Effects of Breastfeeding Exclusivity and Duration on Child Cognitive Development at 5 Years of Age in Morelos, Mexico. Pubblico
Cheaib, Ruba (2014)
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
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