What is the question?

• The question is: What is the relationship between feeding a higher intensity, proportion, or amount of human milk by bottle versus by breast and food allergies, allergic rhinitis, atopic dermatitis, and asthma?

What is the answer to the question?

• There is no evidence to determine the relationship between feeding a higher intensity, proportion, or amount of human milk by bottle versus by breast and food allergies, allergic rhinitis, atopic dermatitis, and asthma throughout the lifespan. 

Why was this question asked? 

• This important public health question was identified and prioritized as part of the U.S. Department of Agriculture and Department of Health and Human Services Pregnancy and Birth to 24 Months Project.

How was this question answered? 

• A team of Nutrition Evidence Systematic Review staff conducted a systematic review in collaboration with a group of experts called a Technical Expert Collaborative.

What is the population of interest? 

• The population of interest was generally healthy infants and toddlers (ages 0-24 months) who were in studies examining food allergies, allergic rhinitis, and atopic dermatitis throughout the lifespan and asthma from childhood through adulthood (ages 2 years and up).

What evidence was found? 

• No evidence was found to answer this systematic review question.

How up-to-date is this systematic review? 

• This review includes literature from 01/1980 to 03/2016.

Background

• This systematic review was conducted as part of the U.S. Department of Agriculture and Department of Health and Human Services Pregnancy and Birth to 24 Months Project.
• The goal of this systematic review was to examine the following question: What is the relationship between feeding a higher intensity, proportion, or amount of human milk by bottle versus by breast and food allergies, allergic rhinitis, atopic dermatitis, and asthma?
• This systematic review examines comparisons of infants fed different intensities, proportions, or amounts of human milk by bottle and by breast. Human milk was defined as mother’s own milk provided at the breast (i.e., nursing) or expressed and fed fresh or after refrigeration or freezing.  Donor milk (e.g., banked milk) was not examined in this review. 
• This systematic review examines available evidence related to food allergies, allergic rhinitis, and atopic dermatitis from birth through adulthood and asthma from childhood through adulthood (outcomes prior to childhood may represent transient recurrent wheeze).

Conclusion Statement and Grade

• There is no evidence to determine the relationship between feeding a higher intensity, proportion, or amount of human milk by bottle versus by breast and food allergies, allergic rhinitis, atopic dermatitis, and asthma throughout the lifespan. 
  
  Grade: Grade Not Assignable

Methods 

• The systematic review was conducted by a team of staff from the Nutrition Evidence Systematic Review in collaboration with a Technical Expert Collaborative.
• A single literature search was conducted to identify literature for several related systematic reviews that examined infant milk-feeding practices and different outcomes. The search was conducted in CINAHL, Cochrane, Embase, and PubMed, and used a search date range of January 1980 to March 2016. A manual search was done to identify articles that may not have been included in the electronic databases searched. 
• Articles were screened independently by 2 NESR analysts to determine which articles met predetermined criteria for inclusion.
• Because no articles were identified that met the inclusion criteria, the conclusion statement and grade reflect the absence of evidence and that no grade was assignable to the strength of the evidence.

Summary of Evidence 

• No articles met the inclusion criteria for this systematic review.