<p>Small-scale and regional observational and interventional studies have reported associations between breastfeeding and healthier development as well as higher IQ in children. However, these findings have not been validated in large nationwide cohorts. We used nationwide data from the Korean National Health Screening Program for Infants and Children (NHSPIC). The study analyzed the impact of feeding type, reported during the first NHSPIC exam at 4–6&#xa0;months of age, on the occurrence of developmental delays in the preschool period using regression analysis. We adjusted for multiple covariates including sex, place of residence, economic status, prematurity or low birth weight, and the result of the neonatal hearing exam. Developmental status was further specified to six domains: gross motor, fine motor, cognition, language, sociality, and self-care skills. Among the 1,769,897 children, exclusive breastfeeding (aOR 0.69; 95% CI, 0.67–0.72) and mixed feeding (aOR 0.83; 95% CI, 0.80–0.86) during the age of 4 to 6&#xa0;months were associated with a significantly lower risk of developmental delay in the preschool period compared to exclusive formula feeding. These associations were consistent across six developmental domains and remained robust in various subgroup analyses and sensitivity analyses.</p><p> <i>Conclusion</i>: In this nationwide cohort study, breastfeeding during the age of 4 to 6&#xa0;months was dose-dependently associated with a reduced risk of developmental delays during the preschool years. <Table Float="No" ID="Taba"> <tgroup cols="1"> <colspec align="left" colname="c1" colnum="1" /> <tbody> <row> <entry align="left" colname="c1"> <p><b>What is Known</b>:</p> </entry> </row> <row> <entry align="left" colname="c1"> <p>• <i>Breastfeeding has been linked to better neurodevelopment in small-scale or regional studies</i>.</p> <p>• <i>Evidence from large nationwide cohorts has been lacking</i>.</p> </entry> </row> <row> <entry align="left" colname="c1"> <p><b>What is New</b>:</p> </entry> </row> <row> <entry align="left" colname="c1"> <p>• <i>In a Korean nationwide cohort of 1.7 million children, breastfeeding at 4–6&#xa0;months was dose-dependently associated with lower risks of developmental delay</i>.</p> <p>• <i>The protective association was consistent across six developmental domains and robust in subgroup/sensitivity analyses</i>.</p> </entry> </row> </tbody> </tgroup> </Table></p>

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Impact of breastfeeding at 4–6 months of age on preschool neurodevelopmental outcomes: a nationwide population-based study

  • Ye Kyung Kim,
  • Yoo Jinie Kim,
  • Seungbok Lee,
  • Peong Gang Park

摘要

Small-scale and regional observational and interventional studies have reported associations between breastfeeding and healthier development as well as higher IQ in children. However, these findings have not been validated in large nationwide cohorts. We used nationwide data from the Korean National Health Screening Program for Infants and Children (NHSPIC). The study analyzed the impact of feeding type, reported during the first NHSPIC exam at 4–6 months of age, on the occurrence of developmental delays in the preschool period using regression analysis. We adjusted for multiple covariates including sex, place of residence, economic status, prematurity or low birth weight, and the result of the neonatal hearing exam. Developmental status was further specified to six domains: gross motor, fine motor, cognition, language, sociality, and self-care skills. Among the 1,769,897 children, exclusive breastfeeding (aOR 0.69; 95% CI, 0.67–0.72) and mixed feeding (aOR 0.83; 95% CI, 0.80–0.86) during the age of 4 to 6 months were associated with a significantly lower risk of developmental delay in the preschool period compared to exclusive formula feeding. These associations were consistent across six developmental domains and remained robust in various subgroup analyses and sensitivity analyses.

Conclusion: In this nationwide cohort study, breastfeeding during the age of 4 to 6 months was dose-dependently associated with a reduced risk of developmental delays during the preschool years.

What is Known:

Breastfeeding has been linked to better neurodevelopment in small-scale or regional studies.

Evidence from large nationwide cohorts has been lacking.

What is New:

In a Korean nationwide cohort of 1.7 million children, breastfeeding at 4–6 months was dose-dependently associated with lower risks of developmental delay.

The protective association was consistent across six developmental domains and robust in subgroup/sensitivity analyses.