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. 2001 Feb;91(2):304–307. doi: 10.2105/ajph.91.2.304

Maternal smoking and the risk of early weaning: a meta-analysis.

B L Horta 1, M S Kramer 1, R W Platt 1
PMCID: PMC1446540  PMID: 11211645

Abstract

OBJECTIVES: This study reviewed evidence on the effect of maternal smoking on early weaning. METHODS: The following databases and journals were searched: Medline, Scientific Citation Index, Pediatrics, Journal of Pediatrics, New England Journal of Medicine, and Lancet. Analysis was restricted to studies in which infants who had never been breastfed were excluded or the prevalence of breastfeeding initiation was more than 90%. RESULTS: In smoking vs nonsmoking mothers, the random effects odds ratio for weaning before 3 months was 1.93 (95% confidence interval [CI] = 1.55, 2.40). An adjusted odds ratio of 1.50 (95% CI = 1.34, 1.68) was shown in studies that had lost-to-follow-up rates below 15% and included adequate adjustment for confounding. CONCLUSIONS: Maternal smoking increases the risk of early weaning.

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Selected References

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  1. Akre J. Infant feeding. The physiological basis. Bull World Health Organ. 1989;67 (Suppl):1–108. [PMC free article] [PubMed] [Google Scholar]
  2. Andersen A. N., Rønn B., Tjønneland A., Djursing H., Schiøler V. Low maternal but normal fetal prolactin levels in cigarette smoking pregnant women. Acta Obstet Gynecol Scand. 1984;63(3):237–239. doi: 10.3109/00016348409155504. [DOI] [PubMed] [Google Scholar]
  3. Andersen A. N., Schiøler V. Influence of breast-feeding pattern on pituitary-ovarian axis of women in an industrialized community. Am J Obstet Gynecol. 1982 Jul 15;143(6):673–677. doi: 10.1016/0002-9378(82)90113-2. [DOI] [PubMed] [Google Scholar]
  4. Aono T., Shioji T., Shoda T., Kurachi K. The initiation of human lactation and prolactin response to suckling. J Clin Endocrinol Metab. 1977 Jun;44(6):1101–1106. doi: 10.1210/jcem-44-6-1101. [DOI] [PubMed] [Google Scholar]
  5. Berkey C. S., Hoaglin D. C., Mosteller F., Colditz G. A. A random-effects regression model for meta-analysis. Stat Med. 1995 Feb 28;14(4):395–411. doi: 10.1002/sim.4780140406. [DOI] [PubMed] [Google Scholar]
  6. Biggerstaff B. J., Tweedie R. L. Incorporating variability in estimates of heterogeneity in the random effects model in meta-analysis. Stat Med. 1997 Apr 15;16(7):753–768. doi: 10.1002/(sici)1097-0258(19970415)16:7<753::aid-sim494>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  7. Birenbaum E., Vila Y., Linder N., Reichman B. Continuation of breast-feeding in an Israeli population. J Pediatr Gastroenterol Nutr. 1993 Apr;16(3):311–315. doi: 10.1097/00005176-199304000-00016. [DOI] [PubMed] [Google Scholar]
  8. Brown K. H., Black R. E., Lopez de Romaña G., Creed de Kanashiro H. Infant-feeding practices and their relationship with diarrheal and other diseases in Huascar (Lima), Peru. Pediatrics. 1989 Jan;83(1):31–40. [PubMed] [Google Scholar]
  9. Clements M. S., Mitchell E. A., Wright S. P., Esmail A., Jones D. R., Ford R. P. Influences on breastfeeding in southeast England. Acta Paediatr. 1997 Jan;86(1):51–56. doi: 10.1111/j.1651-2227.1997.tb08831.x. [DOI] [PubMed] [Google Scholar]
  10. Eriksen W. Breastfeeding, smoking and the presence of the child's father in the household. Acta Paediatr. 1996 Nov;85(11):1272–1277. doi: 10.1111/j.1651-2227.1996.tb13910.x. [DOI] [PubMed] [Google Scholar]
  11. Ever-Hadani P., Seidman D. S., Manor O., Harlap S. Breast feeding in Israel: maternal factors associated with choice and duration. J Epidemiol Community Health. 1994 Jun;48(3):281–285. doi: 10.1136/jech.48.3.281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Feinstein J. M., Berkelhamer J. E., Gruszka M. E., Wong C. A., Carey A. E. Factors related to early termination of breast-feeding in an urban population. Pediatrics. 1986 Aug;78(2):210–215. [PubMed] [Google Scholar]
  13. Ford K., Labbok M. Who is breast-feeding? Implications of associated social and biomedical variables for research on the consequences of method of infant feeding. Am J Clin Nutr. 1990 Sep;52(3):451–456. doi: 10.1093/ajcn/52.3.451. [DOI] [PubMed] [Google Scholar]
  14. Ford R. P., Mitchell E. A., Scragg R., Stewart A. W., Taylor B. J., Allen E. M. Factors adversely associated with breast feeding in New Zealand. J Paediatr Child Health. 1994 Dec;30(6):483–489. doi: 10.1111/j.1440-1754.1994.tb00717.x. [DOI] [PubMed] [Google Scholar]
  15. Freysteinsson H., Sigurdsson J. A. Breast-feeding in Iceland. Predictive factors and effects of interventive measures. Scand J Soc Med. 1996 Mar;24(1):62–66. doi: 10.1177/140349489602400110. [DOI] [PubMed] [Google Scholar]
  16. Hill P. D., Aldag J. C. Smoking and breastfeeding status. Res Nurs Health. 1996 Apr;19(2):125–132. doi: 10.1002/(SICI)1098-240X(199604)19:2<125::AID-NUR4>3.0.CO;2-O. [DOI] [PubMed] [Google Scholar]
  17. Hopkinson J. M., Schanler R. J., Fraley J. K., Garza C. Milk production by mothers of premature infants: influence of cigarette smoking. Pediatrics. 1992 Dec;90(6):934–938. [PubMed] [Google Scholar]
  18. Horta B. L., Victora C. G., Barros F. C., dos Santos I. da S., Menezes A. M. Tabagismo em gestantes de área urbana da região Sul do Brasil, 1982 e 1993. Rev Saude Publica. 1997 Jun;31(3):247–253. [PubMed] [Google Scholar]
  19. Horta B. L., Victora C. G., Menezes A. M., Barros F. C. Environmental tobacco smoke and breastfeeding duration. Am J Epidemiol. 1997 Jul 15;146(2):128–133. doi: 10.1093/oxfordjournals.aje.a009243. [DOI] [PubMed] [Google Scholar]
  20. Howie P. W., McNeilly A. S., McArdle T., Smart L., Houston M. The relationship between suckling-induced prolactin response and lactogenesis. J Clin Endocrinol Metab. 1980 Apr;50(4):670–673. doi: 10.1210/jcem-50-4-670. [DOI] [PubMed] [Google Scholar]
  21. Håkansson A., Carlsson B. Maternal cigarette smoking, breast-feeding, and respiratory tract infections in infancy. A population-based cohort study. Scand J Prim Health Care. 1992 Mar;10(1):60–65. doi: 10.3109/02813439209014037. [DOI] [PubMed] [Google Scholar]
  22. Jansson A., Andersson K., Bjelke B., Eneroth P., Fuxe K. Effects of a postnatal exposure to cigarette smoke on hypothalamic catecholamine nerve terminal systems and on neuroendocrine function in the postnatal and adult male rat. Evidence for long-term modulation of anterior pituitary function. Acta Physiol Scand. 1992 Apr;144(4):453–462. doi: 10.1111/j.1748-1716.1992.tb09320.x. [DOI] [PubMed] [Google Scholar]
  23. Kauppila A., Kivinen S., Ylikorkala O. A dose response relation between improved lactation and metoclopramide. Lancet. 1981 May 30;1(8231):1175–1177. doi: 10.1016/s0140-6736(81)92347-3. [DOI] [PubMed] [Google Scholar]
  24. Kulski J. K., Hartmann P. E., Martin J. D., Smith M. Effects of bromocriptine mesylate on the composition of the mammary secretion in non-breast-feeding women. Obstet Gynecol. 1978 Jul;52(1):38–42. [PubMed] [Google Scholar]
  25. Little R. E., Lambert M. D., Worthington-Roberts B. Drinking and smoking at 3 months postpartum by lactation history. Paediatr Perinat Epidemiol. 1990 Jul;4(3):290–302. doi: 10.1111/j.1365-3016.1990.tb00653.x. [DOI] [PubMed] [Google Scholar]
  26. Lyon A. J. Factors affecting breast feeding--a comparison of two British Military Hospitals. J R Army Med Corps. 1983 Oct;129(3):135–139. doi: 10.1136/jramc-129-03-03. [DOI] [PubMed] [Google Scholar]
  27. MILLS C. A. Tobacco smoking: some hints of its biologic hazards. Ohio State Med J. 1950 Dec;46(12):1165–1170. [PubMed] [Google Scholar]
  28. Mansbach I. K., Greenbaum C. W., Sulkes J. Onset and duration of breast feeding among Israeli mothers: relationships with smoking and type of delivery. Soc Sci Med. 1991;33(12):1391–1397. doi: 10.1016/0277-9536(91)90284-j. [DOI] [PubMed] [Google Scholar]
  29. Michaelsen K. F., Larsen P. S., Thomsen B. L., Samuelson G. The Copenhagen cohort study on infant nutrition and growth: duration of breast feeding and influencing factors. Acta Paediatr. 1994 Jun;83(6):565–571. doi: 10.1111/j.1651-2227.1994.tb13082.x. [DOI] [PubMed] [Google Scholar]
  30. Nafstad P., Jaakkola J. J., Hagen J. A., Pedersen B. S., Qvigstad E., Botten G., Kongerud J. Weight gain during the first year of life in relation to maternal smoking and breast feeding in Norway. J Epidemiol Community Health. 1997 Jun;51(3):261–265. doi: 10.1136/jech.51.3.261. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Niemelä A., Järvenpä A. L. Is breastfeeding beneficial and maternal smoking harmful to the cognitive development of children? Acta Paediatr. 1996 Oct;85(10):1202–1206. doi: 10.1111/j.1651-2227.1996.tb18229.x. [DOI] [PubMed] [Google Scholar]
  32. Nolan L., Goel V. Sociodemographic factors related to breastfeeding in Ontario: results from the Ontario Health Survey. Can J Public Health. 1995 Sep-Oct;86(5):309–312. [PubMed] [Google Scholar]
  33. Persson L. A. Multivariate approaches to the analysis of breast-feeding habits. Bull World Health Organ. 1985;63(6):1129–1136. [PMC free article] [PubMed] [Google Scholar]
  34. Piper S., Parks P. L. Predicting the duration of lactation: evidence from a national survey. Birth. 1996 Mar;23(1):7–12. doi: 10.1111/j.1523-536x.1996.tb00454.x. [DOI] [PubMed] [Google Scholar]
  35. Popkin B. M., Adair L., Akin J. S., Black R., Briscoe J., Flieger W. Breast-feeding and diarrheal morbidity. Pediatrics. 1990 Dec;86(6):874–882. [PubMed] [Google Scholar]
  36. Rutishauser I. H., Carlin J. B. Body mass index and duration of breast feeding: a survival analysis during the first six months of life. J Epidemiol Community Health. 1992 Dec;46(6):559–565. doi: 10.1136/jech.46.6.559. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Schwartz-Bickenbach D., Schulte-Hobein B., Abt S., Plum C., Nau H. Smoking and passive smoking during pregnancy and early infancy: effects on birth weight, lactation period, and cotinine concentrations in mother's milk and infant's urine. Toxicol Lett. 1987 Jan;35(1):73–81. doi: 10.1016/0378-4274(87)90088-9. [DOI] [PubMed] [Google Scholar]
  38. Sousa P. L. Letter: Metoclopramide and breast-feeding. Br Med J. 1975 Mar 1;1(5956):512–512. doi: 10.1136/bmj.1.5956.512-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Ståhlberg M. R. Breast-feeding and social factors. Acta Paediatr Scand. 1985 Jan;74(1):36–39. doi: 10.1111/j.1651-2227.1985.tb10917.x. [DOI] [PubMed] [Google Scholar]
  40. Thornhill J. A., Conroy R. M., Kelly D. G., Walsh A., Fennelly J. J., Fitzpatrick J. M. Public awareness of testicular cancer and the value of self examination. Br Med J (Clin Res Ed) 1986 Aug 23;293(6545):480–481. doi: 10.1136/bmj.293.6545.480. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Victora C. G., Smith P. G., Vaughan J. P., Nobre L. C., Lombardi C., Teixeira A. M., Fuchs S. M., Moreira L. B., Gigante L. P., Barros F. C. Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil. Lancet. 1987 Aug 8;2(8554):319–322. doi: 10.1016/s0140-6736(87)90902-0. [DOI] [PubMed] [Google Scholar]
  42. Vio F., Salazar G., Infante C. Smoking during pregnancy and lactation and its effects on breast-milk volume. Am J Clin Nutr. 1991 Dec;54(6):1011–1016. doi: 10.1093/ajcn/54.6.1011. [DOI] [PubMed] [Google Scholar]
  43. Whichelow M. J. Breast feeding in Cambridge, England: factors affecting the mother's milk supply. J Adv Nurs. 1979 May;4(3):253–261. doi: 10.1111/j.1365-2648.1979.tb03007.x. [DOI] [PubMed] [Google Scholar]
  44. Widström A. M., Werner S., Matthiesen A. S., Svensson K., Uvnäs-Moberg K. Somatostatin levels in plasma in nonsmoking and smoking breast-feeding women. Acta Paediatr Scand. 1991 Jan;80(1):13–21. doi: 10.1111/j.1651-2227.1991.tb11723.x. [DOI] [PubMed] [Google Scholar]
  45. Woodward A. Smoking and reduced duration of breast-feeding. Med J Aust. 1988 May 2;148(9):477–478. doi: 10.5694/j.1326-5377.1988.tb139578.x. [DOI] [PubMed] [Google Scholar]
  46. Wright H. J., Walker P. C. Prediction of duration of breast feeding in primiparas. J Epidemiol Community Health. 1983 Jun;37(2):89–94. doi: 10.1136/jech.37.2.89. [DOI] [PMC free article] [PubMed] [Google Scholar]

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