Amanda Sacker (University College London), Mary Renfrew (University of York), Yvonne Kelly (University College London), Claire Carson (NPEU), Katriina Heikkila (NPEU (Former member)), Christine Hockley (NPEU (Former member))
Breastfeeding, Child health and development, Preterm birth
The literature to date gives conflicting findings as to the effect of breastfeeding on child cognitive development and behaviour.
The objective of this study was to assess the relationship between breastfeeding and child cognitive development and behaviour in a large population-based UK cohort, and to assess whether these relationships vary according to prematurity.
We used data from Sweeps 1 and 3 of the UK Millennium Cohort Study.
Children were grouped according to their breastfeeding status (ever versus never; and duration of any and exclusive breastfeeding).
Results are stratified according to gestational age at birth.
The main outcome measures were the British Ability Scales tests, the Strengths and Difficulties Questionnaire and the school-based Foundation Stage Profile which were administered when the children were aged 5 years.
In the analysis, we took account of potential confounders and mediators of the effect of breastfeeding on child development and behaviour.
Breastfeeding is associated with improved cognitive development at age 5 years, especially in preterm children.
On average, children who have been breastfed for a few months will be 1-6 months ahead of a typical non-breastfed child, even after allowing for a wide range of confounders and mediators.
Children who are breastfed are more likely to have good school performance at age 5 years compared with children who are non-breastfed.
The effect was noted for those who were breastfed for up to 2 months (RR=1.09), those who were breastfed for 2-4 months (RR=1.17) and those who were breastfed for at least 4 months (RR=1.16).
Children who are breastfed are less likely to have behavioural problems at age 5 years compared with children who are non-breastfed (OR=0.67).
Taken together, these results suggest that there is evidence of breastfeeding having a long term effect on child development, behaviour and education.