Long-term Effects of Breast-feeding on Cognition and Educational Attainment

Frazer, Kirsten M.

doi:10.7916/d8-3g74-6243

Cited by 1 publication

(2 citation statements)

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“…A systematic review of three studies in 2007 reported higher educational achievement in breastfed children in late adolescence and young adulthood [3]. In a 2019 review of 73 studies, the majority of the studies demonstrated a positive effect of breastfeeding on cognitive development and educational achievements [10]. Similarly, in a 2015 meta-analysis of 17 studies, Horta et al, found that breastfed children scored 3.4 points higher on intelligence tests than non-breastfed children [2].…”

Section: Discussionmentioning

confidence: 99%

“…If breastfeeding does improve cognitive development and educational achievement, then we would expect to find evidence for this association across a range of different contexts; however, a review published in 2013 compared results from high-income and low-and middle-income countries and concluded that the 13 studies from low-and middle-income countries (LMICs) were more likely to report no effect of breastfeeding on cognitive development than the 71 studies from high-income countries [9]. Like other systematic reviews and meta-analyses exploring the association between breastfeeding and cognitive development or educational achievement [2,10], this review did not identify any studies from sub-Saharan Africa for inclusion [9].…”

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confidence: 99%

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The association of breastfeeding with cognitive development and educational achievement in sub-Saharan Africa: A systematic review

et al. 2022

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Background Systematic reviews and meta-analyses of studies mainly from high-income countries suggest that breastfeeding improves cognitive function and educational achievement. However, these associations may be a manifestation of who breastfeeds in these settings rather than an actual effect of breastfeeding. We investigated the association of breastfeeding with cognitive development and educational achievements in sub-Saharan Africa, where breastfeeding is the norm, and socioeconomic status is not strongly correlated with ever breastfeeding. Methods We searched Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), and Africa-Wide Information in January 2021 for studies that assessed the cognitive and educational benefits of breastfeeding in children and adolescents in sub-Saharan Africa. Two reviewers independently screened, extracted, and critically appraised the included studies. Results After reviewing 5552 abstracts and 151 full-text articles, seventeen studies on cognitive development and two on educational achievements met our predefined inclusion criteria. The included studies were from ten sub-Saharan African countries and published between 2013 and 2021, with sample sizes ranging from 54 to 6573. Most of the studies (n = 14) were prospective cohort studies, but only nine collected data on breastfeeding prospectively. The studies differed in analytic approaches and cognitive and educational achievements measurements. Of the 17 studies on cognitive development, only four adjusted sufficiently for key confounders. None of these four studies found an overall association between breastfeeding and cognitive development in children or adolescents in sub-Saharan Africa. The two studies on education measured achievements based on the highest grade of school attained, 12 or more years of education, or grade repetition at age 7-11 years. Both studies adjusted for a range of sociodemographic factors and found no evidence that children exclusively breastfed or breastfed for a longer duration have a better educational outcome than sub-optimally breastfed children. Conclusions The current evidence from sub-Saharan Africa is limited but does not corroborate previous findings that breastfeeding is associated with improved cognitive development and educational achievement. Registration This study is registered with PROSPERO, CRD42021236009.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%