Infant feeding practices and childhood acute leukemia: Findings from the Childhood Cancer & Leukemia International Consortium

Jeremy M. Schraw, Helen D. Bailey, Audrey Bonaventure, Ana M. Mora, Eve Roman, Beth A. Mueller, Jacqueline Clavel, Eleni T. Petridou, Maria Karalexi, Evangelia Ntzani, Sameera Ezzat, Wafaa M. Rashed, Erin L. Marcotte, Logan G. Spector, Catherine Metayer, Alice Y. Kang, Corrado Magnani, Lucia Miligi, John D. Dockerty, Juan Manuel Mejίa-AranguréJuan Carlos Nuñez-Enriquez, Claire Infante-Rivard, Elizabeth Milne, Michael E. Scheurer

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Increasing evidence suggests that breastfeeding may protect from childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). However, most studies have limited their analyses to any breastfeeding, and only a few data have examined exclusive breastfeeding, or other exposures such as formula milk. We performed pooled analyses and individual participant data metaanalyses of data from 16 studies (N = 17 189 controls; N = 10 782 ALL and N = 1690 AML cases) from the Childhood Leukemia International Consortium (CLIC) to characterize the associations of breastfeeding duration with ALL and AML, as well as exclusive breastfeeding duration and age at introduction to formula with ALL. In unconditional multivariable logistic regression analyses of pooled data, we observed decreased odds of ALL among children breastfed 4 to 6 months (0.88, 95% CI 0.81-0.96) or 7 to 12 months (OR 0.85, 0.79-0.92). We observed a similar inverse association between breastfeeding ≥4 months and AML (0.82, 95% CI 0.71-0.95). Odds of ALL were reduced among children exclusively breastfed 4 to 6 months (OR 0.73, 95% CI 0.63-0.85) or 7 to 12 months (OR 0.70, 95% CI 0.53-0.92). Random effects metaanalyses produced similar estimates, and findings were unchanged in sensitivity analyses adjusted for race/ethnicity or mode of delivery, restricted to children diagnosed ≥1 year of age or diagnosed with B-ALL. Our pooled analyses indicate that longer breastfeeding is associated with decreased odds of ALL and AML. Few risk factors for ALL and AML have been described, therefore our findings highlight the need to promote breastfeeding for leukemia prevention.

Original languageEnglish (US)
Pages (from-to)1013-1023
Number of pages11
JournalInternational Journal of Cancer
Issue number7
StatePublished - Oct 1 2022

Bibliographical note

Funding Information:
A.B. de Lautour Charitable Trust; Agence Française de Sécurité Sanitaire de l'Environnement et du Travail; Agence Française de Sécurité Sanitaire des Produits de Santé; Agence Nationale de la Recherche; Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail; Alex's Lemonade Stand Foundation for Childhood Cancer; Association pour la Recherche sur le Cancer, Grant/Award Number: PDF20190508759; Associazione Italiana per la Ricerca sul Cancro; Associazione Neuroblastoma; Canadian Bureau of Chronic Disease Epidemiology; Cancer Society of New Zealand; Cancéropôle Île‐de‐France; Cent pour Sang la Vie; Childhood Cancer Research Fund; CHILDREN with CANCER UK; Comitato per la vita ‘Daniele Chianelli’‐Associazione per la Ricerca e la Cura delle Leucemie, Linfomi e Tumori di Adulti e Bambini; Enfants et Santé; Fondation de France; Fondation Jeanne Liot; Fondation pour la Recherche Médicale; Fondation Weisbrem‐Berenson; Fonds de la Recherche en Santé du Québec; French Ministère de l'Environnement; Fundação de Amparo à Pesquisa do Estado de São Paulo; Health and Welfare Canada; Health Research Council of New Zealand; Institut Electricité Santé; Institut National Du Cancer; Italian Ministry of Health; Italian Ministry of Labour and Welfare; Leukaemia and Lymphoma Research; Leukemia Research Fund of Canada; Ligue Contre le Cancer; Ligue Contre le Cancer du Val de Marne; Lotto New Zealand; Medical Research Council Canada, Grant/Award Number: MOP 37951; Ministero dell'Istruzione, dell'Università e della Ricerca; National and Kapodistrian University of Athens; National Cancer Institute, Grant/Award Numbers: R03CA132172, R01CA049450, R01CA048051; National Cancer Institute of Canada; National Health and Medical Research Council; National Health and Research Development Program; National Institute of Environmental Health Sciences, Grant/Award Numbers: P01ES018172, R01ES009137, R13ES021145, R13ES022868; Northwestern Mutual Foundation; Otago Medical Research Foundation; Otago Medical School; Ricerca Sanitaria Finalizzata Regione Piemonte Program; Texas Children's Hospital; U.S. Environmental Protection Agency, Grant/Award Number: RD83451101 Funding information

Publisher Copyright:
© 2022 UICC.


  • acute lymphoblastic leukemia
  • acute myeloid leukemia
  • breastfeeding
  • childhood cancer


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