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J Epidemiol Community Health doi:10.1136/jech-2013-202500
  • Research report

Breastfeeding duration and cognitive, language and motor development at 18 months of age: Rhea mother–child cohort in Crete, Greece

  1. Leda Chatzi1
  1. 1Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
  2. 2Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete,Heraklion, Crete, Greece
  3. 3Department of Pediatrics, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
  4. 4Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
  5. 5Hospital del Mar Research Institute (IMIM), Barcelona, Spain
  6. 6CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
  7. 7National School of Public Health, Athens, Greece
  1. Correspondence to Dr Leda Chatzi, Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete 71003, Greece; lchatzi{at}med.uoc.gr
  • Received 15 February 2013
  • Revised 4 November 2013
  • Accepted 8 November 2013
  • Published Online First 13 December 2013

Abstract

Background Breast feeding duration has been associated with improved cognitive development in children. However, few population-based prospective studies have evaluated dose–response relationships of breastfeeding duration with language and motor development at early ages, and results are discrepant.

Methods The study uses data from the prospective mother–child cohort (‘Rhea’ study) in Crete, Greece. 540 mother–child pairs were included in the present analysis. Information about parental and child characteristics and breastfeeding practices was obtained by interview-administered questionnaires. Trained psychologists assessed cognitive, language and motor development by using the Bayley Scales of Infant Toddler Development (3rd edition) at the age of 18 months.

Results Duration of breast feeding was linearly positively associated with all the Bayley scales, except of gross motor. The association persisted after adjustment for potential confounders with an increase of 0.28 points in the scale of cognitive development (β=0.28; 95% CI 0.01 to 0.55), 0.29 points in the scale of receptive communication (β=0.29; 95% CI 0.04 to 0.54), 0.30 points in the scale of expressive communication (β=0.30; 95% CI 0.04 to 0.57) and 0.29 points in the scale of fine motor development (β=0.29; 95% CI 0.02 to 0.56) per accumulated month of breast feeding. Children who were breast fed longer than 6 months had a 4.44-point increase in the scale of fine motor development (β=4.44; 95% CI 0.06 to 8.82) compared with those never breast fed.

Conclusions Longer duration of breast feeding was associated with increased scores in cognitive, language and motor development at 18 months of age, independently from a wide range of parental and infant characteristics. Additional longitudinal studies and trials are needed to confirm these results.

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