Table 2 Synthesis of studies that evaluated association between method of infant feeding and bone mineral mass during childhood, adolescence or in adults

Park [13], Korea 1998, 10^a

Cross-sectional

2-5 months

22 M, 13 F

35, 18 BF, 17 FF

Exclusive BF (from birth to 5 months)

BMC and BMD spine

No association between breastfeeding and bone mass

Multiple regression

Age and body weight

Butte [10], US 2000, 13^a

Cohort

0.5, 12 and 24 months

33 M, 43 F

76, 40 BF, 36 FF

Exclusive BF (from birth to 4 months) Duration of BF

BMC whole body

Negative association between breastfeeding and bone mass

Pearson correlation and linear regression

Current weight and length

Jones [7], Australia 2000, 16^a

Cohort

8 years

215 M, 115 F

330, 175 BF, 151 FF

BF (no, yes) Duration of BF (not, less than 3 months, 3 months or larger)

BMC and BMD whole body, spine, femoral neck

Positive association between breastfeeding and bone mass

Multiple linear regression

Sex, current weight and length, age solids introduced, sports participation, sunlight exposure and current calcium intake

Young [15], EUA 2005, 10^a

Cohort

4 years

103 M, 75 F

178, 57 BF, 121 FF

Exclusive BF (from birth to 4 months)

BMC and BMD whole body

No association between breastfeeding and bone mass

Analysis of variance

Crude

Harvey [12], UK 2009, 16^a

Cohort

4 years

318 M, 281 F

599

Duration of BF (never tried, <1 month, 1-3 months, 4-6 months, 7-11 months, 12 months or more)

BMC and BMD whole body

No association between breastfeeding and bone mass

Correlation and linear regression

Bone area, weight, height, childhood milk intake, maternal birth weight, social class, mother’s prudent diet score, parity, physical activity, body build (triceps skinfold thickness) and smoking

Andres [5], EUA 2013, 15^a

Cohort

3, 6, 9 and 12 months

130 M, 77 F

207

BF (no, yes)

BMC whole body, spine, femoral neck

Positive association between breastfeeding and bone mass

Logistic regression

Age, sex, race, gestational age, birth weight, birth length, food history and socioeconomic status of the mother

Papers evaluating adolescents

Foley [6] Australia 2009, 15^a

Cohort

16 years

116 M, 67 F

183

BF (no, yes) reported by the mother approximately 1 month after birth

BMC and aBMD whole body and spine

Positive association between breastfeeding and bone mass

Logistic regression

Age, weight and height

Molgaard [9], Denmark 2011, 15^a

Cohort

17 years

Males, Females

109

Duration of exclusive BF and any BF up to 9 months. If the infants were breastfed at least once a day, they were classified as breastfed

BMC and BMD whole body and spine

Positive association between breastfeeding and bone mass

Correlation

Sex, weight and height

Fewtrell [11], UK 2013, 16^a

Randomised trial

10 years

193 M, 130 F

323, 120 BF, 203 FF

Exclusive BF (from birth to 12 weeks)

BMC and BMD whole body and spine

No association between breastfeeding and bone mass

Multiple regression

Sex, age, pubertal stage, weight, height, current physical activity and calcium intake

Jones [8] Australia 2013, 16^a

Cohort

16 years

150 M, 265 F

415

BF at 1 month (no, yes) and BF at 3 months (no, yes), Duration of BF (never, <25 days and ≥ 25 days)

BMD whole body and spine

Positive association between breastfeeding and bone mass

Multivariable linear regression

Sex, age, current weight and height

Papers evaluating adults

Pirilä [14], Finland 2011, 15^a

Cohort

32 years

76 M, 82 F

158

Duration BF from birth to 12 months (short BF ≤3 months; intermediate BF >3 but <7 months and prolonged BF ≥7 months)

BMC and BMD whole body, spine and femoral neck

Negative association between breastfeeding and bone mass only in men, No association between breastfeeding and bone mass in women

Multivariate analysis of covariance

Gender, dietary intake of calcium, teen-age and current physical activity, smoking history, alcohol consumption, pregnancies, fractures, weight, height, BMI, weight changes during adult life and birth weight