Association between Breastfeeding Duration and Cognitive Development

Association between Breastfeeding Duration and Cognitive Development

A dose-response relationship links longer duration of breastfeeding with better cognitive and motor development in children

Nutrition Remarks Health News Highlights (June 21, 2013)

Written by Deeksha Sharma, Ph.D., Health News Writer for Nutrition Remarks, Solon, OH, USA

Reviewed by Jonathan Y. Bernard, Inserm, Center for research in Epidemiology and Population Health (CESP), U1018, Epidemiology of Diabetes, Obesity and Renal Diseases: Lifelong Approach Team, F-94807, Villejuif, France; Univ Paris-Sud, UMRS 1018, F94807, Villejuif, France.

In a mother-child cohort study, ever-breastfed children scored higher than never-breastfed children on language ability and overall development assessments, after adjustments for many potential confounders. Findings suggest a significant association between longer breastfeeding duration and better cognitive and motor development in 2- and 3-year-old children.

Breastfeeding is found associated with better language and cognitive abilities but these results could be due to the differences between confounding factors like the socio-demographic and occupational characteristics of mothers who breastfed and those who did not. Therefore, new data on the relationship between breastfeeding duration and the child’s cognitive development are required to make national public health policies, especially for countries where breastfeeding rates are low. This study examines the dose–response relationship between breast milk consumption and cognitive development, with an accurate, prospective data collection of breastfeeding from a large cohort.

French EDEN Mother-Child Cohort Study is an ongoing birth-cohort study that aims to investigate the role of pre- and post-natal determinants of child growth, development, and health. From the maternal declarations about child feeding modes in questionnaires at birth, 4, 8, 12 and 24 months, exclusive and any (exclusive and mixed) breastfeeding durations were estimated. The parent-reported questionnaires Communicative Development Inventory (CDI) and Ages and Stages Questionnaire (ASQ) were used respectively to evaluate language ability in 2-year-old and overall development in 3-year-old children.

In multivariable linear models, after adjustment for potential confounders, ever-breastfed scored 3.7 ± 1.8 (mean ± SE, P = .038) higher on the CDI and 6.2 ± 1.9 (P = .001) points higher on the ASQ than never-breastfed children. Among breastfed children, adjusted linear associations between breastfeeding durations and cognitive assessments were significant and positive. For any breastfeeding duration, an additional month was related with an increase of 0.58 ± 0.20 (P = .004) CDI points and 0.60 ± 0.20 (P = .003) ASQ points. An additional month of exclusive-breastfeeding was associated with an increase of 0.75 ± 0.33 (P = .02) CDI points, and 1.00 ± 0.33 (P = .002) ASQ points. Tests of hypotheses of non-linearity of the associations between breastfeeding durations and cognitive assessments were rejected. No interaction was found between breastfeeding durations and sex, gestational age, parental education, or household income.

Exclusive breastfeeding duration was more strongly associated with both cognitive development assessments than any breastfeeding duration, which is a further argument in favor of a dose–response relationship. The main biological hypothesis to explain this association between breastfeeding and child cognitive development is based on the content of breast milk, especially long-chain poly-unsaturated fatty acids (LCPUFA) that may be essential for brain maturation in the newborn.

Study results agree with previous studies showing a relationship between breastfeeding and cognitive and motor development in early childhood. In addition, by suggesting a dose–response relationship, it brings new evidence to the possible benefits of breastfeeding. This builds a stronger argument to public health professionals for promoting longer duration and continuation of breastfeeding as well, while promoting early initiation of it.

This news highlight is based on the following article published by Jonathan Y. Bernard et al. Additional general background information was acquired from PubMed.

Bernard JY et al. Breastfeeding Duration and Cognitive Development at 2 and 3 Years of Age in the EDEN Mother-Child Cohort. J Pediatr. 2013 Jan 10. pii: S0022-3476(12)01425-4.