The association between exclusive breastfeeding and diarrhoea morbidity in infants aged 0–6 months: a rapid review and meta-analysis

Diarrhoea remains a major cause of mortality among children under five, despite global efforts to reduce childhood morbidity and mortality. Exclusive breastfeeding (EBF) has been recognised as an effective and cost-effective intervention to reduce diarrhoeal disease burden in infants. This rapid review and meta-analysis aimed to assess the association of EBF on diarrhoea morbidity in early childhood, a critical period for growth and development, while addressing existing gaps by employing standardised definitions of EBF. A systematic search was conducted in Medline, Scopus, Embase, and Web of Science databases for studies published between 2010 and 2024. Seventeen studies met inclusion criteria and underwent quality assessment using the Joanna Briggs Institute (JBI) critical appraisal tool. Data from the identified studies were extracted, and a meta-analysis was conducted using random effects models to calculate the pooled effect size, with odds ratios (OR) and 95% confidence intervals (CI). This review found that EBF significantly reduces the risk of diarrhoeal diseases in infants under 6 months of age across diverse geographical regions and study designs. The meta-analysis of the association between exclusive breastfeeding and diarrhoea in infants aged 0–6 months resulted in a pooled OR of 0.57 (95% CI: 0.51, 0.63; I² = 57.66%). These findings underscore the critical role of promoting and supporting EBF as a pivotal public health strategy to enhance early childhood health outcomes and contribute to achieving global child health goals.