Optimal duration of exclusive breastfeeding

Michael S Kramer; Ritsuko Kakuma

doi:10.1002/14651858.CD003517.pub2

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Analysis 1.1

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 1 Monthly weight gain from 4‐6 months (g/mo).

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Analysis 1.2

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 2 Monthly weight gain from 6‐12 months (g/mo).

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Analysis 1.3

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 3 Monthly length gain 4‐6 months (cm/mo).

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Analysis 1.4

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 4 Monthly length gain 6‐12 months (cm/mo).

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Analysis 1.5

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 5 Weight‐for‐age z‐score at 6 months.

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Analysis 1.6

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 6 Length‐for‐age z‐score at 6 months.

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Analysis 1.7

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 7 Weight‐for‐length z‐score at 6 months.

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Analysis 1.8

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 8 Weight‐for‐age z‐score < ‐2 at 6 months.

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Analysis 1.9

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 9 Length‐for‐age z‐score < ‐2 at 6 months.

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Analysis 1.10

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 10 Weight‐for‐length z‐score < ‐2 at 6 months.

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Analysis 1.11

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 11 Receipt of Fe supplements 6‐9 months.

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Analysis 1.12

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 12 Hemoglobin concentration (g/L) at 6 months.

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Analysis 1.13

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 13 Hemoglobin concentration < 110 g/L at 6 months.

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Analysis 1.14

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 14 Hemoglobin concentration < 103 g/L at 6 months.

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Analysis 1.15

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 15 Hematocrit (%) at 6 months.

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Analysis 1.16

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 16 Hematocrit < 33% at 6 months.

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Analysis 1.17

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 17 Plasma ferritin concentration (mcg/L) at 6 months.

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Analysis 1.18

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 18 Plasma ferritin concentration < 12 mcg/L at 6 months.

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Analysis 1.19

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 19 Plasma ferritin concentration < 15 mcg/L at 6 months.

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Analysis 1.20

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 20 Plasma zinc concentration < 70 mcg/dL at 6 months.

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Analysis 1.21

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 21 % of days with fever 4‐6 months.

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Analysis 1.22

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 22 % of days with cough 4‐6 months.

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Analysis 1.23

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 23 % of days with nasal congestion 4‐6 months.

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Analysis 1.24

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 24 % of days with nasal discharge 4‐6 months.

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Analysis 1.25

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 25 % of days with hoarseness 4‐6 months.

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Analysis 1.26

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 26 % of days with diarrhea 4‐6 months.

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Analysis 1.27

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 27 % of days with fever 6‐12 months.

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Analysis 1.28

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 28 % of days with nasal congestion 6‐12 months.

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Analysis 1.29

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 29 % of days with diarrhea 6‐12 months.

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Analysis 1.30

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 30 Age first crawled (mo).

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Analysis 1.31

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 31 Age first sat from lying position (mo).

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Analysis 1.32

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 32 Did not walk by 12 months.

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Analysis 1.33

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 33 Maternal postpartum weight loss 4‐6 months (kg).

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Analysis 1.34

Comparison 1 Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials, Outcome 34 Maternal resumption of menses 6 months postpartum.

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Analysis 2.1

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 1 Monthly weight gain 4‐6 months (g/mo).

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Analysis 2.2

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 2 Monthly weight gain 6‐9 months (g/mo).

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Analysis 2.3

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 3 Monthly length gain 4‐6 months (cm/mo).

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Analysis 2.4

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 4 Monthly length gain 6‐9 months (cm/mo).

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Analysis 2.5

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 5 Weight‐for‐age z‐score at 6‐7 months.

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Analysis 2.6

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 6 Weight‐for‐age z‐score at 9‐10 months.

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Analysis 2.7

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 7 Length‐for‐age z‐score at 6‐7 months.

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Analysis 2.8

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 8 Length‐for‐age z‐score at 9‐10 months.

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Analysis 2.9

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 9 Weight‐for‐length z‐score at 6‐7 months.

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Analysis 2.10

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 10 Weight‐for‐length z‐score at 9‐10 months.

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Analysis 2.11

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 11 Weight‐for‐age z‐score < ‐2 at 6‐7 months.

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Analysis 2.12

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 12 Weight‐for‐age z‐score < ‐2 at 9‐10 months.

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Analysis 2.13

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 13 Length‐for‐age z‐score < ‐2 at 6‐7 months.

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Analysis 2.14

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 14 Length‐for‐age z‐score < ‐2 at 9‐10 months.

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Analysis 2.15

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 15 Weight‐for‐length z‐score < ‐2 at 6‐7 months.

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Analysis 2.16

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 16 Weight‐for‐length z‐score < ‐2 at 9‐10 months.

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Analysis 2.17

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 17 Mid‐upper arm circumference at 6‐7 months (cm).

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Analysis 2.18

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 18 Mid‐upper arm circumference at 9‐10 months (cm).

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Analysis 2.19

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 19 One or more episodes of gastrointestinal infection at 4‐6 months.

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Analysis 2.20

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 20 One or more episodes of respiratory infection at 4‐6 months.

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Analysis 2.21

Comparison 2 Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies, Outcome 21 Resumption of menses by 6‐7 months postpartum.

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Analysis 3.1

Comparison 3 Exclusive breastfeeding for > 6 months versus 6 months, developing countries, observational studies, Outcome 1 Weight‐for‐age < 75% of reference mean.

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Analysis 4.1

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 1 Monthly weight gain 3‐8 months (g/mo).

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Analysis 4.2

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 2 Monthly weight gain 6‐9 months (g/mo).

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Analysis 4.3

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 3 Monthly weight gain 8‐12 months (g/mo).

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Analysis 4.4

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 4 Monthly length gain 3‐8 months (cm/mo).

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Analysis 4.5

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 5 Monthly length gain 6‐9 months (cm/mo).

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Analysis 4.6

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 6 Monthly length gain 8‐12 months (cm/mo).

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Analysis 4.7

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 7 Weight‐for‐age z‐score at 6 months.

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Analysis 4.8

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 8 Weight‐for‐age z‐score at 9 months.

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Analysis 4.9

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 9 Weight‐for‐age z‐score at 12 months.

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Analysis 4.10

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 10 Length‐for‐age z‐score at 6 months.

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Analysis 4.11

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 11 Length‐for‐age z‐score at 9 months.

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Analysis 4.12

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 12 Length‐for‐age z‐score at 12 months.

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Analysis 4.13

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 13 Weight‐for‐length z‐score at 6 months.

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Analysis 4.14

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 14 Weight‐for‐length z‐score at 9 months.

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Analysis 4.15

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 15 Weight‐for‐length z‐score at 12 months.

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Analysis 4.16

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 16 Weight‐for‐age z‐score < ‐2 at 6 months.

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Analysis 4.17

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 17 Weight‐for‐age z‐score < ‐2 at 9 months.

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Analysis 4.18

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 18 Weight‐for‐age z‐score < ‐2 at 12 months.

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Analysis 4.19

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 19 Length‐for‐age z‐score < ‐2 at 6 months.

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Analysis 4.20

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 20 Length‐for‐age z‐score < ‐2 at 9 months.

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Analysis 4.21

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 21 Length‐for‐age z‐score < ‐2 at 12 months.

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Analysis 4.22

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 22 Weight‐for‐length z‐score < ‐2 at 6 months.

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Analysis 4.23

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 23 Weight‐for‐length z‐score < ‐2 at 9 months.

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Analysis 4.24

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 24 Weight‐for‐length z‐score < ‐2 at 12 months.

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Analysis 4.25

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 25 Head circumference at 6 months (cm).

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Analysis 4.26

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 26 Head circumference at 9 months (cm).

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Analysis 4.27

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 27 Head circumference at 12 months (cm).

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Analysis 4.28

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 28 Sleeping time at 9 months (min/day).

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Analysis 4.29

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 29 Total essential amino acid concentration (umol/L) at 6 months.

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Analysis 4.30

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 30 Total amino acid concentration (umol/L) at 6 months.

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Analysis 4.31

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 31 Atopic eczema in first 12 months.

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Analysis 4.32

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 32 Food allergy at 1 year (by history).

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Analysis 4.33

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 33 Food allergy at 1 year (by double challenge).

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Analysis 4.34

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 34 Two or more episodes of wheezing in first 12 months.

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Analysis 4.35

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 35 Hemoglobin concentration (g/L) at 12 months.

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Analysis 4.36

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 36 Hemoglobin concentration < 110 g/L at 12 months.

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Analysis 4.37

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 37 Serum ferritin concentration (mcg/L) at 12 months.

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Analysis 4.38

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 38 Serum ferritin concentration < 10 mcg/L at 12 months.

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Analysis 4.39

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 39 One or more episodes of gastrointestinal infection in first 12 months.

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Analysis 4.40

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 40 Hospitalization for gastrointestinal infection in first 12 months.

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Analysis 4.41

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 41 One or more episodes of upper respiratory tract infection in first 12 months.

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Analysis 4.42

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 42 Two or more episodes of upper respiratory tract infection in first 12 months.

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Analysis 4.43

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 43 Four or more episodes of upper respiratory tract infection in first 12 months.

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Analysis 4.44

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 44 One or more episodes of lower respiratory tract infection in first 12 months.

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Analysis 4.45

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 45 Two or more episodes of respiratory tract infection (upper or lower) in first 12 months.

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Analysis 4.46

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 46 Hospitalization for respiratory tract infection in first 12 months.

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Analysis 4.47

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 47 Number of episodes of otitis media in first 12 months.

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Analysis 4.48

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 48 One or more episodes of otitis media in first 12 months.

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Analysis 4.49

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 49 Frequent otitis media in first 12 months.

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Analysis 4.50

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 50 Death in first 12 months.

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Analysis 4.51

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 51 Any dental caries (decayed, missing, or filled teeth) at 6 years.

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Analysis 4.52

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 52 Any incisor caries (decayed, missing, or filled teeth) at 6 years.

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Analysis 4.53

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 53 Height at 6.5 years.

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Analysis 4.54

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 54 Leg length at 6.5 years.

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Analysis 4.55

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 55 Head circumference at 6.5 years.

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Analysis 4.56

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 56 BMI at 6.5 years.

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Analysis 4.57

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 57 Triceps skinfold thickness at 6.5 years.

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Analysis 4.58

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 58 Subscapular skinfold thickness.

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Analysis 4.59

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 59 Waist circumference at 6.5 years.

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Analysis 4.60

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 60 Hip circumference at 6.5 years.

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Analysis 4.61

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 61 Systolic blood pressure at 6.5 years.

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Analysis 4.62

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 62 Diastolic blood pressure at 6.5 years (mm Hg).

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Analysis 4.63

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 63 Atopic eczema at 5‐7 years.

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Analysis 4.64

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 64 Hay fever at 5‐7 years.

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Analysis 4.65

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 65 Asthma at 5‐7 years.

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Analysis 4.66

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 66 Food allergy at 5 years.

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Analysis 4.67

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 67 Allergy to animal dander at 5 years.

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Analysis 4.68

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 68 Positive skin‐prick test to house dust mite at 6.5 years.

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Analysis 4.69

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 69 Positive skin‐prick test to cat dander at 6.5 years.

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Analysis 4.70

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 70 Positive skin‐prick test to birch pollen at 6.5 years.

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Analysis 4.71

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 71 Positive skin‐prick test to mixed northern grasses at 6.5 years.

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Analysis 4.72

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 72 Positive skin‐prick test to Alternaria at 6.5 years.

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Analysis 4.73

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 73 Any positive skin‐prick test at 6‐7 years.

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Analysis 4.74

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 74 Wechsler cognitive ability test at 6.5 years: vocabulary.

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Analysis 4.75

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 75 Wechsler cognitive ability test at 6.5 years: similarities.

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Analysis 4.76

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 76 Wechsler cognitive ability test at 6.5 years: matrices.

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Analysis 4.77

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 77 Wechsler cognitive ability test at 6.5 years: block designs.

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Analysis 4.78

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 78 Wechsler cognitive ability test at 6.5 years: verbal IQ.

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Analysis 4.79

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 79 Wechsler cognitive ability test at 6.5 years: performance IQ.

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Analysis 4.80

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 80 Wechsler cognitive ability test at 6.5 years: full‐scale IQ.

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Analysis 4.81

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 81 Teacher's academic rating at 6.5 years: reading.

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Analysis 4.82

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 82 Teacher's academic rating at 6.5 years: writing.

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Analysis 4.83

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 83 Teacher's academic rating at 6.5 years: mathematics.

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Analysis 4.84

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 84 Teacher's academic rating at 6.5 years: other subjects.

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Analysis 4.85

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 85 Parent's behavior rating at 6.5 years: total difficulties.

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Analysis 4.86

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 86 Parent's behavior rating at 6.5 years: emotional symptoms.

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Analysis 4.87

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 87 Parent's behavior rating at 6.5 years: conduct problems.

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Analysis 4.88

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 88 Parent's behavior rating at 6.5 years: hyperactivity/inattention.

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Analysis 4.89

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 89 Parent's behavior rating at 6.5 years: peer problems.

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Analysis 4.90

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 90 Parent's behavior rating at 6.5 years: prosocial behavior.

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Analysis 4.91

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 91 Teacher's behavior rating at 6.5 years: total difficulties.

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Analysis 4.92

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 92 Teacher's behavior rating at 6.5 years: emotional symptoms.

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Analysis 4.93

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 93 Teacher's behavior rating at 6.5 years: conduct problems.

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Analysis 4.94

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 94 Teacher's behavior rating at 6.5 years: hyperactivity/inattention.

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Analysis 4.95

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 95 Teacher's behavior rating at 6.5 years: peer problems.

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Analysis 4.96

Comparison 4 Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies, Outcome 96 Teacher's behavior rating at 6.5 years: prosocial behavior.

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Analysis 5.1

Comparison 5 Exclusive breastfeeding for > 6 months versus 6 months, developed countries, observational studies, Outcome 1 Very low density lipoprotein concentration (mmol/L) at 9 months.

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Analysis 5.2

Comparison 5 Exclusive breastfeeding for > 6 months versus 6 months, developed countries, observational studies, Outcome 2 Low density lipoproteinconcentration (mmol/L) at 9 months.

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Analysis 5.3

Comparison 5 Exclusive breastfeeding for > 6 months versus 6 months, developed countries, observational studies, Outcome 3 High‐density lipoprotein‐2 concentration (mmol/L) at 9 months.

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Analysis 5.4

Comparison 5 Exclusive breastfeeding for > 6 months versus 6 months, developed countries, observational studies, Outcome 4 High‐density lipoprotein‐3 concentration (mmol/L) at 9 months.

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Analysis 5.5

Comparison 5 Exclusive breastfeeding for > 6 months versus 6 months, developed countries, observational studies, Outcome 5 Apoprotein B concentration (mg/dL) at 9 months.

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Analysis 5.6

Comparison 5 Exclusive breastfeeding for > 6 months versus 6 months, developed countries, observational studies, Outcome 6 Total triglyceride concentration (mmol/L) at 9 months.

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Comparison 1. Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Monthly weight gain from 4‐6 months (g/mo) Show forest plot	2	265	Mean Difference (IV, Fixed, 95% CI)	20.78 [‐21.99, 63.54]

2 Monthly weight gain from 6‐12 months (g/mo) Show forest plot	2	233	Mean Difference (IV, Fixed, 95% CI)	‐2.62 [‐25.85, 20.62]

3 Monthly length gain 4‐6 months (cm/mo) Show forest plot	2	265	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.04, 0.24]

4 Monthly length gain 6‐12 months (cm/mo) Show forest plot	2	233	Mean Difference (IV, Fixed, 95% CI)	‐0.04 [‐0.10, 0.02]

5 Weight‐for‐age z‐score at 6 months Show forest plot	2	260	Mean Difference (IV, Fixed, 95% CI)	0.18 [‐0.06, 0.41]

6 Length‐for‐age z‐score at 6 months Show forest plot	2	260	Mean Difference (IV, Fixed, 95% CI)	0.11 [‐0.11, 0.33]

7 Weight‐for‐length z‐score at 6 months Show forest plot	2	260	Mean Difference (IV, Fixed, 95% CI)	0.09 [‐0.13, 0.31]

8 Weight‐for‐age z‐score < ‐2 at 6 months Show forest plot	2	260	Risk Ratio (M‐H, Fixed, 95% CI)	2.14 [0.74, 6.24]

9 Length‐for‐age z‐score < ‐2 at 6 months Show forest plot	2	260	Risk Ratio (M‐H, Fixed, 95% CI)	1.18 [0.56, 2.50]

10 Weight‐for‐length z‐score < ‐2 at 6 months Show forest plot	2	260	Risk Ratio (M‐H, Fixed, 95% CI)	1.38 [0.17, 10.98]

11 Receipt of Fe supplements 6‐9 months Show forest plot	1	139	Risk Ratio (M‐H, Fixed, 95% CI)	1.20 [0.91, 1.58]

12 Hemoglobin concentration (g/L) at 6 months Show forest plot	1	139	Mean Difference (IV, Fixed, 95% CI)	‐5.0 [‐8.46, ‐1.54]

13 Hemoglobin concentration < 110 g/L at 6 months Show forest plot	1	139	Risk Ratio (M‐H, Fixed, 95% CI)	1.20 [0.91, 1.58]

14 Hemoglobin concentration < 103 g/L at 6 months Show forest plot	1	139	Risk Ratio (M‐H, Fixed, 95% CI)	1.29 [0.75, 2.23]

15 Hematocrit (%) at 6 months Show forest plot	1	139	Mean Difference (IV, Fixed, 95% CI)	‐1.20 [‐2.15, ‐0.25]

16 Hematocrit < 33% at 6 months Show forest plot	1	139	Risk Ratio (M‐H, Fixed, 95% CI)	1.50 [0.85, 2.64]

17 Plasma ferritin concentration (mcg/L) at 6 months Show forest plot	1	135	Mean Difference (IV, Fixed, 95% CI)	‐18.9 [‐37.31, ‐0.49]

18 Plasma ferritin concentration < 12 mcg/L at 6 months Show forest plot	1	135	Risk Ratio (M‐H, Fixed, 95% CI)	2.34 [0.86, 6.35]

19 Plasma ferritin concentration < 15 mcg/L at 6 months Show forest plot	1	135	Risk Ratio (M‐H, Fixed, 95% CI)	2.93 [1.13, 7.56]

20 Plasma zinc concentration < 70 mcg/dL at 6 months Show forest plot	1	101	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.43, 1.33]

21 % of days with fever 4‐6 months Show forest plot	2	260	Mean Difference (IV, Fixed, 95% CI)	0.26 [‐1.29, 1.81]

22 % of days with cough 4‐6 months Show forest plot	2	260	Mean Difference (IV, Random, 95% CI)	2.33 [‐6.00, 12.65]

23 % of days with nasal congestion 4‐6 months Show forest plot	2	260	Mean Difference (IV, Fixed, 95% CI)	0.11 [‐4.41, 4.63]

24 % of days with nasal discharge 4‐6 months Show forest plot	2	260	Mean Difference (IV, Random, 95% CI)	‐0.72 [‐6.81, 5.38]

25 % of days with hoarseness 4‐6 months Show forest plot	2	260	Mean Difference (IV, Fixed, 95% CI)	‐0.19 [‐1.17, 0.79]

26 % of days with diarrhea 4‐6 months Show forest plot	2	260	Mean Difference (IV, Fixed, 95% CI)	1.15 [‐0.35, 2.65]

27 % of days with fever 6‐12 months Show forest plot	2	258	Mean Difference (IV, Fixed, 95% CI)	‐0.39 [‐2.80, 2.02]

28 % of days with nasal congestion 6‐12 months Show forest plot	2	258	Mean Difference (IV, Fixed, 95% CI)	3.11 [‐0.12, 6.35]

29 % of days with diarrhea 6‐12 months Show forest plot	2	258	Mean Difference (IV, Fixed, 95% CI)	‐0.74 [‐2.34, 0.86]

30 Age first crawled (mo) Show forest plot	2	240	Mean Difference (IV, Fixed, 95% CI)	‐0.80 [‐1.26, ‐0.34]

31 Age first sat from lying position (mo) Show forest plot	2	238	Mean Difference (IV, Random, 95% CI)	‐0.22 [‐0.91, 0.46]

32 Did not walk by 12 months Show forest plot	2	233	Risk Ratio (M‐H, Random, 95% CI)	0.88 [0.50, 1.55]

33 Maternal postpartum weight loss 4‐6 months (kg) Show forest plot	2	260	Mean Difference (IV, Fixed, 95% CI)	0.42 [0.02, 0.82]

34 Maternal resumption of menses 6 months postpartum Show forest plot	2	189	Risk Ratio (M‐H, Fixed, 95% CI)	0.58 [0.33, 1.03]

Comparison 1. Exclusive breastfeeding for 6 versus 4 months, developing countries, controlled trials

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Comparison 2. Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Monthly weight gain 4‐6 months (g/mo) Show forest plot	4	1803	Mean Difference (IV, Fixed, 95% CI)	‐10.10 [‐27.68, 7.48]

2 Monthly weight gain 6‐9 months (g/mo) Show forest plot	1	319	Mean Difference (IV, Fixed, 95% CI)	‐6.0 [‐54.15, 42.15]

3 Monthly length gain 4‐6 months (cm/mo) Show forest plot	4	1803	Mean Difference (IV, Fixed, 95% CI)	0.04 [‐0.02, 0.11]

4 Monthly length gain 6‐9 months (cm/mo) Show forest plot	1	319	Mean Difference (IV, Fixed, 95% CI)	0.04 [‐0.06, 0.14]

5 Weight‐for‐age z‐score at 6‐7 months Show forest plot	1	370	Mean Difference (IV, Fixed, 95% CI)	0.13 [‐0.09, 0.35]

6 Weight‐for‐age z‐score at 9‐10 months Show forest plot	1	319	Mean Difference (IV, Fixed, 95% CI)	0.09 [‐0.15, 0.33]

7 Length‐for‐age z‐score at 6‐7 months Show forest plot	1	370	Mean Difference (IV, Fixed, 95% CI)	0.04 [‐0.14, 0.22]

8 Length‐for‐age z‐score at 9‐10 months Show forest plot	1	319	Mean Difference (IV, Fixed, 95% CI)	0.11 [‐0.09, 0.31]

9 Weight‐for‐length z‐score at 6‐7 months Show forest plot	1	370	Mean Difference (IV, Fixed, 95% CI)	0.11 [‐0.09, 0.31]

10 Weight‐for‐length z‐score at 9‐10 months Show forest plot	1	319	Mean Difference (IV, Fixed, 95% CI)	0.01 [‐0.21, 0.23]

11 Weight‐for‐age z‐score < ‐2 at 6‐7 months Show forest plot	1	370	Risk Ratio (M‐H, Fixed, 95% CI)	0.92 [0.54, 1.58]

12 Weight‐for‐age z‐score < ‐2 at 9‐10 months Show forest plot	1	319	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.64, 1.36]

13 Length‐for‐age z‐score < ‐2 at 6‐7 months Show forest plot	1	370	Risk Ratio (M‐H, Fixed, 95% CI)	1.20 [0.57, 2.53]

14 Length‐for‐age z‐score < ‐2 at 9‐10 months Show forest plot	1	319	Risk Ratio (M‐H, Fixed, 95% CI)	1.21 [0.62, 2.37]

15 Weight‐for‐length z‐score < ‐2 at 6‐7 months Show forest plot	1	370	Risk Ratio (M‐H, Fixed, 95% CI)	0.42 [0.12, 1.50]

16 Weight‐for‐length z‐score < ‐2 at 9‐10 months Show forest plot	1	319	Risk Ratio (M‐H, Fixed, 95% CI)	0.82 [0.39, 1.71]

17 Mid‐upper arm circumference at 6‐7 months (cm) Show forest plot	1	370	Mean Difference (IV, Fixed, 95% CI)	0.20 [‐0.04, 0.44]

18 Mid‐upper arm circumference at 9‐10 months (cm) Show forest plot	1	319	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.16, 0.36]

19 One or more episodes of gastrointestinal infection at 4‐6 months Show forest plot	1	193	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.21, 0.78]

20 One or more episodes of respiratory infection at 4‐6 months Show forest plot	1	193	Risk Ratio (M‐H, Fixed, 95% CI)	0.68 [0.43, 1.06]

21 Resumption of menses by 6‐7 months postpartum Show forest plot	1	686	Risk Ratio (M‐H, Fixed, 95% CI)	0.19 [0.05, 0.79]

Comparison 2. Exclusive breastfeeding for 6‐7 versus 3‐4 months, developing countries, observational studies

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Comparison 3. Exclusive breastfeeding for > 6 months versus 6 months, developing countries, observational studies

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Weight‐for‐age < 75% of reference mean Show forest plot	1	31	Risk Ratio (M‐H, Fixed, 95% CI)	0.61 [0.26, 1.43]

Comparison 3. Exclusive breastfeeding for > 6 months versus 6 months, developing countries, observational studies

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Comparison 4. Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Monthly weight gain 3‐8 months (g/mo) Show forest plot	4	4388	Mean Difference (IV, Random, 95% CI)	‐7.95 [‐31.84, 15.93]

2 Monthly weight gain 6‐9 months (g/mo) Show forest plot	2	3432	Mean Difference (IV, Random, 95% CI)	21.11 [‐44.70, 86.91]

3 Monthly weight gain 8‐12 months (g/mo) Show forest plot	3	3450	Mean Difference (IV, Fixed, 95% CI)	‐1.82 [‐16.72, 13.08]

4 Monthly length gain 3‐8 months (cm/mo) Show forest plot	4	4385	Mean Difference (IV, Random, 95% CI)	‐0.03 [‐0.11, 0.06]

5 Monthly length gain 6‐9 months (cm/mo) Show forest plot	2	3430	Mean Difference (IV, Fixed, 95% CI)	‐0.04 [‐0.10, 0.01]

6 Monthly length gain 8‐12 months (cm/mo) Show forest plot	3	3448	Mean Difference (IV, Fixed, 95% CI)	0.09 [0.03, 0.14]

7 Weight‐for‐age z‐score at 6 months Show forest plot	1	3455	Mean Difference (IV, Fixed, 95% CI)	‐0.09 [‐0.16, ‐0.02]

8 Weight‐for‐age z‐score at 9 months Show forest plot	1	3400	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐0.18, ‐0.02]

9 Weight‐for‐age z‐score at 12 months Show forest plot	1	3458	Mean Difference (IV, Fixed, 95% CI)	‐0.09 [‐0.17, ‐0.01]

10 Length‐for‐age z‐score at 6 months Show forest plot	1	3454	Mean Difference (IV, Fixed, 95% CI)	‐0.12 [‐0.20, ‐0.04]

11 Length‐for‐age z‐score at 9 months Show forest plot	1	3398	Mean Difference (IV, Fixed, 95% CI)	‐0.14 [‐0.22, ‐0.06]

12 Length‐for‐age z‐score at 12 months Show forest plot	1	3458	Mean Difference (IV, Fixed, 95% CI)	‐0.02 [‐0.10, 0.06]

13 Weight‐for‐length z‐score at 6 months Show forest plot	1	3454	Mean Difference (IV, Fixed, 95% CI)	0.02 [‐0.07, 0.11]

14 Weight‐for‐length z‐score at 9 months Show forest plot	1	3398	Mean Difference (IV, Fixed, 95% CI)	0.03 [‐0.06, 0.12]

15 Weight‐for‐length z‐score at 12 months Show forest plot	1	3458	Mean Difference (IV, Fixed, 95% CI)	‐0.08 [‐0.17, 0.01]

16 Weight‐for‐age z‐score < ‐2 at 6 months Show forest plot	1	3461	Risk Ratio (M‐H, Fixed, 95% CI)	0.92 [0.04, 19.04]

17 Weight‐for‐age z‐score < ‐2 at 9 months Show forest plot	1	3408	Risk Ratio (M‐H, Fixed, 95% CI)	1.52 [0.16, 14.62]

18 Weight‐for‐age z‐score < ‐2 at 12 months Show forest plot	1	3466	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.13, 10.31]

19 Length‐for‐age z‐score < ‐2 at 6 months Show forest plot	1	3460	Risk Ratio (M‐H, Fixed, 95% CI)	1.53 [0.84, 2.78]

20 Length‐for‐age z‐score < ‐2 at 9 months Show forest plot	1	3406	Risk Ratio (M‐H, Fixed, 95% CI)	1.46 [0.80, 2.64]

21 Length‐for‐age z‐score < ‐2 at 12 months Show forest plot	1	3466	Risk Ratio (M‐H, Fixed, 95% CI)	0.66 [0.23, 1.87]

22 Weight‐for‐length z‐score < ‐2 at 6 months Show forest plot	1	3460	Risk Ratio (M‐H, Fixed, 95% CI)	0.31 [0.02, 5.34]

23 Weight‐for‐length z‐score < ‐2 at 9 months Show forest plot	1	3406	Risk Ratio (M‐H, Fixed, 95% CI)	1.14 [0.24, 5.37]

24 Weight‐for‐length z‐score < ‐2 at 12 months Show forest plot	1	3466	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.13, 10.31]

25 Head circumference at 6 months (cm) Show forest plot	1	3440	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐0.23, 0.03]

26 Head circumference at 9 months (cm) Show forest plot	1	3389	Mean Difference (IV, Fixed, 95% CI)	0.07 [‐0.06, 0.20]

27 Head circumference at 12 months (cm) Show forest plot	1	3450	Mean Difference (IV, Fixed, 95% CI)	0.19 [0.06, 0.32]

28 Sleeping time at 9 months (min/day) Show forest plot	1	50	Mean Difference (IV, Fixed, 95% CI)	1.0 [‐36.65, 38.65]

29 Total essential amino acid concentration (umol/L) at 6 months Show forest plot	1	44	Mean Difference (IV, Fixed, 95% CI)	22.0 [‐59.60, 103.60]

30 Total amino acid concentration (umol/L) at 6 months Show forest plot	1	44	Mean Difference (IV, Fixed, 95% CI)	73.0 [‐118.22, 264.22]

31 Atopic eczema in first 12 months Show forest plot	2	3618	Risk Ratio (M‐H, Random, 95% CI)	0.65 [0.27, 1.59]

32 Food allergy at 1 year (by history) Show forest plot	1	135	Risk Ratio (M‐H, Fixed, 95% CI)	0.19 [0.08, 0.48]

33 Food allergy at 1 year (by double challenge) Show forest plot	1	135	Risk Ratio (M‐H, Fixed, 95% CI)	0.77 [0.25, 2.41]

34 Two or more episodes of wheezing in first 12 months Show forest plot	2	3993	Risk Ratio (M‐H, Fixed, 95% CI)	0.79 [0.49, 1.28]

35 Hemoglobin concentration (g/L) at 12 months Show forest plot	1	30	Mean Difference (IV, Fixed, 95% CI)	8.0 [4.03, 11.97]

36 Hemoglobin concentration < 110 g/L at 12 months Show forest plot	1	30	Risk Ratio (M‐H, Fixed, 95% CI)	0.12 [0.01, 1.80]

37 Serum ferritin concentration (mcg/L) at 12 months Show forest plot	1	30	Mean Difference (IV, Fixed, 95% CI)	4.70 [‐6.30, 15.70]

38 Serum ferritin concentration < 10 mcg/L at 12 months Show forest plot	1	30	Risk Ratio (M‐H, Fixed, 95% CI)	0.42 [0.12, 1.54]

39 One or more episodes of gastrointestinal infection in first 12 months Show forest plot	1	3483	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.46, 0.97]

40 Hospitalization for gastrointestinal infection in first 12 months Show forest plot	1	3483	Risk Ratio (M‐H, Fixed, 95% CI)	0.79 [0.42, 1.49]

41 One or more episodes of upper respiratory tract infection in first 12 months Show forest plot	1	510	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.96, 1.20]

42 Two or more episodes of upper respiratory tract infection in first 12 months Show forest plot	2	3993	Risk Ratio (M‐H, Fixed, 95% CI)	0.91 [0.82, 1.02]

43 Four or more episodes of upper respiratory tract infection in first 12 months Show forest plot	1	510	Risk Ratio (M‐H, Fixed, 95% CI)	0.82 [0.52, 1.29]

44 One or more episodes of lower respiratory tract infection in first 12 months Show forest plot	1	510	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.86, 1.33]

45 Two or more episodes of respiratory tract infection (upper or lower) in first 12 months Show forest plot	1	3483	Risk Ratio (M‐H, Fixed, 95% CI)	0.90 [0.79, 1.03]

46 Hospitalization for respiratory tract infection in first 12 months Show forest plot	2	3993	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.60, 0.94]

47 Number of episodes of otitis media in first 12 months Show forest plot	1	279	Mean Difference (IV, Fixed, 95% CI)	‐0.04 [‐0.49, 0.41]

48 One or more episodes of otitis media in first 12 months Show forest plot	2	3762	Risk Ratio (M‐H, Fixed, 95% CI)	1.28 [1.04, 1.57]

49 Frequent otitis media in first 12 months Show forest plot	1	279	Risk Ratio (M‐H, Fixed, 95% CI)	0.81 [0.43, 1.52]

50 Death in first 12 months Show forest plot	1	3483	Risk Ratio (M‐H, Fixed, 95% CI)	2.30 [0.21, 25.37]

51 Any dental caries (decayed, missing, or filled teeth) at 6 years Show forest plot	1	2948	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.94, 1.03]

52 Any incisor caries (decayed, missing, or filled teeth) at 6 years Show forest plot	1	2948	Odds Ratio (M‐H, Fixed, 95% CI)	0.91 [0.72, 1.16]

53 Height at 6.5 years Show forest plot	1	2951	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.40, 0.60]

54 Leg length at 6.5 years Show forest plot	1	2951	Mean Difference (IV, Fixed, 95% CI)	0.20 [‐0.14, 0.54]

55 Head circumference at 6.5 years Show forest plot	1	2951	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.04, 0.24]

56 BMI at 6.5 years Show forest plot	1	2951	Mean Difference (IV, Fixed, 95% CI)	0.20 [0.02, 0.38]

57 Triceps skinfold thickness at 6.5 years Show forest plot	1	2951	Mean Difference (IV, Fixed, 95% CI)	0.90 [0.51, 1.29]

58 Subscapular skinfold thickness Show forest plot	1	2951	Mean Difference (IV, Fixed, 95% CI)	0.5 [0.25, 0.75]

59 Waist circumference at 6.5 years Show forest plot	1	2951	Mean Difference (IV, Fixed, 95% CI)	0.0 [‐0.42, 0.42]

60 Hip circumference at 6.5 years Show forest plot	1	2951	Mean Difference (IV, Fixed, 95% CI)	0.5 [0.05, 0.95]

61 Systolic blood pressure at 6.5 years Show forest plot	1	2951	Mean Difference (IV, Fixed, 95% CI)	1.30 [0.39, 2.21]

62 Diastolic blood pressure at 6.5 years (mm Hg) Show forest plot	1	2951	Mean Difference (IV, Fixed, 95% CI)	1.0 [0.29, 1.71]

63 Atopic eczema at 5‐7 years Show forest plot	2	3584	Risk Ratio (M‐H, Fixed, 95% CI)	0.86 [0.47, 1.58]

64 Hay fever at 5‐7 years Show forest plot	2	3584	Risk Ratio (M‐H, Random, 95% CI)	0.80 [0.39, 1.65]

65 Asthma at 5‐7 years Show forest plot	3	4023	Risk Ratio (M‐H, Fixed, 95% CI)	1.02 [0.72, 1.44]

66 Food allergy at 5 years Show forest plot	1	113	Risk Ratio (M‐H, Fixed, 95% CI)	0.61 [0.12, 3.19]

67 Allergy to animal dander at 5 years Show forest plot	1	113	Risk Ratio (M‐H, Fixed, 95% CI)	0.81 [0.24, 2.72]

68 Positive skin‐prick test to house dust mite at 6.5 years Show forest plot	1	2320	Odds Ratio (M‐H, Fixed, 95% CI)	0.86 [0.62, 1.20]

69 Positive skin‐prick test to cat dander at 6.5 years Show forest plot	1	2320	Odds Ratio (M‐H, Fixed, 95% CI)	0.86 [0.60, 1.24]

70 Positive skin‐prick test to birch pollen at 6.5 years Show forest plot	1	2320	Odds Ratio (M‐H, Fixed, 95% CI)	0.80 [0.55, 1.18]

71 Positive skin‐prick test to mixed northern grasses at 6.5 years Show forest plot	1	2320	Odds Ratio (M‐H, Fixed, 95% CI)	0.71 [0.50, 1.01]

72 Positive skin‐prick test to Alternaria at 6.5 years Show forest plot	1	2320	Odds Ratio (M‐H, Fixed, 95% CI)	0.74 [0.47, 1.17]

73 Any positive skin‐prick test at 6‐7 years Show forest plot	2	2651	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.81, 1.11]

74 Wechsler cognitive ability test at 6.5 years: vocabulary Show forest plot	1	2944	Mean Difference (IV, Fixed, 95% CI)	0.5 [‐0.57, 1.57]

75 Wechsler cognitive ability test at 6.5 years: similarities Show forest plot	1	2944	Mean Difference (IV, Fixed, 95% CI)	0.30 [‐0.56, 1.16]

76 Wechsler cognitive ability test at 6.5 years: matrices Show forest plot	1	2944	Mean Difference (IV, Fixed, 95% CI)	‐0.20 [‐1.07, 0.67]

77 Wechsler cognitive ability test at 6.5 years: block designs Show forest plot	1	2944	Mean Difference (IV, Fixed, 95% CI)	1.30 [0.40, 2.20]

78 Wechsler cognitive ability test at 6.5 years: verbal IQ Show forest plot	1	2944	Mean Difference (IV, Fixed, 95% CI)	0.5 [‐0.95, 1.95]

79 Wechsler cognitive ability test at 6.5 years: performance IQ Show forest plot	1	2944	Mean Difference (IV, Fixed, 95% CI)	0.80 [‐0.55, 2.15]

80 Wechsler cognitive ability test at 6.5 years: full‐scale IQ Show forest plot	1	2944	Mean Difference (IV, Fixed, 95% CI)	0.80 [‐0.58, 2.18]

81 Teacher's academic rating at 6.5 years: reading Show forest plot	1	2196	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐0.19, ‐0.01]

82 Teacher's academic rating at 6.5 years: writing Show forest plot	1	2196	Mean Difference (IV, Fixed, 95% CI)	‐0.12 [‐0.20, ‐0.04]

83 Teacher's academic rating at 6.5 years: mathematics Show forest plot	1	2196	Mean Difference (IV, Fixed, 95% CI)	‐0.04 [‐0.12, 0.04]

84 Teacher's academic rating at 6.5 years: other subjects Show forest plot	1	2196	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐0.17, ‐0.03]

85 Parent's behavior rating at 6.5 years: total difficulties Show forest plot	1	2941	Mean Difference (IV, Fixed, 95% CI)	0.30 [‐0.16, 0.76]

86 Parent's behavior rating at 6.5 years: emotional symptoms Show forest plot	1	2941	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.09, 0.29]

87 Parent's behavior rating at 6.5 years: conduct problems Show forest plot	1	2941	Mean Difference (IV, Fixed, 95% CI)	0.0 [‐0.13, 0.13]

88 Parent's behavior rating at 6.5 years: hyperactivity/inattention Show forest plot	1	2941	Mean Difference (IV, Fixed, 95% CI)	0.20 [‐0.01, 0.41]

89 Parent's behavior rating at 6.5 years: peer problems Show forest plot	1	2941	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.05, 0.25]

90 Parent's behavior rating at 6.5 years: prosocial behavior Show forest plot	1	2941	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.05, 0.25]

91 Teacher's behavior rating at 6.5 years: total difficulties Show forest plot	1	2525	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.46, 0.66]

92 Teacher's behavior rating at 6.5 years: emotional symptoms Show forest plot	1	2525	Mean Difference (IV, Fixed, 95% CI)	0.0 [‐0.18, 0.18]

93 Teacher's behavior rating at 6.5 years: conduct problems Show forest plot	1	2525	Mean Difference (IV, Fixed, 95% CI)	0.0 [‐0.17, 0.17]

94 Teacher's behavior rating at 6.5 years: hyperactivity/inattention Show forest plot	1	2525	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐0.37, 0.17]

95 Teacher's behavior rating at 6.5 years: peer problems Show forest plot	1	2525	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.08, 0.28]

96 Teacher's behavior rating at 6.5 years: prosocial behavior Show forest plot	1	2525	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐0.33, 0.13]

Comparison 4. Exclusive breastfeeding for 6‐7 months versus 3‐4 months, developed countries, observational studies

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Comparison 5. Exclusive breastfeeding for > 6 months versus 6 months, developed countries, observational studies

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Very low density lipoprotein concentration (mmol/L) at 9 months Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	0.05 [‐0.10, 0.20]

2 Low density lipoproteinconcentration (mmol/L) at 9 months Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐0.88, 0.68]

3 High‐density lipoprotein‐2 concentration (mmol/L) at 9 months Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	0.08 [‐0.05, 0.21]

4 High‐density lipoprotein‐3 concentration (mmol/L) at 9 months Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	0.0 [‐0.07, 0.07]

5 Apoprotein B concentration (mg/dL) at 9 months Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	5.0 [‐14.93, 24.93]

6 Total triglyceride concentration (mmol/L) at 9 months Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	0.3 [‐0.23, 0.83]

Comparison 5. Exclusive breastfeeding for > 6 months versus 6 months, developed countries, observational studies

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