How Good Is the Evidence Linking Breastfeeding and Intelligence?

Jain, Anjali; Concato, John; Leventhal, John M.

doi:10.1542/peds.109.6.1044

Cited by 188 publications

(126 citation statements)

References 47 publications

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“…Residual confounding is particularly important because adjustment for factors other than income and education, such as child care patterns and cultural practices, remains a challenge. This possibility has been widely discussed in the context of studies reporting an association between breastfeeding and intelligence, 32 but less attention seems to be given to this possibility in the literature on childhood overweight. Studies from low-and middle-income countries may help understand the role of residual confounding, because in many such settings breastfeeding does not show a clear trend among social groups (or if anything breastfeeding is shorter among the rich), and in addition overweight seems to be more common among the rich than the poor.…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding and overweight in childhood: evidence from the Pelotas 1993 birth cohort study

et al. 2005

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Objectives: The effect of breastfeeding duration on the prevalence of overweight and on mean weight for height z-score (WHZ) was evaluated in Brazilian children. Design: Prospective population-based birth cohort study. Subjects: In total, 1273 children aged 4 years, corresponding to a follow-up rate of 87.2%. Measurements: Three explanatory variables were studied: duration of any breastfeeding, duration of exclusive or predominant breastfeeding, and ever breastfeeding. Weight and height were measured using a digital electronic scale and a portable stadiometer. Overweight was defined as WHZ 42 using the National Center for Health Statistics reference curve. Results: Overweight prevalence at the age of 4 years was 10.2% (95% CI 8.4; 11.8). The lowest prevalence (6.5%) was observed among children breastfed for 411 months. Among those breastfed for less than 3 months, the prevalence of overweight was approximately 9.5%. Mean WHZ ranged from 0.38 among children breastfed for less than 1 month to 0.62 among those breastfed for 9-11.9 months. No linear trends were detected in the association between breastfeeding and anthropometric indicators. None of the three breastfeeding variables was significantly associated with the prevalence of overweight or mean WHZ in multivariable analyses. No interactions were detected between breastfeeding and the variables sex, birth weight, socioeconomic status, skin color and pregestational in body mass index. Conclusion: Our results do not support the hypothesis that breastfeeding promotion would reduce overweight or obesity in this population. Existing evidence on many other benefits of breastfeeding for the mother and the child supports its continued promotion, protection and support.

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Section: Discussionmentioning

confidence: 99%

Breastfeeding and overweight in childhood: evidence from the Pelotas 1993 birth cohort study

et al. 2005

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“…A meta-analysis of 20 studies undertaken in the late 1990's found that breastfeeding in normal birth weight infants increased IQ by 2.7 points and in low birth weight children by 5.2 points, but only six of the studies controlled for maternal IQ (Anderson et al, 1999). Three critical reviews conducted in the early 1990's concluded that the evidence linking breastfeeding and cognitive development has not yet been comprehensively demonstrated (Drane and Logemann, 2000;Jain et al, 2002;Rey, 2003). However, a more recent review by Michaelsen et al (2009) concluded that the majority of studies found an association between breastfeeding and cognitive development, even after adjusting for confounders, and the difference in IQ related to breastfeeding is around 2-5 points at any age.…”

Section: Breastfeedingmentioning

confidence: 99%

The Role of Nutrition in Children's Neurocognitive Development, From Pregnancy Through Childhood

Nyaradi¹,

Li²,

Hickling³

et al. 2015

Prenatal and Childhood Nutrition

129

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This review examines the current evidence for a possible connection between nutritional intake (including micronutrients and whole diet) and neurocognitive development in childhood. Earlier studies which have investigated the association between nutrition and cognitive development have focused on individual micronutrients, including omega-3 fatty acids, vitamin B12, folic acid, choline, iron, iodine, and zinc, and single aspects of diet. The research evidence from observational studies suggests that micronutrients may play an important role in the cognitive development of children. However, the results of intervention trials utilizing single micronutrients are inconclusive. More generally, there is evidence that malnutrition can impair cognitive development, whilst breastfeeding appears to be beneficial for cognition. Eating breakfast is also beneficial for cognition. In contrast, there is currently inconclusive evidence regarding the association between obesity and cognition. Since individuals consume combinations of foods, more recently researchers have become interested in the cognitive impact of diet as a composite measure. Only a few studies to date have investigated the associations between dietary patterns and cognitive development. In future research, more well designed intervention trials are needed, with special consideration given to the interactive effects of nutrients.

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“…It is notable that evidence is inconsistent regarding benefits of human milk intake during the neonatal hospitalization on neurodevelopment in preterm infants, whereas both observational (6,7,10,22) and interventional (11) studies in healthy, full-term populations have been more consistent in showing a benefit. While human milk evolved to provide optimal nutrition for full-term infants, preterm infants have different nutritional needs (12), which is why fortification of human milk is routine practice in most neonatal units.…”

Section: Discussionmentioning

confidence: 99%

Human milk intake in preterm infants and neurodevelopment at 18 months corrected age

et al. 2016

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Background:The effect of human milk intake on neurodevelopment in preterm infants is uncertain. Methods: We analyzed data from 611 participants in the DHA for Improvement of Neurodevelopmental Outcomes study, enrolled at ≤33 wk gestation from five Australian perinatal centers. The main exposures were (i) average daily human milk intake during the neonatal hospitalization and (ii) total duration of human milk intake before and after discharge. Outcomes were Bayley Scales of Infant Development, 2nd Edition Mental (MDI), and Psychomotor (PDI) Development Indexes. results: Adjusting for confounders in linear regression, human milk intake was not associated with higher MDI (0.2 points per 25 ml/kg/d; 95% confidence interval (CI): −0.6, 1.0) or PDI (−0.3 points; 95% CI: −1.1, 0.4). Longer duration of human milk intake was also not associated with MDI (0.1 points per month; 95% CI: −0.2, 0.3) or PDI (−0.2 points per month; 95% CI: −0.5, 0.01) scores, except in infants born 29-33 wk gestation (n = 364, MDI 0.3 points higher per additional month, 95% CI: 0.1, 0.6). conclusions: We found no associations of human milk intake during the neonatal hospitalization with neurodevelopment at 18 mo corrected age.

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How Good Is the Evidence Linking Breastfeeding and Intelligence?

Abstract: Although the majority of studies concluded that breastfeeding promotes intelligence, the evidence from higher quality studies is less persuasive.

Cited by 188 publications

References 47 publications

Breastfeeding and overweight in childhood: evidence from the Pelotas 1993 birth cohort study

Breastfeeding and overweight in childhood: evidence from the Pelotas 1993 birth cohort study

The Role of Nutrition in Children's Neurocognitive Development, From Pregnancy Through Childhood

Human milk intake in preterm infants and neurodevelopment at 18 months corrected age

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