Prolonged breastfeeding for 24 months or more and mental health at 6 years of age: evidence from the 2004 Pelotas Birth Cohort Study, Brazil

Abstract

Background: There is scarce and conflicting evidence on medium-to long-term effects of prolonged breastfeeding on child behavior. Method: A population-based birth cohort study started in 2004 in the city of Pelotas, Southern Brazil. Children were followed up at 3, 12, 24, and 48 months and 6 years of age. Breastfeeding duration was determined based on information collected around the time of weaning. Psychiatric disorders were assessed using the Development and Well-Being Assessment (DAWBA). Children who were never breastfed were excluded from the analysis. Crude and adjusted analyses were performed using Poisson regression with robust variance. Results: Data on breastfeeding and mental health at the age of 6 years were available for 3377 children. Prevalence of breastfeeding for 24-35 months and ≥36 months was 16.1% (95% CI: 14.8-17.3) and 8.1% (95% CI: 7.2-9.1), respectively. Prevalence of psychiatric disorders among those who were breastfed for <24 months, 24-35 months and ≥36 months was 12.4% (95% CI: 11.1-13.7), 13.1% (95% CI: 10.4-16.2) and 12.3% (95% CI: 8.7-16.8), respectively. No association was found between breastfeeding for 24 months or more and psychiatric disorders among children aged 6 years both in the crude and adjusted analyses. Conclusions: In this cohort there was no association between breastfeeding for 24 months or more and an increased prevalence of psychiatric disorders at the age of 6 years. Studies analyzing the medium-and longterm effects of prolonged breastfeeding for 2 years or more are scarce and further research is needed regarding this practice. Key Practitioner Message• Breastfeeding for ≥24 months is not associated with increased rates of psychiatric disorders at the age of 6 years.• Prolonged breastfeeding is associated with neurodevelopmental and mental health advantages. • These findings strongly support the WHO recommendation to maintain breastfeeding for 2 years or more.

Extended Breastfeeding in Poland: Knowledge of Health Care Providers and Attitudes on Breastfeeding Beyond Infancy

“…Breastfeeding children longer than 1 year has numerous benefits for both mother and child (Gittens & Dixon, 2017; Delgado, Munhoz, Santos, Barros & Matijasevich, 2017). Thus far, there is no evidence of any adverse influences associated with breastfeeding children beyond infancy (Wambach & Riordan, 2016).…”

Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries

“…Eight studies from the 1993 Pelotas Birth Cohort were included from our search, including the following topics: genes associated with ADHD symptoms in adolescents, 39 , 40 gene-environment interaction on externalizing problems in adolescents, 41 the effects of socioeconomic changes on psychopathology in adolescents, 25 the prevalence of psychopathology in 11-year-olds, 42 the continuity of behavioral and emotional problems from childhood into pre-adolescence, 43 adverse childhood experiences and alcohol, tobacco, and drug use, 44 and determinants of attention and hyperactivity problems in adolescents. 26 Thirteen studies from the 2004 Pelotas Birth Cohort were included from our search, including the following topics: the effects of early hospitalization on psychiatric disorders in children and pre-adolescents, 45 the prevalence of psychiatric disorders in children/pre-adolescents, 28 , 29 risk factors for disruptive mood dysregulation disorder, 46 ADHD associations, 47 - 49 maternal mood disorders/symptoms and child psychopathology, 50 , 51 intrauterine exposure and emotional/hyperactivity problems, 30 breastfeeding and mental health in children, 52 gestational age at birth and behavioral problems, 53 and bed-sharing and psychiatric disorders in children. 54 …”