusions. Breast-feeding is protective against H. pylori infection, especially in middle- and low-income nations.

Original languageEnglish (US)
Pages (from-to)430-437
Number of pages8
JournalClinical Infectious Diseases
Issue number4
StatePublished - Feb 15 2009

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)


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