Breastfeeding and behavioral development: a nationwide longitudinal survey in Japan
Takashi Yorifuji1, Toshihide Kubo2, Michiyo Yamakawa1
1Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan.
Insights
Breastfeeding offers prolonged benefits for children's behavioral development, with exclusive breastfeeding showing the most significant protective effects. These positive impacts on developmental skills were observed up to age 5.5 years.
Area of Science:
- Developmental Pediatrics
- Behavioral Science
- Public Health Nutrition
Background:
- Breastfeeding is widely recognized for its health benefits, but its long-term impact on behavioral development requires further investigation.
- Understanding the relationship between infant feeding practices and developmental trajectories is crucial for public health initiatives.
Purpose of the Study:
- To prospectively examine the prolonged effect of breastfeeding on behavioral development in a large Japanese cohort.
- To determine if a dose-response relationship exists between breastfeeding duration/exclusivity and behavioral outcomes.
Main Methods:
- A nationwide Japanese longitudinal survey (n=41,188) of term singletons with birth weight >2500g was utilized.
- Infant feeding practices were assessed at 6-7 months; behavioral development was evaluated at 2.5 and 5.5 years.
- Logistic regression analyses controlled for child and parental confounding factors, with formula feeding as the reference.
Main Results:
- A dose-response relationship was observed between breastfeeding status and the ability to perform age-appropriate behaviors.
- Exclusive breastfeeding was associated with significantly better outcomes compared to partial breastfeeding or formula feeding.
- These protective associations remained robust after adjusting for extensive confounding factors.
Conclusions:
- Prolonged protective effects of breastfeeding on developmental behavior skills were evident at ages 2.5 and 5.5 years.
- Exclusive breastfeeding demonstrated the most significant beneficial impact on developmental skills.
- The specific mechanisms, whether biological or interactional, underlying these benefits remain to be elucidated.
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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