Effects of Breastfeeding Exclusivity and Duration on Child Cognitive Development at 5 Years of Age in Morelos, Mexico. Öffentlichkeit

Abstract

Background: Several studies have attempted to assess the relationship between breastfeeding and child cognitive development. Results have been mixed and inconclusive with some studies reporting an association and others not. The many potential confounders that may interfere make it difficult to properly assess this relationship; many researchers have concluded that the possible reported benefit of breastfeeding on child development may be due to those confounding factors and not breastfeeding itself.

Objective: The objective of this analysis is to assess the effects of breastfeeding status at 3 months postpartum as well as duration of breastfeeding on child cognitive outcomes at 5 years of age using the Spanish Language version of the McCarthy Scale of Developmental Abilities in a group of women in Morelos, Mexico.

Methods: This analysis used data from a prospective mother-child cohort in Morelos, Mexico. 689 mother-child pairs were included in this analysis. Information about maternal and infant characteristics were collected and child cognition was assessed on six different scales using the Spanish Version of the McCarthy Scales of Developmental Abilities. Bivariate associations were assessed to determine potential confounders and multivariate logistic regression was used to assess the relationship between the breastfeeding status and the outcome.

Results: Mothers who predominantly breastfed or exclusively breastfed at 3 months were more likely to continue breastfeeding for a prolonged amount of time. Breastfeeding was not seen to be associated with any of the six McCarthy Scales of Children's Abilities before and after adjusting for possible confounders. Effect sizes for breastfeeding on cognitive development decreased in almost all cases after adjusting for maternal intelligence, education, infant birth weight among other variables.

Discussion: There does not appear to be an association between breastfeeding exclusivity at 3 months postpartum or breastfeeding duration and later child cognition in this study population. Possible positive benefits that have been documented in past studies may be due to other confounding factors that influence both breastfeeding and child development. More rigorous control for potential confounders and stronger study designs need to be implemented to properly assess this relationship in the future.

Table of Contents

Chapter 1: Literature Review _______________________________________________________________________9
Introduction _____________________________________________________________________________________9
Possible Mechanisms Linking Breastfeeding and Child Cognition ___________________________________________11
Potential Consequences of Malnutrition and Delayed Cognitive Development ________________________________11
Current Literature on the Topic _____________________________________________________________________13
Current Breastfeeding Practices and Potential Influencers________________________________________________18
Chapter 2: Manuscript ____________________________________________________________________________22
Introduction_____________________________________________________________________________________ 23
Methods ________________________________________________________________________________________26
Results _________________________________________________________________________________________30
Discussion_______________________________________________________________________________________32
Tables and Figures _______________________________________________________________________________36
References ______________________________________________________________________________________41
Chapter 3: Discussion, Conclusions and Public Health Implications _________________________________________44
Discussion and Conclusions_________________________________________________________________________ 44
Public Health Implications__________________________________________________________________________ 47
Works Cited _____________________________________________________________________________________49

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health Psychology, Cognitive
Stichwort	Breastfeeding Nutrtion Cognitive Development Infant Feeding
Committee Chair / Thesis Advisor	Ramakrishnan, Usha, Emory University
Partnering Agencies	University, college or educational institution (other than Emory)

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