Breastfeeding and cognitive development

Mother and childThere have always been debates on the importance of breastfeeding in terms of baby’s health as well as the significance of mother-baby connection. Numerous studies have been conducted and results boil down to the same.

Basics:

Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts (i.e., via lactation) rather than from a baby bottle or other container. Babies have a sucking reflex that enables them to suck and swallow milk. It is recommended that mothers breastfeed for six months or more, without the addition of infant formula or solid food. After the addition of solid food, mothers are advised to continue breastfeeding for at least a year, and can continue for two years or more.[1]
Breastfeeding during infancy appears to result in enhanced cognitive development during childhood, but it is not known whether breastfeeding should be encouraged for infants born small for gestational age (SGA) whose growth might otherwise benefit from nutritional supplementation. To address this issue, duration of exclusive breastfeeding and cognitive development were evaluated prospectively for 220 term children born SGA and 299 term children born appropriate for gestational age (AGA). Cognitive development was assessed using the Bayley Scale of Infant Development at 13 mo and Wechsler Preschool and Primary Scales of Intelligence at 5 y of age. Infants born SGA were given supplemental foods significantly earlier than those born AGA. Growth of infants born SGA was not related to early nutritional supplementation. The salutary effect of exclusive breastfeeding on cognitive development was greater for children born SGA than for those born AGA. Based on a linear association between duration of exclusive breastfeeding and intelligence quotient (IQ), children born SGA and exclusively breastfed for 24 wk were predicted to have an 11-point IQ advantage over those breastfed for 12 wk, as opposed to a 3-point advantage for children born AGA with similar durations of breastfeeding. The IQ distribution of children born SGA and exclusively breastfed for more than 12 wk was not different from that of all children born AGA.
Duration of exclusive breastfeeding has a significant impact on cognitive development without compromising growth among children born SGA. These data suggest that mothers should breastfeed exclusively for 24 wk to enhance cognitive development.[2]
Although the results of many clinical studies suggest that breast-fed children score higher on tests of cognitive function than do formula-fed children, some investigators have suggested that these differences are related to confounding covariables such as socioeconomic status or maternal education. After conducting meta-analysis indicated that, after adjustment for appropriate key cofactors, breast-feeding was associated with significantly higher scores for cognitive development than was formula feeding.[3]
The experimental intervention led to a large increase in exclusive breastfeeding at age 3 months (43.3% for the experimental group vs 6.4% for the control group; P < .001) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. The experimental group had higher means on all of the Wechsler Abbreviated Scales of Intelligence measures, with cluster-adjusted mean differences (95% confidence intervals) of +7.5 (+0.8 to +14.3) for verbal IQ, +2.9 (–3.3 to +9.1) for performance IQ, and +5.9 (–1.0 to +12.8) for full-scale IQ. Teachers’ academic ratings were significantly higher in the experimental group for both reading and writing.
These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children’s cognitive development. [4]
Eight-hundred fifty-five newborns were enrolled in a prospective study between 1978 and 1982 and then followed through school age. To determine whether the mode of infant feeding affected developmental scores or school grades, prospective data were collected on how the children were fed; 788 of the children had Bayley tests at 6 months, 720 at 12 months, 676 at 18 months and 670 at 2 years. McCarthy testing was done on 645 children at 3 years, 628 at 4 years and 636 at 5 years. Testers were not specifically blind to feeding method. The families provided report cards from grade 3 or higher for 366 children. There were statistically significant but small increases in scores among breast-fed children on at least some subscales of the Bayley and McCarthy at all time points from 2 years through 5 years and slightly higher English grades on report cards in both crude analyses and in multivariate analyses that allowed adjustment for the most plausible confounding variables. We conclude that, in a volunteer, 95% white sample of middle class children, those breast-fed scored slightly better than those bottle fed; the effect is small but still detectable at school age.[5]
A strong positive relationship was demonstrated between breastfeeding and the PPVT-R scores with increasing scores with increased duration of breastfeeding. After adjusting for a wide range of biological and social factors, the adjusted mean for those breastfed for 6 months or more was 8.2 points higher for females and 5.8 points for males when compared to those never breastfed.[6]
The effects of breastfeeding on cognitive, visuomotor and language development were examined in healthy children born at full term, after they had reached 56 months of age. Three hundred and sixty-three children were breastfed for less than 5 months, and 363 for 5 months or more. The groups were matched pairwise having regard to maternal education and sex of the child. Significant differences were found in relation to scores reflecting general cognitive capacity, and the results of the visuomotor integration test between children breastfed for less than 5 months and those breastfed for 5 months or more, and between children of mothers who had smoked during pregnancy and non-smoking mothers. In multiple linear regression analysis prolonged breastfeeding was significantly related to scores reflecting general cognitive capacity and results of the visuomotor integration test. However, smoking by mothers during pregnancy was not significantly related to scores in cognitive tests. Biological factors, and factors such as lifestyle and social background, may be more important determinants of a child’s development than breastfeeding. [7]
Conclusion: After conducting numerous researches all the studies have proven the importance and the benefits of breastfeeding. However it must be kept in mind that breastfeeding is not the only factor influencing a child’s cognitive abilities. Social surroundings, parental support and a child’s environment in general play a very important role in the development of a child’s cognitive abilities.

Resources:

[1] http://en.wikipedia.org/wiki/Breastfeeding
[2] Effect of breastfeeding on cognitive development of infants born small for gestational age by: MR Rao, MR Hediger, RJ Levine, AB Naficy, T Vik
[3] Breast-feeding and cognitive development: a meta-analysis by: James W Anderson, Bryan M Johnstone and Daniel T Remley
[4] Breastfeeding and Child Cognitive Development, Arch Gen Psychiatry. 2008;65(5):578-584 by a group of authors
[5] Breast-feeding and cognitive development, by: Walter J. Rogan, Beth C. Gladen
[6] The effect of breastfeeding on child development at 5 years: A cohort study, by: PJ Quinn, M O’Callaghan, GM Williams, JM Najman, MJ Andersen, W Bor
[7] “Is breastfeeding beneficial and maternal smoking harmful to the cognitive development of children?” by: A. Niemelä and A-L Järvenpää

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