Association of infant and young child feeding practices with cognitive development at 10–12 years: a birth cohort in rural Western China

Abstract

We aimed to comprehensively examine the association of breast-feeding, types and initial timing of complementary foods with adolescent cognitive development in low- and middle-income countries. We conducted a prospective cohort study of 745 adolescents aged 10–12 years who were born to women who participated in a randomised trial of prenatal micronutrient supplementation in rural Western China. An infant feeding index was constructed based on the current WHO recommendations. Full-scale intelligence quotient (FSIQ) was assessed and derived by the fourth edition of the Wechsler Intelligence Scale for Children. The duration of exclusive or any breast-feeding was not significantly associated with adolescent cognitive development. Participants who regularly consumed Fe-rich or Fe-fortified foods during 6–23 months of age had higher FSIQ than those who did not (adjusted mean differences 4·25; 95 % CI 1·99, 6·51). For cows’/goats’ milk and high protein-based food, the highest FSIQ was found in participants who initially consumed at 10–12 and 7–9 months, respectively. A strong dose–response relationship of the composite infant feeding index was also identified, with participants in the highest tertile of overall feeding quality having 3·03 (95 % CI 1·37, 4·70) points higher FSIQ than those in the lowest tertile. These findings suggest that appropriate infant feeding practices (breast-feeding plus timely introduction of appropriate complementary foods) were associated with significantly improved early adolescent cognitive development scores in rural China. In addition, improvement in Fe-rich or Fe-fortified foods complementary feeding may produce better adolescent cognitive development outcomes.

Indexes to assess feeding practices of children under 2 years old: a systematic review

“…The studies included in the qualitative synthesis were published between 2000 and 2020, with the majority (n 26) after 2010 (26,27,29,(31)(32)(33)(34)(35)(36)(37)(38)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(52)(53)(54)56) . Six studies were published between 2019 and 2020 (27,37,42,45,50,53) . The sample ranged from eighty-two (28) to 12 146 (56) participants.…”

“…Twenty-four studies employed a cross-sectional design (10,(25)(26)(27)(28)(29)31,32,34,37,38,40,43,44,48,49,(52)(53)(54)(56)(57)(58)(59) , six were longitudinal studies (36,39,42,(45)(46)(47) , five were intervention studies (30,33,35,41,50) and one presented cross-sectional and longitudinal analyses (55) .…”

“…Twelve studies were conducted in Asian countries (27,34,39,44,45,49,51,(55)(56)(57)(58)(59) , ten in Latin America (10,32,33,35,37,38,40,48,50,54) , four studies in Europe (29)(30)(31)43) , four in North America (28,42,46,53) , three in Oceania (26,36,41) and three in Africa (25,47,52) . Only two studies (10,52) evaluated data from more than one country.…”

“…According to Newcastle-Ottawa Scale instrument, twenty-four articles were classified as having good quality (twenty cross-sectional; four longitudinal) (25,27,29,31,32,34,38,40,(42)(43)(44)(45)(47)(48)(49)51,(53)(54)(55)(56)(57)(58)(59) , three were allocated to the fair category (10,37,46) and five as poor (26,28,36,39,52) . The main reasons why the articles were classified as fair or poor were because they did not justify the sample size, state the response rate and the characteristics of the nonrespondents or control the analyses for possible confounding factors.…”

“…Obesity protective dietary index (OPDI) (41) Specific foods; UPF 24-h dietary recall Previous day Yes Overall food score (42) Specific foods; food groups Child feeding practices questionnaire A day No Diet quality score (43) Specific foods; food groups; UPF FFQ Previous month Yes Feeding practices index (44) BF; food groups Child feeding practices questionnaire Not reported Yes Infant and young child feeding index (45) BF; food groups FFQ and child feeding practices questionnaire…”