Association Between Breastfeeding and Neurodevelopment at 6 Years of Age in the French PELAGIE Birth Cohort
Marion Monperrus1,2, Cécile Chevrier3, Nathalie Costet3
1Department of Obstetrics and Gynecology, University Hospital Rennes, Rennes, France.
Insights
Breastfeeding for at least four months is linked to better child cognitive performance, specifically verbal comprehension. These findings support recommendations for extended breastfeeding duration.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Breastfeeding is associated with improved child cognitive outcomes, but causality is debated.
- Previous studies often show this association disappears after adjusting for maternal factors and socioeconomic status.
- The relationship between breastfeeding and cognitive development in the French population requires further exploration.
Purpose of the Study:
- To investigate the association between breastfeeding and cognitive performance in French children.
- To explore the impact of breastfeeding duration on cognitive outcomes.
- To examine the complex interplay of breastfeeding, maternal factors, and child cognition.
Main Methods:
- Utilized data from the PELAGIE woman-child cohort (n=286) with children assessed at age 6.
- Employed the Wechsler Intelligence Scale for Children (WISC-IV) and NEPSY scales for cognitive assessment.
- Applied multivariable linear regression and structural equation modeling (SEM), adjusting for maternal cognition, education, and home environment.
Main Results:
- Children breastfed for ≥4 months showed significantly higher WISC Verbal Comprehension Index (VCI) scores.
- Increased breastfeeding duration, especially within the first 4 months, correlated with higher WISC-VCI scores.
- Breastfeeding was associated with better performance on NEPSY subtests including visual attention and narrative memory, confirmed by SEM.
Conclusions:
- Findings support current recommendations promoting breastfeeding for at least 4–6 months.
- This study provides evidence for a positive association between breastfeeding and specific aspects of child cognitive performance.
- The results reinforce the public health importance of encouraging extended breastfeeding practices.
Introduction:
Breastfeeding has been shown to be associated with improved child cognitive performance, but the causality of this association is still debated because it tends to disappear when accounting for maternal cognitive performance and socioeconomic status. We aimed to explore the relationship between breastfeeding and the cognitive performance of children in the French general population.
Methods:
From the PELAGIE woman-child cohort, which included pregnant women between 2002 and 2006 in Brittany (France), 286 children were evaluated using the Wechsler Intelligence Scale for Children (WISC-IV) and the Developmental Neuropsychological Assessment (NEPSY) scales at age 6. Associations between breastfeeding and cognitive performance were assessed using multivariable linear regression models adjusted for maternal verbal cognitive performance and education level, familial stimulation and environment (Home Observation for Measurement of the Environment scale), and Rey's Social Deprivation Index (contextual indicator). In addition, we performed structural equation modeling (SEM) to investigate the complex interrelation between these variables.
Results:
Children who were breastfed for at least 4 months had significantly higher scores on the WISC Verbal Comprehension Index (WISC-VCI) than those who were never breastfed or who were breastfed less than 15 days (βadjusted, 4.95 points; 95% CI, 0.54-9.37). Among the 193 children who were breastfed, the duration of breastfeeding, in particular during the first 4 months, was increasingly associated with the WISC-VCI score. We also observed statistically significant associations between breastfeeding itself or the duration of breastfeeding and better performance on several NEPSY subtests, including visual attention, design copying, arrows, and narrative memory. SEM analysis confirmed these associations. No statistical association was observed between breastfeeding and the WISC Working Memory Index or other NEPSY subtests.
Discussion:
These data support current national and World Health Organization global 2025 targets of promoting breastfeeding for at least 4 to 6 months.
