Breast- Versus Bottle-Feeding: Psychological Outcome

Abstract

Two recent articles report an association, presumably causal, between bottle-feeding and, in the first paper,¹ an increase in learning disorders, and, in the second paper,² a generally lower academic performance. In both studies the comparison was with a group of breast-fed infants. One implication of these studies is that nutritional factors, presumably higher concentration of protein in cow’s milk formula, result in decreased academic performance. The findings of these studies add to the mounting enthusiasm for a return to breast-feeding as the primary source of nutrition for all infants. Evidence for the potential advantage of breast-feeding is most easily and reliably obtained from investigations that directly analyze differences in the nutrient and biological activity of breast milk compared to cow’s milk formula. However, once those differences are verified, they must be shown to relate to different outcomes in the health or development of children. If such a relationship cannot be established, the biological analysis would be unimportant. This need to correlate basic findings with clinical outcome has led to several studies in recent years comparing the later health and/or psychological performance of infants that are exclusively fed breast milk and those exclusively fed formula derived from cow’s milk.