Abstract
ObjectiveTo investigate the effects of infant feeding mode on childhood cognition and language as the differential effects of infant feeding on development remain understudied.MethodsBreastfed [BF, 174], cow's milk‐based formula‐fed [MF, 169], or soy protein‐based formula‐fed [SF, 161] children were longitudinally tested from age 3 to 60 months for neurodevelopment. Data were analyzed using mixed models while adjusting for multiple covariates. Sex differences were also assessed.ResultsStandard scores were within established norms for all groups. There were no differences in mental development to age 24 months, yet BF children had significantly higher motor development scores at age 3 months than SF children (99.1 versus. 97.2). BF children had significantly higher composite intelligence scores at 48 months than MF and SF children (113.4 versus. 109.6 and 108.4, respectively) and higher verbal intelligence scores than SF children at 48 (105.6 versus. 100.7) and 60 months (109.8 versus. 105.9). Greater total language scores at ages 36 and 48 months were found in BF children compared with children fed MF or SF (p < .001), with differences between sexes for auditory comprehension. Higher total language scores at age 60 months were found between BF and SF (105.0 versus. 100.1).ConclusionBreastfeeding was associated with small, statistically significant, differences between children ages 3 and 5 years in verbal intelligence, expressive communication, and auditory comprehension with the latter having potential sexual dimorphic effects. Yet, these differences remain small and may not be of clinical relevance. Overall, MF and SF did not significantly differ.
Highlights
The American Academy of Pediatrics (AAP) recommends the use of human milk as an ideal source of nutrition for the first year of life and endorses exclusive breastfeeding (BF) until six months of age (American Academy of Pediatrics, 2012; World Health Organization [WHO], 2013)
A more recent meta-analysis showed a smaller difference in cognitive scores between BF and FF children age 1–15 years when controlling for maternal intelligence quotient (IQ) (Horta, Loret de Mola, & Victora, 2015)
All infant diets investigated in this study provided adequate nutrients to sustain development in children between ages 3–60 months. In this cohort, breastfeeding (BF) infants were more likely to be part of families whose mothers had significantly higher full-scale intelligence quotients (IQs), whose parents were married or cohabitating, TA B L E 6 Least squares means of preschool language scale-3 auditory comprehension scores stratified by sex1
Summary
The American Academy of Pediatrics (AAP) recommends the use of human milk as an ideal source of nutrition for the first year of life and endorses exclusive breastfeeding (BF) until six months of age (American Academy of Pediatrics, 2012; World Health Organization [WHO], 2013). A more recent meta-analysis showed a smaller difference in cognitive scores between BF and FF children age 1–15 years when controlling for maternal intelligence quotient (IQ) (Horta, Loret de Mola, & Victora, 2015). Smith, (2015) highlighted that when maternal IQ or vocabulary skills were considered, modest, but significant, differences in language development remained in studies with larger sample sizes, for infants who were fed breast milk (BM) for longer durations, or for infants who were exclusively fed BM (Smith, 2015). More research is needed to fully elucidate the impact of early-life diet on language skills and cognition, including SF in the investigation of developmental outcomes. This report examined differences in the first 5 years of life of children who were fed BM, MF, or SF as infants with respect to sex, race, gestational age, maternal and paternal education, maternal. No significant differences on the assessments administered were expected at any age between the MF and SF infants
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