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Breastfeeding and motor development in term and preterm infants in a longitudinal US cohort
Kara A Michels1, Akhgar Ghassabian1, Sunni L Mumford1
1Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
Insights
This study found that introducing solids alongside breastfeeding in term infants did not significantly impact motor development milestones like standing or walking. Early infant feeding practices appear to have minimal long-term effects on motor skill acquisition.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Infant Nutrition
Background:
- Previous studies on breastfeeding and motor development are limited by confounding factors, retrospective data, and early assessment of motor skills.
- Accurate characterization of the relationship between infant feeding and early motor development requires robust study designs.
Purpose of the Study:
- To investigate the association between infant feeding methods and the achievement of major motor milestones in a US-based cohort.
- To provide reliable data on infant feeding and motor development, addressing limitations of prior research.
Main Methods:
- Utilized data from the Upstate New York Infant Development Screening Program (Upstate KIDS Study) with 4270 infants.
- Collected infant feeding information at 4 months postpartum and motor development data at 4, 8, 12, 18, and 24 months.
- Employed accelerated failure time models, adjusting for covariates and stratifying by preterm birth status, to analyze time to standing and walking.
Main Results:
- Term infants introduced to solids with breast milk showed a trend towards faster achievement of standing and walking, but this was not statistically significant after multiple testing correction.
- Exclusive breastfeeding prevalence was lower in preterm infants (8%) compared to term infants (19%) at 4 months.
- No significant feeding-associated differences in motor milestone achievement were observed in preterm infants.
Conclusions:
- Infant feeding practices, including the introduction of solids, are unlikely to cause substantial differences in the timing of major motor development.
- The findings suggest that motor development is influenced by a complex interplay of factors beyond infant feeding.
- The Upstate KIDS Study provides valuable longitudinal data on infant development and feeding.
Abstract:
Background: The relation between breastfeeding and early motor development is difficult to characterize because of the problems in existing studies such as incomplete control for confounding, retrospective assessment of infant feeding, and even the assessment of some motor skills too early.Objective: We sought to estimate associations between infant feeding and time to achieve major motor milestones in a US cohort.Design: The Upstate New York Infant Development Screening Program (Upstate KIDS Study) enrolled mothers who delivered live births in New York (2008-2010). Mothers of 4270 infants (boys: 51.7%) reported infant motor development at 4, 8, 12, 18, and 24 mo postpartum; information on infant feeding was reported at 4 mo. Accelerated failure time models were used to compare times to standing or walking across feeding categories while adjusting for parental characteristics, daycare, region, and infant plurality, sex, rapid weight gain, and baseline neurodevelopmental test results. Main models were stratified by preterm birth status.Results: The prevalence of exclusive breastfeeding in preterm infants was lower than in term infants at 4 mo postpartum (8% compared with 19%). After adjustment for confounders, term infants who were fed solids in addition to breast milk at 4 mo postpartum achieved both standing [acceleration factor (AF): 0.93; 95% CI: 0.87, 0.99] and walking (AF: 0.93; 95% CI: 0.88, 0.98) 7% faster than did infants who were exclusively breastfed, but these findings did not remain statistically significant after correction for multiple testing. We did not identify feeding-associated differences in motor milestone achievement in preterm infants.Conclusion: Our results suggest that differences in feeding likely do not translate into large changes in motor development. The Upstate KIDS Study was registered at clinicaltrials.gov as NCT03106493.
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