European Journal of Pediatrics

, Volume 171, Issue 1, pp 151–158

Effect of exclusive breastfeeding on the development of children’s cognitive function in the Krakow prospective birth cohort study

Authors

    • Chair of Epidemiology and Preventive MedicineJagiellonian University Medical College
  • Frederica Perera
    • Columbia Center for Children’s Environmental Health, Mailman School of Public HealthColumbia University
  • Jeffrey Jankowski
    • Albert Einstein College of Medicine of Yeshiva University
  • Maria Butscher
    • Polish–American Institute of PediatricsJagiellonian University Medical College
  • Elzbieta Mroz
    • Chair of Epidemiology and Preventive MedicineJagiellonian University Medical College
  • Elzbieta Flak
    • Chair of Epidemiology and Preventive MedicineJagiellonian University Medical College
  • Irena Kaim
    • Chair of Obstetrics and GynecologyJagiellonian University Medical College
  • Ilona Lisowska-Miszczyk
    • Chair of Obstetrics and GynecologyJagiellonian University Medical College
    • Neonatology ClinicJagiellonian University Medical College
  • Anita Skarupa
    • Chair of Epidemiology and Preventive MedicineJagiellonian University Medical College
  • Agata Sowa
    • Chair of Epidemiology and Preventive MedicineJagiellonian University Medical College
Original Paper

DOI: 10.1007/s00431-011-1507-5

Cite this article as:
Jedrychowski, W., Perera, F., Jankowski, J. et al. Eur J Pediatr (2012) 171: 151. doi:10.1007/s00431-011-1507-5

Abstract

The main goal of the study was to assess the effect of exclusive breastfeeding on the neurodevelopment of children over a 7-year follow-up period and to test the hypothesis that the observed cognitive gain in breastfed children in the first years of life is a strong predictor of their cognitive development trajectory, which may be continued in later life. The analysis is based on data from the 7-year follow-up of 468 term babies (>36 weeks of gestation) born to non-smoking mothers participating in an ongoing prospective cohort study. The cognitive function of children was assessed by psychometric tests performed five times at regular intervals from infancy through the preschool age. The study included valid neurodevelopmental assessment of the children—443 participants were evaluated least twice; 425, three times; and 307, five times in the follow-up period. The association between the cognitive achievements of preschool age children and exclusive breastfeeding of various durations was performed using the generalized estimating equation longitudinal model, adjusted for major confounders such as maternal education, gender, parity, and weight gain in pregnancy. Children breastfed exclusively for up to 3 months had intelligence quotients (IQs) that were on average 2.1 points higher compared to the others (95% confidence interval (CI), 0.24–3.9); children breastfed for 4–6 months scored higher by 2.6 points (95% CI, 0.87–4.27); and the benefit for children breastfed even longer (>6 months) increased by 3.8 points (95% CI, 2.11–5.45). Other predictors were maternal education, gender of the child, having an older sibling, and weight gain during pregnancy. The results of the study support the WHO expert recommendations on exclusive breastfeeding for 6 months; moreover, they provide evidence that even a shorter duration of exclusive breastfeeding in early infancy produces beneficial effects on the cognitive development of children. The breastfeeding-related IQ gain observed already at the age of 1 was sustained through preschool age, and the difference in terms of IQ score between breastfed children and the reference group (mixed breastfeeding) held constant over the whole preschool period.

Keywords

BreastfeedingCognitive function in early childhoodProspective birth cohort study

Copyright information

© Springer-Verlag 2011