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Maternal breastfeeding and attention-deficit/hyperactivity disorder in children: a meta-analysis


Previous studies have suggested environmental factors may contribute to the risk of attention-deficit/hyperactivity disorder (ADHD). The current meta-analysis examined (1) the difference in the duration of maternal breastfeeding between children with and without ADHD, and (2) the association between maternal breastfeeding and ADHD in children. The data of individual studies were synthesized with a random-effects model. Eleven articles were included in this meta-analysis. Children with ADHD had significantly less breastfeeding duration than controls (Hedges’ g = − 0.36, 95% confidence intervals (CIs) = − 0.61 to − 0.11, p = 0.005; difference in means: − 2.44 months, 95% CIs = − 3.17 to − 1.71, p < 0.001). In addition, the rates of non-exclusive breastfeeding in children with ADHD is significantly higher in “under 3 months” (odds ratio (OR) = 1.90, 95% CIs = 1.45 to 2.48, p < 0.001) but lower in “6 to 12 months” (OR = 0.69, 95% CIs = 0.49 to 0.98, p = 0.039) and “over 12 months” (OR = 0.58, 95% CIs = 0.35 to 0.97, p = 0.038) than controls. Children with ADHD received significantly higher rate of exclusive breastfeeding duration “under 3 months” (OR = 1.51, 95% CIs = 1.20 to 1.89, p < 0.001) but lower in “over 3 months” (OR = 0.52, 95% CIs = 0.29 to 0.95, p = 0.033) than controls. Furthermore, an association was found between non-breastfeeding and ADHD children (adjusted OR = 3.71, 95% CI = 1.94 to 7.11, p < 0.001). Our results suggest maternal breastfeeding is associated with a lower risk of ADHD in children. Future longitudinal research is required to confirm/refute these findings and to explore possible mechanisms underlying this association.

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Fig. 1
Fig. 2



Attention-deficit/hyperactivity disorder




Confidence interval


Conners’ Parent Rating Scale


Conners’ teacher rating form


Diagnostic and statistical manual of mental disorders, fifth edition


Diagnostic and statistical manual of mental disorders, fourth edition


Effect size


International statistical classification of diseases and related health problems 10th revision




Meta-analysis of observational studies in epidemiology


Not available


Newcastle–Ottawa scale


Odds ratio


Polyunsaturated fatty acids


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The authors declare that there are no conflicts of interest or funding in relation to the subject of this study. This manuscript had been presented as the poster in the 55th Annual Meeting of Taiwanese Society of Psychiatry. We had contacted the authors Field S.S., Lemcke S., Ptacek R., Say G.N., and Turkoglu S. for inquiry of original data and we thank for their responding and help.

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Correspondence to Pao-Yen Lin.

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Tseng, PT., Yen, CF., Chen, YW. et al. Maternal breastfeeding and attention-deficit/hyperactivity disorder in children: a meta-analysis. Eur Child Adolesc Psychiatry 28, 19–30 (2019).

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  • Attention-deficit/hyperactivity disorder
  • Breastfeeding
  • Meta-analysis
  • Nutrition
  • Risk