Effects of prolonged and exclusive breastfeeding on child behavior and maternal adjustment: evidence from a large,
Michael S Kramer1, Eric Fombonne, Sergei Igumnov
1Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, Canada. michael.kramer@mcgill.ca
Insights
This study found no long-term effects of breastfeeding on child behavior or maternal adjustment. However, breastfeeding promotion positively influenced subsequent breastfeeding duration and exclusivity.
Area of Science:
- Public Health
- Pediatrics
- Maternal Health
Background:
- Breastfeeding is encouraged for infant health benefits.
- Long-term effects on child behavior and maternal adjustment require further investigation.
Purpose of the Study:
- To assess long-term effects of breastfeeding on child behavior.
- To evaluate the impact of breastfeeding on maternal adjustment.
Main Methods:
- Followed 13,889 mother-infant pairs from a breastfeeding promotion trial at 6.5 years.
- Utilized Strengths and Difficulties Questionnaire for child behavior assessment.
- Assessed maternal relationships and subsequent breastfeeding practices.
Main Results:
- No significant effects of breastfeeding promotion on child behavior or maternal adjustment were found.
- Breastfeeding promotion significantly increased breastfeeding duration and exclusivity for subsequent children.
- Maternal relationships and satisfaction showed no significant treatment effects.
Conclusions:
- Prolonged and exclusive breastfeeding showed no evidence of risks or benefits for child and maternal behavior in this large trial.
- Breastfeeding promotion interventions positively impact breastfeeding of subsequent children.
- Further research may explore other long-term outcomes beyond behavior and adjustment.
Objective:
The objective of this study was to assess the long-term effects of breastfeeding on child behavior and maternal adjustment.
Methods:
We followed up children who were in the Promotion of Breastfeeding Intervention Trial, a cluster-randomized trial of a breastfeeding promotion intervention based on the World Health Organization/United Nations Children's Fund Baby-Friendly Hospital Initiative. A total of 17,046 healthy, breastfeeding mother-infant pairs were enrolled from 31 Belarussian maternity hospitals and affiliated polyclinics; 13,889 (81.5%) were followed up at 6.5 years. Mothers and teachers completed the Strengths and Difficulties Questionnaire and supplemental questions bearing on internalizing and externalizing behavioral problems. Mothers also responded to questions concerning their relationships to their partner and child and their breastfeeding of subsequently born children.
Results:
The experimental intervention led to a large increase in exclusive breastfeeding at 3 months (43.3% vs 6.4%) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. No significant treatment effects were observed on either the mother or the teacher Strengths and Difficulties Questionnaire ratings of total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, or prosocial behavior or on the supplemental behavioral questions. We found no evidence of treatment effects on the parent's marriage or on the mother's satisfaction with her relationships with her partner or child, but the experimental intervention significantly increased the duration of any breastfeeding, and mothers in the experimental group were nearly twice as likely to breastfeed exclusively the next-born child for at least 3 months.
Conclusions:
On the basis of the largest randomized trial ever conducted in the area of human lactation, we found no evidence of risks or benefits of prolonged and exclusive breastfeeding for child and maternal behavior. Breastfeeding promotion does, however, favorably affect breastfeeding of the subsequent child.
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