The Effect of Breastfeeding and Stimulation in the Home on Cognitive Development in One-year-old Infants

Sloan, Seaneen; Stewart, Moira; Dunne, Laura

doi:10.1080/13575270903529136

Cited by 9 publications

(7 citation statements)

References 36 publications

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“…Overall, based on the primary endpoint of cognitive function, there were 21 studies showing no association between IQ and breastfeeding,24 25 30–32 35 36 39 54 56 62 63 73 74 86 87 89 91 97 100 101 28 positive studies,9 15 21 27–29 37 38 42 48 51 57 59 61 64 68 71 72 75 79–82 85 90 94 95 98 18 initially positive studies that became negative after accounting for confounders,13 23 26 33 43–46 49 50 52 55 65 66 69 78 84 96 and 17 studies where the initial positive effect was diminished but remained statistically significant after accounting for confounders (table 2). 22 34 40 41 47 53 58 60 67 70 76 77 83 88 92 93 99…”

Section: Resultsmentioning

confidence: 99%

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Breast milk and cognitive development—the role of confounders: a systematic review

et al. 2013

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ObjectivesThe association between breastfeeding and child cognitive development is conflicted by studies reporting positive and null effects. This relationship may be confounded by factors associated with breastfeeding, specifically maternal socioeconomic class and IQ.DesignSystematic review of the literature.Setting and participantsAny prospective or retrospective study, in any language, evaluating the association between breastfeeding and cognitive development using a validated method in healthy term infants, children or adults, was included.Primary and secondary outcome measuresExtracted data included the study design, target population and sample size, breastfeeding exposure, cognitive development assessment tool used and participants’ age, summary of the results prior to, and following, adjustment for confounders, and all confounders adjusted for. Study quality was assessed as well.Results84 studies met our inclusion criteria (34 rated as high quality, 26 moderate and 24 low quality). Critical assessment of accepted studies revealed the following associations: 21 null, 28 positive, 18 null after adjusting for confounders and 17 positive—diminished after adjusting for confounders. Directionality of effect did not correlate with study quality; however, studies showing a decreased effect after multivariate analysis were of superior quality compared with other study groupings (14/17 high quality, 82%). Further, studies that showed null or diminished effect after multivariate analysis corrected for significantly more confounders (7.7±3.4) as compared with those that found no change following adjustment (5.6±4.5, p=0.04). The majority of included studies were carried out during childhood (75%) and set in high-income countries (85.5%).ConclusionsMuch of the reported effect of breastfeeding on child neurodevelopment is due to confounding. It is unlikely that additional work will change the current synthesis. Future studies should attempt to rigorously control for all important confounders. Alternatively, study designs using sibling cohorts discordant for breastfeeding may yield more robust conclusions.

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Section: Resultsmentioning

confidence: 99%

“…22 24 35–37* 38 51 54 60 64* 69 70* 72* 73 74* 78* 86* 90* Childhood: Refs. 9 13 15 21 23 25–34 37* 40–43* 45–50 52 53 55–59 61–64* 65–68 70* 72* 74* 75–78* 79–82 84–86* 87–90* 91–101…”

Section: Resultsmentioning

confidence: 99%

Breast milk and cognitive development—the role of confounders: a systematic review

et al. 2013

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“…This suggests that confounding variables, including socioeconomic status and maternal cognitive ability, affect the choice to breastfeed and the positive effects found. Measuring the duration of EBF accurately is challenging because of factors related to definition, timing, and duration of recall [ 11 , 12 ], and many of the studies were limited by poor documentation of breastfeeding patterns [ 13 , 14 ]. Further limitations included small sample sizes [ 15 , 16 ] and predominantly Caucasian populations, with only one small study from Africa [ 16 ], which found no association with cognitive development but some advantages for child behaviour in breastfed infants.…”

Section: Introductionmentioning

confidence: 99%

Exclusive Breastfeeding and Cognition, Executive Function, and Behavioural Disorders in Primary School-Aged Children in Rural South Africa: A Cohort Analysis

et al. 2016

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BackgroundExclusive breastfeeding (EBF) is associated with early child health; its longer-term benefits for child development remain inconclusive. We examine the associations between EBF, HIV exposure, and other maternal/child factors and the cognitive and emotional-behavioural development of children aged 7–11 y.Methods and FindingsThe Vertical Transmission Study (VTS) supported EBF in HIV-positive and HIV-negative women; between 2012 and 2014, HIV-negative VTS children (332 HIV exposed, 574 HIV unexposed) were assessed in terms of cognition (Kaufman Assessment Battery for Children Second Edition [KABC-II]), executive function (Developmental Neuropsychological Assessment Second Edition [NEPSY-II]), and emotional-behavioural functioning (parent-reported Child Behaviour Checklist, [CBCL]). We developed population means by combining the VTS sample with 629 same-aged HIV-negative children from the local demographic platform. For each outcome, we split the VTS sample into scores above or at/below each population mean and modelled each outcome using logistic regression analyses, overall and stratified by child sex. There was no demonstrated effect of EBF on overall cognitive functioning. EBF was associated with fewer conduct disorders overall (adjusted odds ratio [aOR] 0.44 [95% CI 0.3–0.7], p ≤ 0.01), and there was weak evidence of better cognition in boys who had been exclusively breastfed for 2–5 mo versus ≤1 mo (Learning subscale aOR 2.07 [95% CI 1.0–4.3], p = 0.05). Other factors associated with better child cognition were higher maternal cognitive ability (aOR 1.43 [95% CI 1.1–1.9], p = 0.02, Sequential; aOR 1.74 [95% CI 1.3–2.4], p < 0.001, Planning subscales) and crèche attendance (aOR 1.96 [95% CI 1.1–3.5], p = 0.02, Sequential subscale). Factors positively associated with executive function were home stimulation (aOR 1.36 [95% CI 1.0–1.8], p = 0.04, Auditory Attention; aOR 1.35 [95% CI 1.0–1.8], p = 0.05, Response Set) and crèche (aOR 1.74 [95% CI 1.0–3.0], p = 0.05, Animal Sorting). Maternal mental health problems and parenting stress were associated with increased emotional-behavioural problems on the total CBCL (aOR 2.44 [95% CI 1.3–4.6], p = 0.01; aOR 7.04 [95% CI 4.2–11.9], p < 0.001, respectively). Maternal HIV status was not associated with any outcomes in the overall cohort. Limitations include the nonrandomised study design and lack of maternal mental health assessment at the child’s birth.ConclusionsEBF was associated with fewer than average conduct disorders and weakly associated with improved cognitive development in boys. Efforts to improve stimulation at home, reduce maternal stress, and enable crèche attendance are likely to improve executive function and emotional-behavioural development of children.

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“…Well-documented associations have been reported between breastfeeding and a host of improved outcomes for children, including cognitive function, motor skills, immunology, and mortality (e.g. Cunningham 1995;Duijts et al 2010;Sloan et al 2010;Oddy et al 2011). Moreover, breastmilk provides benefits even to children in developed countries in obesity, blood pressure, cholesterol, and cancer domains (Hoddinott et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal associations between breastfeeding and observed mother–child interaction qualities in early childhood

Papp

2013

Child

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Background Despite extensive literature on the role of breastfeeding in maternal and child health and cognitive development, few studies have systematically tested whether breastfeeding predicts children's socio-emotional outcomes. The present study examined associations between trajectories of breastfeeding and observed parent-child interaction qualities of maternal sensitivity, child positivity, and child negativity from 6 months to 3 years of age. Methods Data were drawn from the NICHD Study of Early Child Care and Youth Development (N = 1,306 U.S. families). Hierarchical linear modeling accounted for demographic and early characteristics, including home environment, maternal depression, and observed global relationship quality. Results Breastfeeding was associated with increases in observed maternal sensitivity over time, even after the effects of demographic and early characteristics were controlled. Accounting for the covariates, breastfeeding was not associated with child behavior (i.e., positivity, negativity) in mother-child interaction across early childhood. Conclusions Improved relationship quality, specifically through changes in maternal behavior, may be another advantage experienced by breastfeeding mothers and children.

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The Effect of Breastfeeding and Stimulation in the Home on Cognitive Development in One-year-old Infants

Cited by 9 publications

References 36 publications

Breast milk and cognitive development—the role of confounders: a systematic review

Breast milk and cognitive development—the role of confounders: a systematic review

Exclusive Breastfeeding and Cognition, Executive Function, and Behavioural Disorders in Primary School-Aged Children in Rural South Africa: A Cohort Analysis

Longitudinal associations between breastfeeding and observed mother–child interaction qualities in early childhood

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