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Breast feeding, pacifier use and infant development at 12 months of age: a birth cohort study in Brazil
F C Barros1, C G Victora, S S Morris
1Departamento de Medicina Social, Universidade Federal de Pelotas, RS, Brazil.
Insights
Longer breast-feeding duration is linked to reduced developmental delays in infants. Pacifier use showed no independent effect on child development when breast-feeding duration was considered.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Breastfeeding is widely believed to enhance child development.
- Previous research yielded conflicting results on breastfeeding's long-term impact on intelligence.
- The role of pacifier use in infant development requires further investigation.
Purpose of the Study:
- To investigate the association between breast-feeding duration, pacifier use, and suspected developmental delay at 12 months.
- To analyze confounding factors influencing infant development in a Brazilian birth cohort.
- To clarify the independent effects of breastfeeding and pacifier use on early childhood development.
Main Methods:
- A prospective birth cohort study of 5304 infants born in Pelotas, Brazil, in 1993.
- Data collected at birth and at 1, 3, 6, and 12 months, including breastfeeding practices, pacifier use, and developmental delay (Denver II test).
- Logistic regression analysis was used to assess associations, controlling for confounding variables.
Main Results:
- The prevalence of suspected developmental delay at 12 months was 34.1%.
- Children breastfed for 9 months or longer had significantly lower rates of developmental delay (25.5%) compared to those breastfed for less than 1 month (42.4%).
- Pacifier use was initially associated with higher developmental delay, but this effect vanished after adjusting for breastfeeding duration.
Conclusions:
- Extended breastfeeding duration is strongly associated with reduced risk of suspected developmental delay in infancy.
- Pacifier use does not appear to independently impact infant development when breastfeeding duration is accounted for.
- Breastfeeding duration is a significant protective factor for early child development, more so than pacifier use.
Abstract:
Many studies suggest that breast feeding confers developmental and intellectual advantages on children. In a recent study, however, no association was found between breast feeding and intelligence in adult life after adjustment for other variables, and the use of pacifier in infancy was the most important predictor of intelligence. We analysed the associations between breast-feeding duration, pacifier use and suspected developmental delay at 12 months of age in a birth cohort in Pelotas, southern Brazil. All 5304 hospital births occurring during 1993 were studied and a sample was followed up at 1, 3, 6 and 12 months of age. Breast-feeding practices and use of pacifiers were assessed at each visit, as well as suspected developmental delay, measured by the Denver II test. The prevalence of developmental delay was analysed, through logistic regression, according to breast-feeding status and pacifier use, accounting for the possible confounding effect of other variables. The prevalence of suspected developmental delay at 12 months was 34.1%, being slightly higher among children who used pacifiers at 6 months than among non-users (35.3% and 28.7% respectively). There was a marked negative association between breast-feeding duration and developmental delay, with children breast fed for 9 months or more presenting significantly less suspected developmental delay (25.5%) than those breast fed for less than 1 month (42.4%). The effects of multiple variables were tested, and only high parity, smoking during pregnancy, birthweight, gestational age, pacifier use and breast-feeding duration remained significantly associated with suspected developmental delay. The effect of pacifier use, however, disappeared after adjusting for breast-feeding duration, suggesting that breast feeding, and not pacifiers, affects child development.