J Korean Med Sci.  2016 Apr;31(4):579-584. 10.3346/jkms.2016.31.4.579.

Effect of Breastfeeding Duration on Cognitive Development in Infants: 3-Year Follow-up Study

• Lee H
• Park H
• Ha E
• Hong YC
• Ha M
• Park H
• Kim BN
• Lee B
• Lee SJ
• Lee KY
• Kim JH
• Jeong KS
• Kim Y

• KMID: 2363697
• DOI: http://doi.org/10.3346/jkms.2016.31.4.579

Abstract

We investigated the association between breastfeeding and cognitive development in infants during their first 3 years. The present study was a part of the Mothers' and Children's Environmental Health (MOCEH) study, which was a multi-center birth cohort project in Korea that began in 2006. A total of 697 infants were tested at age 12, 24, and 36 months using the Korean version of the Bayley Scales of Infant Development II (K-BSID-II). The use and duration of breastfeeding and formula feeding were measured. The relationship between breastfeeding and the mental development index (MDI) score was analyzed by multiple linear regression analysis. The results indicated a positive correlation between breastfeeding duration and MDI score. After adjusting for covariates, infants who were breastfed for ≥ 9 months had significantly better cognitive development than those who had not been breastfed. These results suggest that the longer duration of breastfeeding improves cognitive development in infants.

Keyword

Breastfeeding; Korean Bayley Scales of Infant Development II (K-BSID-II); Mental Development Index

MeSH Terms

Adult
*Breast Feeding
Child Development/*physiology
Child, Preschool
Cognition/*physiology
Demography
Female
Follow-Up Studies
Humans
Infant
Interviews as Topic
Linear Models
Male
Mothers/psychology
Multivariate Analysis
Program Evaluation
Prospective Studies
Republic of Korea

Figure

• 

  Fig. 1 Mental development index (MDI) scores of infants who were breastfed for different durations at 1 (A), 2 (B), and 3 years (C). *,†Significant difference from formula only. Dunnett’s post-hoc test (P < 0.05, P < 0.01, respectively). MDI indicates mental development index in Korean Bayley Scales of Infant Development II (K-BSID-II).

Reference

1. Bouchard TJ Jr, McGue M. Genetic and environmental influences on human psychological differences. J Neurobiol. 2003; 54:4–45.

2. Berk LE. Cognitive development: Piagetian, core knowledge, and Vygotskian perspectives. Child Development. 8th ed. Boston, MA: Allyn & Bacon/Pearson Education;2009. p. 258–266.

3. Englund MM, Luckner AE, Whaley GJ, Egeland B. Children’s achievement in early elementary school: longitudinal effects of parental involvement, expectations, and quality of assistance. J Educ Psychol. 2004; 96:723–730.

4. Landry SH, Smith KE, Swank PR. Responsive parenting: establishing early foundations for social, communication, and independent problem-solving skills. Dev Psychol. 2006; 42:627–642.

5. Mills-Koonce WR, Willoughby MT, Zvara B, Barnett M, Gustafsson H, Cox MJ; Family Life Project Key Investigators. Mothers’ and fathers’ sensitivity and children’s cognitive development in low-income, rural families. J Appl Dev Psychol. 2015; 38:1–10.

6. Bachrach VR, Schwarz E, Bachrach LR. Breastfeeding and the risk of hospitalization for respiratory disease in infancy: a meta-analysis. Arch Pediatr Adolesc Med. 2003; 157:237–243.

7. Bhandari N, Bahl R, Mazumdar S, Martines J, Black RE, Bhan MK; Infant Feeding Study Group. Effect of community-based promotion of exclusive breastfeeding on diarrhoeal illness and growth: a cluster randomised controlled trial. Lancet. 2003; 361:1418–1423.

8. Howie PW, Forsyth JS, Ogston SA, Clark A, Florey CD. Protective effect of breast feeding against infection. BMJ. 1990; 300:11–16.

9. Bartels M, van Beijsterveldt CE, Boomsma DI. Breastfeeding, maternal education and cognitive function: a prospective study in twins. Behav Genet. 2009; 39:616–622.

10. Anderson JW, Johnstone BM, Remley DT. Breast-feeding and cognitive development: a meta-analysis. Am J Clin Nutr. 1999; 70:525–535.

11. Kramer MS, Aboud F, Mironova E, Vanilovich I, Platt RW, Matush L, Igumnov S, Fombonne E, Bogdanovich N, Ducruet T, et al. Breastfeeding and child cognitive development: new evidence from a large randomized trial. Arch Gen Psychiatry. 2008; 65:578–584.

12. Kramer MS, Chalmers B, Hodnett ED, Sevkovskaya Z, Dzikovich I, Shapiro S, Collet JP, Vanilovich I, Mezen I, Ducruet T, et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA. 2001; 285:413–420.

13. Der G, Batty GD, Deary IJ. Effect of breast feeding on intelligence in children: prospective study, sibling pairs analysis, and meta-analysis. BMJ. 2006; 333:945.

14. Jedrychowski W, Perera F, Jankowski J, Butscher M, Mroz E, Flak E, Kaim I, Lisowska-Miszczyk I, Skarupa A, Sowa A. Effect of exclusive breastfeeding on the development of children’s cognitive function in the Krakow prospective birth cohort study. Eur J Pediatr. 2012; 171:151–158.

15. Wigg NR, Tong S, McMichael AJ, Baghurst PA, Vimpani G, Roberts R. Does breastfeeding at six months predict cognitive development? Aust N Z J Public Health. 1998; 22:232–236.

16. Jacobson SW, Chiodo LM, Jacobson JL. Breastfeeding effects on intelligence quotient in 4- and 11-year-old children. Pediatrics. 1999; 103:e71.

17. Kim BM, Ha M, Park HS, Lee BE, Kim YJ, Hong YC, Kim Y, Chang N, Roh YM, Kim BN, et al. The mothers and children’s environmental health (MOCEH) study. Eur J Epidemiol. 2009; 24:573–583.

18. Harwood L, Fergusson D. Breastfeeding and later cognitive and academic outcome. Pediatrics. 1998; 101:1–7.

19. Celi AC, Rich-Edwards JW, Richardson MK, Kleinman KP, Gillman MW. Immigration, race/ethnicity, and social and economic factors as predictors of breastfeeding initiation. Arch Pediatr Adolesc Med. 2005; 159:255–260.

20. Belfort MB, Rifas-Shiman SL, Kleinman KP, Guthrie LB, Bellinger DC, Taveras EM, Gillman MW, Oken E. Infant feeding and childhood cognition at ages 3 and 7 years: effects of breastfeeding duration and exclusivity. JAMA Pediatr. 2013; 167:836–844.

21. Guxens M, Mendez MA, Moltó-Puigmartí C, Julvez J, García-Esteban R, Forns J, Ferrer M, Vrijheid M, López-Sabater MC, Sunyer J. Breastfeeding, long-chain polyunsaturated fatty acids in colostrum, and infant mental development. Pediatrics. 2011; 128:e880–9.

22. Quigley MA, Kelly YJ, Sacker A. Breastfeeding and hospitalization for diarrheal and respiratory infection in the United Kingdom Millennium Cohort Study. Pediatrics. 2007; 119:e837–42.

23. Chantry CJ, Howard CR, Auinger P. Full breastfeeding duration and associated decrease in respiratory tract infection in US children. Pediatrics. 2006; 117:425–432.

24. Makrides M, Neumann MA, Gibson RA. Effect of maternal docosahexaenoic acid (DHA) supplementation on breast milk composition. Eur J Clin Nutr. 1996; 50:352–357.

25. Janssen CI, Zerbi V, Mutsaers MP, de Jong BS, Wiesmann M, Arnoldussen IA, Geenen B, Heerschap A, Muskiet FA, Jouni ZE, et al. Impact of dietary n-3 polyunsaturated fatty acids on cognition, motor skills and hippocampal neurogenesis in developing C57BL/6J mice. J Nutr Biochem. 2015; 26:24–35.

26. Janssen CI, Kiliaan AJ. Long-chain polyunsaturated fatty acids (LCPUFA) from genesis to senescence: the influence of LCPUFA on neural development, aging, and neurodegeneration. Prog Lipid Res. 2014; 53:1–17.

27. Bjerve KS, Brubakk AM, Fougner KJ, Johnsen H, Midthjell K, Vik T. Omega-3 fatty acids: essential fatty acids with important biological effects, and serum phospholipid fatty acids as markers of dietary omega 3-fatty acid intake. Am J Clin Nutr. 1993; 57:801S–5S.

28. Carlson SE, Werkman SH, Rhodes PG, Tolley EA. Visual-acuity development in healthy preterm infants: effect of marine-oil supplementation. Am J Clin Nutr. 1993; 58:35–42.

29. Clandinin MT, Jumpsen J, Suh M. Relationship between fatty acid accretion, membrane composition, and biologic functions. J Pediatr. 1994; 125:S25–32.

30. Uauy RD, Birch DG, Birch EE, Tyson JE, Hoffman DR. Effect of dietary omega-3 fatty acids on retinal function of very-low-birth-weight neonates. Pediatr Res. 1990; 28:485–492.

31. Birch EE, Birch DG, Hoffman DR, Uauy R. Dietary essential fatty acid supply and visual acuity development. Invest Ophthalmol Vis Sci. 1992; 33:3242–3253.

32. Makrides M, Simmer K, Goggin M, Gibson RA. Erythrocyte docosahexaenoic acid correlates with the visual response of healthy, term infants. Pediatr Res. 1993; 33:425–427.

33. Stack DM, Muir DW. Adult tactile stimulation during face-to-face interactions modulates five-month-olds’ affect and attention. Child Dev. 1992; 63:1509–1525.

34. Wambach K, Riordan J. Chapter 17. Child health: theories of development. Breastfeeding and human lactation. 5th ed. Burlington, MA: Jones & Bartlett Learning;2014. p. 679.

35. Schaffer HR. The early experience assumption: past, present, and future. Int J Behav Dev. 2000; 24:5–14.

36. Bornstein MH, Hahn CS, Haynes OM. Specific and general language performance across early childhood: stability and gender considerations. First Lang. 2004; 24:267–304.

37. Cho B, Park H. The standardization study (1) of Korean Bayley Scales of Infant Development (K-BSID-II): analyses of Korean infants’ performance of K-BSID-II in terms of demographical variables. Korean J Dev Psychol. 2004; 17:191–206.

38. World Health Organization. The optimal duration of exclusive breastfeeding: report of an expert consultation. Geneva, Switzerland 28-30 March 2001 [Internet]. Geneva: World Health Organization;2002. accessed on 25 May 2015. Available at http://apps.who.int/iris/bitstream/10665/67219/1/WHO_NHD_01.09.pdf?ua=1&ua=1.

39. Johnston M, Landers S, Noble L, Szucs K, Viehmann L. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012; 129:e827–41.

40. Cai S, Pang WW, Low YL, Sim LW, Sam SC, Bruntraeger MB, Wong EQ, Fok D, Broekman BF, Singh L, et al. Infant feeding effects on early neurocognitive development in Asian children. Am J Clin Nutr. 2015; 101:326–336.