The Effects of Breastfeeding on Childhood Behavioral and Emotional Development: A Prospective Cohort Study in China
Ying Meng1,2, Hongzhao Yu1,2, Mingxuan Zhang1,2
1Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, 38 Xueyuan Rd., Beijing 100191, China.
Insights
Exclusive breastfeeding for the first 6 months and longer breastfeeding durations are linked to better childhood behavioral and emotional development. These feeding practices may reduce risks of externalizing and internalizing problems in children.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Breastfeeding's early health benefits are known, but long-term impacts on child behavior are unclear.
- Understanding feeding practices' influence on emotional and behavioral development is crucial.
Purpose of the Study:
- To assess the association between infant feeding patterns and childhood behavioral and emotional outcomes.
- To investigate the impact of exclusive breastfeeding and breastfeeding duration on child development.
Main Methods:
- Population-based birth cohort study of 2489 mother-child dyads.
- Prospective data collection on feeding patterns (exclusive breastfeeding vs. non-exclusive) and breastfeeding duration (up to 18+ months).
- Child Behavior Checklist (CBCL) used to assess externalizing and internalizing problems; multivariable regression analyses performed.
Main Results:
- Exclusive breastfeeding (EBF) for the first 6 months was associated with lower internalizing problems and marginally lower externalizing problems.
- EBF was linked to a reduced risk of externalizing problems.
- Longer breastfeeding duration (13-18 months and >18 months) was associated with lower scores for both internalizing and externalizing problems compared to ≤6 months.
Conclusions:
- Exclusive breastfeeding for the initial 6 months supports positive behavioral and emotional development.
- Extended breastfeeding duration, whether exclusive or partial, offers significant benefits for children's behavioral and emotional well-being.
Background:
Breastfeeding could improve a child's health early on, but its long-term effects on childhood behavioral and emotional development remain inconclusive. We aimed to estimate the associations of feeding practice with childhood behavioral and emotional development.
Methods:
In this population-based birth cohort study, data on feeding patterns for the first 6 mo of life, the duration of breastfeeding, and children's emotional and behavioral outcomes were prospectively collected from 2489 mother-child dyads. Feeding patterns for the first 6 mo included exclusive breastfeeding (EBF) and non-exclusive breastfeeding (non-EBF, including mixed feeding or formula feeding), and the duration of breastfeeding (EBF or mixed feeding) was categorized into ≤6 mo, 7-12 mo, 13-18 mo, and >18 mo. Externalizing problems and internalizing problems were assessed with the Child Behavior Checklist (CBCL) and operationalized according to recommended clinical cutoffs, corresponding to T scores ≥64. Multivariable linear regression and logistic regression were used to evaluate the association of feeding practice with CBCL outcomes.
Results:
The median (interquartile range) age of children at the outcome measurement was 32.0 (17.0) mo. Compared with non-EBF for the first 6 mo, EBF was associated with a lower T score of internalizing problems [adjusted mean difference (aMD): -1.31; 95% confidence interval (95% CI): -2.53, -0.10], and it was marginally associated with T scores of externalizing problems (aMD: -0.88; 95% CI: -1.92, 0.15). When dichotomized, EBF versus non-EBF was associated with a lower risk of externalizing problems (aOR: 0.54, 95% CI: 0.34, 0.87), and it was marginally associated with internalizing problems (aOR: 0.75, 95% CI: 0.54, 1.06). Regarding the duration of breastfeeding, breastfeeding for 13-18 mo versus ≤6 mo was associated with lower T scores of internalizing problems (aMD: -2.50; 95% CI: -4.43, -0.56) and externalizing problems (aMD: -2.75; 95% CI: -4.40, -1.10), and breastfeeding for >18 mo versus ≤6 mo was associated with lower T scores of externalizing problems (aMD: -1.88; 95% CI: -3.68, -0.08). When dichotomized, breastfeeding for periods of 7-12 mo, 13-18 mo, and >18 mo was associated with lower risks of externalizing problems [aOR (95% CI): 0.96 (0.92, 0.99), 0.94 (0.91, 0.98), 0.96 (0.92, 0.99), respectively].
Conclusions:
Exclusive breastfeeding for the first 6 mo and a longer duration of breastfeeding, exclusively or partially, are beneficial for childhood behavioral and emotional development.
Related Concept Videos
01:30Socioemotional Development during Infancy
Primary Temperament Types
01:30Socioemotional Experience and Gender Development
01:27Parenting Styles
Authoritarian Parenting
This style is strict and controlling, with little room for open dialogue. Authoritarian parents demand obedience and often enforce rules with minimal warmth. Children raised this way may lack social skills and initiative, usually comparing themselves to others unfavorably.
Authoritative...
02:04Bullying
01:20Attachment
01:29Environmental Influences on Intelligence