Breast-feeding and cognitive development: a meta-analysis. Am J Clin Nutr

Metabolic Research Group, Veterans Affairs Medical Center.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 11/1999; 70(4):525-35.
Source: PubMed


Although the results of many clinical studies suggest that breast-fed children score higher on tests of cognitive function than do formula-fed children, some investigators have suggested that these differences are related to confounding covariables such as socioeconomic status or maternal education.
Our objective was to conduct a meta-analysis of observed differences in cognitive development between breast-fed and formula-fed children.
In this meta-analysis we defined the effect estimate as the mean difference in cognitive function between breast-fed and formula-fed groups and calculated average effects using fixed-effects and random-effects models.
Of 20 studies meeting initial inclusion criteria, 11 studies controlled for >/=5 covariates and presented unadjusted and adjusted results. An unadjusted benefit of 5.32 (95% CI: 4.51, 6.14) points in cognitive function was observed for breast-fed compared with formula-fed children. After adjustment for covariates, the increment in cognitive function was 3.16 (95% CI: 2.35, 3.98) points. This adjusted difference was significant and homogeneous. Significantly higher levels of cognitive function were seen in breast-fed than in formula-fed children at 6-23 mo of age and these differences were stable across successive ages. Low-birth-weight infants showed larger differences (5.18 points; 95% CI: 3.59, 6.77) than did normal-birth-weight infants (2.66 points; 95% CI: 2.15, 3.17) suggesting that premature infants derive more benefits in cognitive development from breast milk than do full-term infants. Finally, the cognitive developmental benefits of breast-feeding increased with duration.
This meta-analysis indicated that, after adjustment for appropriate key cofactors, breast-feeding was associated with significantly higher scores for cognitive development than was formula feeding.

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    • "Proponents of breast-feeding initiatives cite numerous health benefits attributed to breast-feeding, including decreased rates of sudden infant death syndrome, otitis media (ear infections), respiratory disease, gastrointestinal illness, childhood leukemia and lymphoma, and pediatric and adolescent obesity (American Public Health Association 2007; AAP 2012). Breastfeeding has also been associated with intellectual gains (although the evidence for this, and for several of the aforementioned health benefits, is highly contested ) (Lucas et al. 1992; Anderson et al. 1999; Kramer et al. 2008; Sloan et al. 2010). 2 Mothers who breast-feed may also benefit, achieving greater postpartum weight loss and potentially reducing the risk of postpartum depression , type 2 diabetes, and cancers of the breast and ovaries (Ip et al. 2007). Breast-feeding may also produce economic benefits, costing less for families who would otherwise purchase infant formula, and saving the health system money by preventing treatment costs of conditions associated with formulafeeding (U.S. Breastfeeding Committee 2002). "
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    • "Breastfeeding has been associated with significantly higher scores for cognitive development than formula feeding [4] [5] [6]. Human milk is unique regarding the diversity, quantity and complexity of human milk oligosaccharides (HMOs), with more than 150 structures identified so far [7]. "
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