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Nutrients or nursing? Understanding how breast milk feeding affects child cognition

Nutrients or nursing? Understanding how breast milk feeding affects child cognition
Nutrients or nursing? Understanding how breast milk feeding affects child cognition
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.
Breast milk expression, Breastfeeding, Child cognition, Memory
1436-6207
609-619
Pang, Wei Wei
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Tan, Pei Ting
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Cai, Shirong
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Fok, Doris
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Chua, Mei Chien
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Lim, Sock Bee
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Shek, Lynette P.
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Chan, Shiao-Yng
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Tan, Kok Hian
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Yap, Fabian
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Gluckman, Peter D.
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Godfrey, Keith
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Meaney, Michael J.
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Broekman, Birit
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Kramer, Michael S.
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Chong, Yap-Seng
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Rifkin-Graboi, Anne
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Pang, Wei Wei
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Tan, Pei Ting
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Cai, Shirong
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Fok, Doris
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Chua, Mei Chien
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Lim, Sock Bee
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Shek, Lynette P.
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Chan, Shiao-Yng
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Tan, Kok Hian
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Yap, Fabian
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Gluckman, Peter D.
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Godfrey, Keith
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Meaney, Michael J.
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Broekman, Birit
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Kramer, Michael S.
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Chong, Yap-Seng
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Rifkin-Graboi, Anne
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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).

Record type: Article

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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Accepted/In Press date: 9 February 2019
e-pub ahead of print date: 26 February 2019
Published date: 1 March 2020
Additional Information: Funding Information: We wish to thank participants of the GUSTO study, all staff involved in the collection and management of data, and the GUSTO study group. The GUSTO study group includes Allan Sheppard, Amutha Chinnadurai, Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Arijit Biswas, Bee Wah Lee, Birit F.P. Broekman, Boon Long Quah, Borys Shuter, Chai Kiat Chng, Cheryl Ngo, Choon Looi Bong, Christiani Jeyakumar Henry, Claudia Chi, Cornelia Yin Ing Chee, Yam Thiam Daniel Goh, Doris Fok, E Shyong Tai, Elaine Tham, Elaine Quah Phaik Ling, Evelyn Chung Ning Law, Evelyn Xiu Ling Loo, Fabian Yap, Falk Mueller-Riemenschneider, George Seow Heong Yeo, Helen Chen, Heng Hao Tan, Hugo P S van Bever, Iliana Magiati, Inez Bik Yun Wong, Ivy Yee-Man Lau, Izzuddin Bin Mohd Aris, Jeevesh Kapur, Jenny L. Richmond, Jerry Kok Yen Chan, Joanna D. Holbrook, Joanne Yoong, Joao N. Ferreira., Jonathan Tze Liang Choo, Jonathan Y. Bernard, Joshua J. Gooley, Keith M. Godfrey, Kenneth Kwek, Kok Hian Tan, Krishnamoorthy Niduvaje, Kuan Jin Lee, Leher Singh, Lieng Hsi Ling, Lin Lin Su, Ling-Wei Chen, Lourdes Mary Daniel, Lynette P Shek, Marielle V. Fortier, Mark Hanson, Mary Foong-Fong Chong, Mary Rauff, Mei Chien Chua, Melvin Khee-Shing Leow, Michael Meaney, Mya Thway Tint, Neerja Karnani, Ngee Lek, Oon Hoe Teoh, P. C. Wong, Paulin Tay Straughan, Peter D. Gluckman, Pratibha Agarwal, Queenie Ling Jun Li, Rob M. van Dam, Salome A. Rebello, Seang-Mei Saw, See Ling Loy, S. Sendhil Velan, Seng Bin Ang, Shang Chee Chong, Sharon Ng, Shiao-Yng Chan, Shirong Cai, Shu-E Soh, Sok Bee Lim, Stella Tsotsi, Chin-Ying Stephen Hsu, Sue Anne Toh, Swee Chye Quek, Victor Samuel Rajadurai, Walter Stunkel, Wayne Cutfield, Wee Meng Han, Wei Wei Pang, Yap-Seng Chong, Yin Bun Cheung, Yiong Huak Chan and Yung Seng Lee. Publisher Copyright: © 2019, The Author(s).
Keywords: Breast milk expression, Breastfeeding, Child cognition, Memory

Identifiers

Local EPrints ID: 428683
URI: http://eprints.soton.ac.uk/id/eprint/428683
ISSN: 1436-6207
PURE UUID: 450806c9-f51c-4971-ab3e-9aada0677201
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 06 Mar 2019 17:30
Last modified: 28 Oct 2022 01:36

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Contributors

Author: Wei Wei Pang
Author: Pei Ting Tan
Author: Shirong Cai
Author: Doris Fok
Author: Mei Chien Chua
Author: Sock Bee Lim
Author: Lynette P. Shek
Author: Shiao-Yng Chan
Author: Kok Hian Tan
Author: Fabian Yap
Author: Peter D. Gluckman
Author: Keith Godfrey ORCID iD
Author: Michael J. Meaney
Author: Birit Broekman
Author: Michael S. Kramer
Author: Yap-Seng Chong
Author: Anne Rifkin-Graboi

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