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Infant feeding and school attainment in five cohorts from low- and middle-income countries

Infant feeding and school attainment in five cohorts from low- and middle-income countries
Infant feeding and school attainment in five cohorts from low- and middle-income countries
Performance in intelligence tests tends to be higher among individuals breastfed as infants, but little is known about the association between breastfeeding and achieved schooling. We assessed the association of infant feeding with school achievement in five cohorts from low- and middle-income countries. Unlike high-income country settings where most previous studies come from, breastfeeding is not positively associated with socioeconomic position in our cohorts, thus reducing the likelihood of a spurious positive association.

Methodology and Principal Findings
Participants included 10,082 young adults from five birth cohorts (Brazil, India, Guatemala, the Philippines, and South Africa). The exposures variables were whether the subject was ever breastfed, total duration of breastfeeding, and age at introduction of complementary foods. We adjusted the estimates for age at follow up, sex, maternal age, smoking during pregnancy, birthweight and socioeconomic position at birth. The key outcome was the highest grade achieved at school. In unadjusted analyses, the association between ever breastfeeding and schooling was positive in Brazil, inverse in the Philippines, and null in South Africa; in adjusted analyses, these associations were attenuated. In Brazil, schooling was highest among individuals breastfed for 3–12 months whereas in the Philippines duration of breastfeeding was inversely associated with schooling; and null associations were observed in South Africa and Guatemala. These associations were attenuated in adjusted models. Late introduction of solid foods was associated with lower schooling achievement in Brazil and South Africa.

Conclusion
Measures of breastfeeding are not consistently related to schooling achievement in contemporary cohorts of young adults in lower and middle-income countries.

1932-6203
e71548
Horta, B.L.
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Bas, A.
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Bhargava, S.K.
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Fall, C.H.
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Feranil, A.
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de Kadt, J.
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Martorell, R.
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Richter, L.M.
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Stein, A.D.
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Victora, C.G.
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Horta, B.L.
c1c0cf75-59af-47f3-8e02-20297f95bc1f
Bas, A.
d4d0b1db-f43c-4837-b87b-f88ae0806e33
Bhargava, S.K.
aaa4d65d-aa8b-463d-8dd2-51a9b8516f49
Fall, C.H.
7171a105-34f5-4131-89d7-1aa639893b18
Feranil, A.
d14ed3f6-1a6a-4f86-b9cc-ac9f98962fe4
de Kadt, J.
a0675b05-8238-4f0b-91b7-e59f909d1b54
Martorell, R.
9ee73323-0528-4eff-93e3-c96fb1067356
Richter, L.M.
c76cf803-b586-4bc9-b82a-1dd6f16b65f4
Stein, A.D.
9120fff8-4ef6-4c07-a69f-ebe55dcb1243
Victora, C.G.
e8a269f0-82aa-4890-9274-ec6093470b57

Horta, B.L., Bas, A., Bhargava, S.K., Fall, C.H., Feranil, A., de Kadt, J., Martorell, R., Richter, L.M., Stein, A.D. and Victora, C.G. (2013) Infant feeding and school attainment in five cohorts from low- and middle-income countries. PLoS ONE, 8 (8), e71548. (doi:10.1371/journal.pone.0071548). (PMID:23977075)

Record type: Article

Abstract

Performance in intelligence tests tends to be higher among individuals breastfed as infants, but little is known about the association between breastfeeding and achieved schooling. We assessed the association of infant feeding with school achievement in five cohorts from low- and middle-income countries. Unlike high-income country settings where most previous studies come from, breastfeeding is not positively associated with socioeconomic position in our cohorts, thus reducing the likelihood of a spurious positive association.

Methodology and Principal Findings
Participants included 10,082 young adults from five birth cohorts (Brazil, India, Guatemala, the Philippines, and South Africa). The exposures variables were whether the subject was ever breastfed, total duration of breastfeeding, and age at introduction of complementary foods. We adjusted the estimates for age at follow up, sex, maternal age, smoking during pregnancy, birthweight and socioeconomic position at birth. The key outcome was the highest grade achieved at school. In unadjusted analyses, the association between ever breastfeeding and schooling was positive in Brazil, inverse in the Philippines, and null in South Africa; in adjusted analyses, these associations were attenuated. In Brazil, schooling was highest among individuals breastfed for 3–12 months whereas in the Philippines duration of breastfeeding was inversely associated with schooling; and null associations were observed in South Africa and Guatemala. These associations were attenuated in adjusted models. Late introduction of solid foods was associated with lower schooling achievement in Brazil and South Africa.

Conclusion
Measures of breastfeeding are not consistently related to schooling achievement in contemporary cohorts of young adults in lower and middle-income countries.

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Published date: 20 August 2013
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 359453
URI: http://eprints.soton.ac.uk/id/eprint/359453
ISSN: 1932-6203
PURE UUID: fd0ddc74-bf59-4269-a707-7873cb56f2c4
ORCID for C.H. Fall: ORCID iD orcid.org/0000-0003-4402-5552

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Date deposited: 04 Nov 2013 13:16
Last modified: 18 Feb 2021 16:37

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Contributors

Author: B.L. Horta
Author: A. Bas
Author: S.K. Bhargava
Author: C.H. Fall ORCID iD
Author: A. Feranil
Author: J. de Kadt
Author: R. Martorell
Author: L.M. Richter
Author: A.D. Stein
Author: C.G. Victora

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