Takashi Yorifuji1, Toshihide Kubo2, Michiyo Yamakawa3, Tsuguhiko Kato4, Sachiko Inoue5, Akiko Tokinobu6, Hiroyuki Doi7. 1. Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan. Electronic address: yorichan@md.okayama-u.ac.jp. 2. Department of Pediatrics, Okayama Medical Center, National Hospital Organization, Okayama, Japan. 3. Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan. 4. Department of Public Health and Public Policy, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. 5. Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; Department of Child and Adolescent Psychiatry, Okayama Psychiatric Medical Center, Okayama, Japan. 6. Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan; Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. 7. Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Abstract
OBJECTIVE: To prospectively examine the prolonged effect of breastfeeding on behavioral development. STUDY DESIGN: We used a large, nationwide Japanese population-based longitudinal survey that began in 2001. We restricted participants to term singletons with birth weight >2500 g (n = 41 188). Infant feeding practice was queried at age 6-7 months. Responses to survey questions about age-appropriate behaviors at age 2.5 and 5.5 years were used as indicators of behavioral development. We conducted logistic regression analyses, controlling for potential child and parental confounding factors, with formula feeding as the reference group. RESULTS: We observed a dose-response relationship between breastfeeding status and an inability to perform age-appropriate behaviors at both ages. With a single exception, all ORs for outcomes for exclusive breastfeeding were smaller than those for partial feeding of various durations. The protective associations did not change after adjustment for an extensive list of confounders or in the sensitivity analyses. CONCLUSION: We observed prolonged protective effects of breastfeeding on developmental behavior skills surveyed at age 2.5 and 5.5 years. Beneficial effects were most likely in children who were breastfed exclusively, but whether a biological ingredient in breast milk or extensive interactions through breastfeeding, or both, is beneficial is unclear.
OBJECTIVE: To prospectively examine the prolonged effect of breastfeeding on behavioral development. STUDY DESIGN: We used a large, nationwide Japanese population-based longitudinal survey that began in 2001. We restricted participants to term singletons with birth weight >2500 g (n = 41 188). Infant feeding practice was queried at age 6-7 months. Responses to survey questions about age-appropriate behaviors at age 2.5 and 5.5 years were used as indicators of behavioral development. We conducted logistic regression analyses, controlling for potential child and parental confounding factors, with formula feeding as the reference group. RESULTS: We observed a dose-response relationship between breastfeeding status and an inability to perform age-appropriate behaviors at both ages. With a single exception, all ORs for outcomes for exclusive breastfeeding were smaller than those for partial feeding of various durations. The protective associations did not change after adjustment for an extensive list of confounders or in the sensitivity analyses. CONCLUSION: We observed prolonged protective effects of breastfeeding on developmental behavior skills surveyed at age 2.5 and 5.5 years. Beneficial effects were most likely in children who were breastfed exclusively, but whether a biological ingredient in breast milk or extensive interactions through breastfeeding, or both, is beneficial is unclear.
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