Breastfeeding and Children's Cognitive Development up to the Age of 4 Years: The Japan Environment and Children's Study.

IF 2.1 3区医学 Q2 OBSTETRICS & GYNECOLOGY Breastfeeding Medicine Pub Date : 2024-11-08 DOI:10.1089/bfm.2024.0195

Toshie Nishigori, Hidekazu Nishigori, Taeko Suzuki, Toma Fukuda, Tsuyoshi Murata, Hyo Kyozuka, Akiko Sato, Yuka Ogata, Yuichi Nagasaka, Seiji Yasumura, Keiya Fujimori, Mitsuaki Hosoya, Koichi Hashimoto

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Abstract

Objective: Breastfeeding, depending on its duration, has been suggested to benefit children's cognitive development. We aimed to examine this issue by using the Japan Environment and Children's Study, a nationwide prospective birth cohort study. Methods: We evaluated the relationship between feeding methods and cognitive development in 2- and 4-year-old children. We classified the children based on the following feeding method during the first 6 months postpartum: (1) exclusive breastfeeding group, solely breastfeeding; (2) partial breastfeeding group, solely breastfeeding for ≤5 months and combination of breastfeeding/formula for the rest of months; (3) formula-fed group, solely formula feeding for ≥4 months; and (4) others. Cognitive development was assessed by trained testers using the Kyoto Scale of Psychological Development 2001. Results: Data on 1,329 boys and 1,398 girls were analyzed. Multiple regression analysis was performed using the exclusive breastfeeding group as the reference. Boys of age 2 years in the formula-fed group had significantly lower developmental quotients (DQs) in the language-social developmental (L-S) area (partial regression coefficient [B]: -4.624, p = 0.01), whereas no significant difference was observed in those of age 4 years. Girls of age 2 and 4 years in the formula-fed group had significantly lower L-S area DQ (B: -3.637, p = 0.03 and B: -3.414, p = 0.03, respectively). In the partial breastfeeding group, no significant differences in the L-S area DQ were observed in 2- and 4-year-old boys and girls. Conclusions: Exclusive breastfeeding for the first 6 months postpartum may be more beneficial for verbal cognitive development in 4-year-old girls than solely formula feeding for ≥4 months. Furthermore, breastfeeding combined with formula for the first 6 months postpartum may not have a disadvantage on cognitive development in boys and girls of age ≥ 2 years, when compared with that observed with exclusive breastfeeding during the first 6 months postpartum.

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母乳喂养与 4 岁前儿童的认知发展：日本环境与儿童研究》。

目的：有人认为，母乳喂养（取决于其持续时间）有利于儿童的认知发展。我们旨在通过日本环境与儿童研究（一项全国性的前瞻性出生队列研究）来研究这一问题。研究方法我们评估了 2-4 岁儿童的喂养方式与认知发展之间的关系。我们根据产后头 6 个月的喂养方式对儿童进行了分类：(1) 纯母乳喂养组，即完全以母乳喂养；(2) 部分母乳喂养组，即≤5 个月完全以母乳喂养，其余几个月母乳/配方奶混合喂养；(3) 配方奶喂养组，即≥4 个月完全以配方奶喂养；(4) 其他。认知发展由经过培训的测试人员使用 2001 年京都心理发展量表进行评估。结果：分析了 1 329 名男孩和 1 398 名女孩的数据。以纯母乳喂养组为参照，进行了多元回归分析。配方奶粉喂养组的 2 岁男孩在语言-社会发展（L-S）方面的发展商数（DQs）明显较低（部分回归系数[B]：-4.624，P = 0.01），而 4 岁男孩的发展商数则无明显差异。配方奶喂养组 2 岁和 4 岁女孩的 L-S 面积 DQ 明显较低（B：-3.637，p = 0.03；B：-3.414，p = 0.03）。在部分母乳喂养组中，2 岁和 4 岁男孩和女孩的 L-S 面积 DQ 没有明显差异。结论产后头 6 个月纯母乳喂养可能比单纯配方奶喂养≥4 个月更有利于 4 岁女孩的言语认知发展。此外，与产后头 6 个月纯母乳喂养相比，产后头 6 个月配方奶和母乳喂养对≥2 岁男童和女童的认知发展可能没有不利影响。

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来源期刊

Breastfeeding Medicine OBSTETRICS & GYNECOLOGY-PEDIATRICS

CiteScore

4.20

自引率

11.10%

发文量

130

审稿时长

6-12 weeks

期刊介绍： Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols. Breastfeeding Medicine coverage includes: Breastfeeding recommendations and protocols Health consequences of artificial feeding Physiology of lactation and biochemistry of breast milk Optimal nutrition for the breastfeeding mother Breastfeeding indications and contraindications Managing breastfeeding discomfort, pain, and other complications Breastfeeding the premature or sick infant Breastfeeding in the chronically ill mother Management of the breastfeeding mother on medication Infectious disease transmission through breast milk and breastfeeding The collection and storage of human milk and human milk banking Measuring the impact of being a “baby-friendly” hospital Cultural competence and cultural sensitivity International public health issues including social and economic issues.