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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Breastfeeding and child cognitive development: New evidence from a large randomized trial
Archives of General Psychiatry, Volume 65, No. 5, Year 2008
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Description
Context: The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother's behavior or her interaction with the infant. Objective: To assess whether prolonged and exclusive breastfeeding improves children's cognitive ability at age 6.5 years. Design: Cluster-randomized trial, with enrollment from June 17, 1996, to December 31, 1997, and follow-up from December 21, 2002, to April 27, 2005. Setting: Thirty-one Belarussian maternity hospitals and their affiliated polyclinics. Participants: A total of 17 046 healthy breastfeeding infants were enrolled, of whom 13 889 (81.5%) were followed up at age 6.5 years. Intervention: Breastfeeding promotion intervention modeled on the Baby-Friendly Hospital Initiative by the World Health Organization and UNICEF. Main Outcome Measures: Subtest and IQ scores on the Wechsler Abbreviated Scales of Intelligence, and teacher evaluations of academic performance in reading, writing, mathematics, and other subjects. Results: The experimental intervention led to a large increase in exclusive breastfeeding at age 3 months (43.3% for the experimental group vs 6.4% for the control group; P<.001) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. The experimental group had higher means on all of the Wechsler Abbreviated Scales of Intelligence measures, with cluster-adjusted mean differences (95% confidence intervals) of +7.5 (+0.8 to +14.3) for verbal IQ, +2.9 (-3.3 to +9.1) for performance IQ, and +5.9 (-1.0 to +12.8) for full-scale IQ. Teachers' academic ratings were significantly higher in the experimental group for both reading and writing. Conclusion: These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development. Trial Registration: isrctn.org Identifier: ISRCTN37687716. ©2008 American Medical Association. All rights reserved.
Authors & Co-Authors
Kramer, Michael S.
Canada, Montreal
Université Mcgill
Canada, Montreal
Centre Universitaire de Santé Mcgill, Hôpital de Montreal Pour Enfants
Aboud, Frances E.
Canada, Montreal
Université Mcgill
Platt, Robert W.
Canada, Montreal
Université Mcgill
Fombonne, Eric J.
Canada, Montreal
Université Mcgill
Chalmers, Beverley Elizabeth
Canada, Kingston
Queen’s University
Hodnett, Ellen D.
Canada, Toronto
University of Toronto
Statistics
Citations: 769
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1001/archpsyc.65.5.578
ISSN:
15383636
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study