Pang, Wei Wei, Tan, Pei Ting, Cai, Shirong, Fok, Doris, Chua, Mei Chien, Lim, Sock Bee, Shek, Lynette P., Chan, Shiao-Yng, Tan, Kok Hian, Yap, Fabian, Gluckman, Peter D., Godfrey, Keith, Meaney, Michael J., Broekman, Birit, Kramer, Michael S., Chong, Yap-Seng and Rifkin-Graboi, Anne (2020) Nutrients or nursing? Understanding how breast milk feeding affects child cognition. European Journal of Nutrition, 59 (2), 609-619. (doi:10.1007/s00394-019-01929-2).
Abstract
Purpose: to explore the associations between type of milk feeding (the “nutrients”) and mode of breast milk feeding (the “nursing”) with child cognition.
Methods: healthy children from the GUSTO (Growing Up in Singapore Toward healthy Outcomes) cohort participated in repeated neurodevelopmental assessments between 6 and 54 months. For “nutrients”, we compared children exclusively bottle-fed according to type of milk received: formula only (n=296) vs some/all breast milk (n=73). For “nursing”, we included only children who were fully fed breast milk, comparing those fed directly at the breast (n=59) vs those fed partially/completely by bottle (n=63).
Results: compared to infants fed formula only, those who were bottle-fed breast milk demonstrated significantly better cognitive performance on both the Bayley Scales of Infant and Toddler Development (Third Edition) at 2 years [adjusted mean difference (95% CI) 1.36 (0.32, 2.40)], and on the Kaufman Brief Intelligence Test (Second Edition) at 4.5 years [7.59 (1.20, 13.99)]. Children bottle-fed breast milk also demonstrated better gross motor skills at 2 years than those fed formula [1.60 (0.09, 3.10)]. Among infants fully fed breast milk, those fed directly at the breast scored higher on several memory tasks compared to children bottle-fed breast milk, including the deferred imitation task at 6 months [0.67 (0.02, 1.32)] and relational binding tasks at 6 [0.41 (0.07, 0.74)], 41 [0.67 (0.04, 1.29)] and 54 [0.12 (0.01, 0.22)] months.
Conclusions: our findings suggest that nutrients in breast milk may improve general child cognition, while nursing infants directly at the breast may influence memory.
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