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Nutrients or nursing? Understanding how breast milk feeding affects child cognition.

ABSTRACT: PURPOSE:To explore the associations between type of milk feeding (the "nutrients") and mode of breast milk feeding (the "nursing") with child cognition. METHODS:Healthy children from the GUSTO (Growing Up in Singapore Toward healthy Outcomes) cohort participated in repeated neurodevelopmental assessments between 6 and 54 months. For "nutrients", we compared children exclusively bottle-fed according to type of milk received: formula only (n?=?296) vs some/all breast milk (n?=?73). For "nursing", we included only children who were fully fed breast milk, comparing those fed directly at the breast (n?=?59) vs those fed partially/completely by bottle (n?=?63). RESULTS:Compared to infants fed formula only, those who were bottle-fed breast milk demonstrated significantly better cognitive performance on both the Bayley Scales of Infant and Toddler Development (Third Edition) at 2 years [adjusted mean difference (95% CI) 1.36 (0.32, 2.40)], and on the Kaufman Brief Intelligence Test (Second Edition) at 4.5 years [7.59 (1.20, 13.99)]. Children bottle-fed breast milk also demonstrated better gross motor skills at 2 years than those fed formula [1.60 (0.09, 3.10)]. Among infants fully fed breast milk, those fed directly at the breast scored higher on several memory tasks compared to children bottle-fed breast milk, including the deferred imitation task at 6 months [0.67 (0.02, 1.32)] and relational binding tasks at 6 [0.41 (0.07, 0.74)], 41 [0.67 (0.04, 1.29)] and 54 [0.12 (0.01, 0.22)] months. CONCLUSIONS:Our findings suggest that nutrients in breast milk may improve general child cognition, while nursing infants directly at the breast may influence memory.

SUBMITTER: Pang WW

PROVIDER: S-EPMC7058674 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Nutrients or nursing? Understanding how breast milk feeding affects child cognition.

Pang Wei Wei WW Tan Pei Ting PT Cai Shirong S Fok Doris D Chua Mei Chien MC Lim Sock Bee SB Shek Lynette P LP Chan Shiao-Yng SY Tan Kok Hian KH Yap Fabian F Gluckman Peter D PD Godfrey Keith M KM Meaney Michael J MJ Broekman Birit F P BFP Kramer Michael S MS Chong Yap-Seng YS Rifkin-Graboi Anne A

European journal of nutrition 20190226 2

<h4>Purpose</h4>To explore the associations between type of milk feeding (the "nutrients") and mode of breast milk feeding (the "nursing") with child cognition.<h4>Methods</h4>Healthy children from the GUSTO (Growing Up in Singapore Toward healthy Outcomes) cohort participated in repeated neurodevelopmental assessments between 6 and 54 months. For "nutrients", we compared children exclusively bottle-fed according to type of milk received: formula only (n = 296) vs some/all breast milk (n = 73). ...[more]

PMID: 30809702

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Project description:In spite of high rates of initiating breast milk feeding (BMF) among preterm infants, a significant rate of discontinuation occurs shortly after discharge. To investigate the effect of mode (direct feeding at the breast vs. expressing) and exclusivity (breast milk combined with formula vs. breast milk only) as well as maternal perceptions on the duration of BMF among preterm infants. The study included mothers whose infants were born before 32 weeks gestation, between January 2012 and August 2015 at Sheba Medical Center (SMC). Perinatal data were collected retrospectively from infants' computerized charts. Mothers were approached >12 months postpartum and were asked to complete a questionnaire. Those who agreed to participate were asked (during their visit to the follow-up clinic or by phone or mail) to complete a questionnaire regarding mode and duration of BMF as well as reasons for its discontinuation. Mothers were also asked about their pre-partum intentions to feed directly at the breast. Out of 162 eligible mothers, 131 (80.8%) initiated BMF during their intensive care unit (ICU) hospitalization. Of these, 66 (50.3%) discontinued BMF earlier than six months postpartum. BMF ≥ 6 months was significantly associated with direct feeding at the breast, duration of exclusive BMF, and singleton birth. Regression analysis revealed that direct feeding at the breast (any or only) and duration of BMF exclusivity were the only significant variables associated with BMF duration (Odds ratio (OR) 5.5 and 95% confidence interval (CI) 2.00-15.37; OR 1.5 and 95% CI 1.25-1.88, respectively). Milk supply (inadequate or nonexistent) was the most commonly reported cause for BMF discontinuation <6 months. Direct feeding at the breast was significantly associated with BMF duration and was more common among singletons. Direct feeding at the breast and duration of exclusive BMF are associated with duration of BMF among infants born <32 weeks of gestational age (GA). These findings suggest that targeting these two factors may play a key role in prolonging BMF duration among preterm infants.

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Nutrients or nursing? Understanding how breast milk feeding affects child cognition.

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Nutrients or nursing? Understanding how breast milk feeding affects child cognition.

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