Breastfeeding and Later Psychosocial Development of Children at 6 Years of Age

Abstract

To examine the association of breastfeeding duration with psychosocial development at 6 years of age. METHODS:We analyzed data from the 2005-2007 Infant Feeding Practices Study II and its 2012 Year 6 Follow-Up (N = 1442). Our breastfeeding duration variable combined overall and exclusive breastfeeding reported during infancy (never breastfed, breastfed ,6 months, breastfed $6 months + exclusive breastfeeding ,3 months, and breastfed $6 months + exclusive breastfeeding $3 months). Maternal responses to the Strengths and Difficulties Questionnaire were used to create our child psychosocial outcome domains (emotional symptoms, conduct problems, hyperactivity, peer problems, prosocial behavior, and total difficulties). Separate multivariable logistic regression models controlling for maternal sociodemographic characteristics, maternal mental health, and child characteristics were used to assess the likelihood of having difficulties on the 6 domains based on breastfeeding duration. RESULTS:Compared with children who were never breastfed, those who were breastfed for $6 months and exclusively breastfed for $3 months had decreased odds of difficulties with emotional symptoms (odds ratio [OR]: 0.52; 95% confidence interval [CI]: 0.27-0.99), conduct problems (OR: 0.24; 95% CI: 0.10-0.54), and total difficulties (OR: 0.39; 95% CI: 0.18-0.85) before adjustment. These associations were no longer significant after adjustment.CONCLUSIONS: Although in our unadjusted analyses we observed significant associations between breastfeeding duration and later psychosocial development, including decreased odds of emotional, conduct, and total difficulties at 6 years of age, these findings were no longer detectable after adjusting for the many potential confounding factors that play a role in psychosocial development. Pediatrics 2014;134: S36-S41

Breastfeeding and behavior disorders among children and adolescents: a systematic review

“…Nearly all studies assessing EBF for ≥ 3 months 33 and EBF for ≥ 6 months 19 did not find any association with total behavior problems, hyperactivity, emotional symptoms, conduct disorder, prosocial behavior, and peer problems 19 , 33 . Only one study found that children EBF for ≥ 6 months had greater interaction with people and self-care in childhood (higher odds of personal-social ability) when compared to non-breastfed children 38 .…”

“…Regarding breastfeeding assessment, seven studies assessed EBF 19 , 29 , 33 , 34 , 36 , 38 , 41 and twelve 26 , 27 , 30 , 32 – 35 , 37 – 41 studies assessed NEBF.…”

“…Nine different instruments were used to assess behavior disorders, and most of the studies used the Strengths and Difficulties Questionnaire (SDQ) 19 , 29 , 32 , 33 , 35 , three used the Child Behavior Checklist (CBCL) 26 , 27 , 36 , and two used the Rutter Behavior Scale 30 , 37 .…”

“…Of the six studies selected, one was carried out in children aged nine months 38 and five involved children aged 4–6 years 19 , 29 , 33 , 36 , 41 . Three 29 , 36 , 38 out of six 19 , 29 , 33 , 36 , 38 , 41 studies investigating EBF found some benefits of breastfeeding on behavior disorders in childhood (somatic complaints, internalized behavior, personal-social ability, total behavior, conduct disorder, hyperactivity, attention symptoms).…”

“…Regarding the methodological quality of the studies, all presented scores ranging from seven to eight, and lower scores were especially due to follow-up losses higher than 15% 29 , 33 , 36 , 38 and breastfeeding recall greater than three years 36 . Most of the studies that did not find any associations had a small sample size (< 1,500), except for the research undertaken by Kramer 35 .…”