Abstract
BackgroundWe aimed to determine the associations between breastfeeding and children’s neurodevelopment indexed by intelligence quotient (IQ) and emotional and behavioural problems through mid-childhood adjusting for prenatal and postnatal depression and multiple confounders; and to test the novel hypothesis that breastfeeding may moderate the effects of prenatal depression and anxiety on children’s neurodevelopment.MethodsThe study is based on women and their children from the longitudinal Avon Longitudinal Study of Parents and Children (n=11,096). Children’s IQ was derived from standardized in-person testing; behaviour problems were assessed according to parent-report; information on breastfeeding, prenatal depression and anxiety and multiple confounders were derived from self-report questionnaires. We conducted hierarchical multiple regression adjusting for several covariates.Results43% women were exclusively breastfeeding at 1 month and an additional 16.8% were engaged in mixed or partial breastfeeding. Both exclusive breastfeeding (B = 2.19; SD = 0.36, p =.00) and mixed feeding (B = 1.59; SD= 0.52; p=.00) were positively associated with IQ at 8 years of age, after adjusting for covariates. Exclusive breastfeeding was negatively associated with hyperactivity/attention deficit at 4 years (B = −.30, SD = .05; p < .01); mixed feeding was related to hyperactivity/attention deficit at age 9 (B = .20; SD = .08; p = .03) after adjustments. There was no association between breastfeeding and emotional or conduct problems. Breastfeeding did not moderate the association between prenatal depression and anxiety and children’s neurodevelopment.ConclusionsThe selective association between breastfeeding and neurodevelopmental measures suggests a nutritional rather than broader beneficial psychological effect on child neurodevelopment. Breastfeeding did not moderate the associations between prenatal depression and anxiety and child neurodevelopment, suggesting separate mechanisms of action.
Highlights
We aimed to determine the associations between breastfeeding and children’s neurodevelopment indexed by intelligence quotient (IQ) and emotional and behavioural problems through mid-childhood adjusting for prenatal and postnatal depression and multiple confounders; and to test the novel hypothesis that breastfeeding may moderate the effects of prenatal depression and anxiety on children’s neurodevelopment
In a large cohort controlled for multiple confounders, breastfeeding was positively associated with IQ in mid-childhood
Exclusive breastfeeding was negatively associated with hyperactivity/attention deficit in children at age 4
Summary
We aimed to determine the associations between breastfeeding and children’s neurodevelopment indexed by intelligence quotient (IQ) and emotional and behavioural problems through mid-childhood adjusting for prenatal and postnatal depression and multiple confounders; and to test the novel hypothesis that breastfeeding may moderate the effects of prenatal depression and anxiety on children’s neurodevelopment. The strength of the causal association continues to be challenged because of, e.g., wide variability in research studies and adjustment for confounders [4,5,6]. Whereas infant formulas may be fortified with vitamins, minerals, supplemental protein concentrates, nucleic factors, and omega 3 fatty acids [12], this form of feeding involves less emotional and physical contact. Compared to findings for neurodevelopment, the evidence concerning breastfeeding benefits for emotional development and behaviour is less clear [13,14,15]
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