Breast-Feeding Linked to Fewer Behavior Problems in Children

Laurie Barclay, MD

May 11, 2011

May 11, 2011 — Breast-feeding is linked to fewer behavioral problems in childhood, according to the results of the Millennium Cohort Study reported Online First May 9 in the Archives of Disease in Childhood.

"Few large prospective studies of the association between infant feeding and child behaviour have been undertaken and overall these studies have had inconsistent findings," write Katriina Heikkilä, from the Finnish Institute of Occupational Health in Helsinki, and colleagues. "...It is possible that increased intake of essential fatty acids from breast milk leads to improved neurological development and behavioural learning and thus fewer behavioural problems. Breast feeding may also lead to more mother–baby interaction and better communication, thus improving behavioural learning and development. "

The goal of the study was to assess whether breast-feeding is associated with behavioral development in children at age 5 years, using data from a large, prospective, nationally representative UK cohort predominantly of white ethnic background. Of 10,037 mother-child pairs included in the analyses, 9525 were term children and 512 were preterm children.

At study baseline, when the children were 9 months old, parental interview was used to determine duration of breast-feeding (at all or exclusively). When the children were 5 years old, child behavior was evaluated with use of a parent-completed questionnaire, the Strengths and Difficulties Questionnaire (SDQ).

The associations of breast-feeding duration with abnormal parent-rated SDQ total and subscores at age 5 years in term and preterm children were evaluated separately with logistic regression.

Compared with preterm children, term children were less likely to have abnormal SDQ scores (1129/9525, 12% vs 78/512, 15%). Compared with children who were never breast-fed, term children who were breast-fed for at least 4 months had lower odds of an abnormal total SDQ score (2741/9525, 29% vs 3292/9525, 35%; multivariable adjusted odds ratio [OR], 0.67; 95% confidence interval [CI], 0.54 - 0.83). Findings were similar for all SDQ subscores.

Despite imprecise effect estimates, longer duration of breast-feeding in preterm children was associated with lower odds of abnormal SDQ total and subscores overall. Both exclusive breast-feeding and any breast-feeding had similar associations with abnormal SDQ scores.

Limitations of this study include possible residual confounding from unmeasured confounders; reliance on interviews with the mother to determine breast-feeding duration; and lack of generalizability to multiple births, extremely premature children, and children from other ethnic backgrounds.

"The findings suggest that, at least in term children, longer duration of breast feeding is associated with fewer parent-rated behavioural problems in children aged 5 years," the study authors write.

The Policy Research Programme in the Department of Health, United Kingdom, funded this study. The views expressed are not necessarily those of the Department. The study authors have received funds from the Economic and Social Research Council, United Kingdom; the Department of Health; the UK Economic and Social Research Council Centre for Lifecourse Studies in Society and Health; and/or the University of York.

Arch Dis Child. Published online May 9, 2011. Abstract

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