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Husain SF, Lim S, Pang WW, Ong YY, Fok D, Rifkin-Graboi A, Chong MFF, Chong YS, Chua MC, Daniel LM, Wlodek ME, Law EC. A longitudinal study of breastmilk feeding duration, EEG power and early academic skills. Early Hum Dev 2024; 198:106110. [PMID: 39260074 DOI: 10.1016/j.earlhumdev.2024.106110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/20/2024] [Accepted: 08/26/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND The cognitive benefits of breastfeeding are widely recognized; however, its effects on brain development and later academic skills require further examination. This study aimed to examine the longitudinal relations between breastmilk feeding, neurophysiological changes, and early academic skills. METHODS In the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort, breastmilk feeding practices were collected every 3 months from 3 weeks to 18 months postpartum. Resting electroencephalography (EEG) was recorded at 18 months and power spectral density was derived. The outcomes were a set of early academic assessments administered at age 4 (n = 810). Structural equation modelling was used to investigate EEG power as a mediator between breastmilk duration and early academic skills. RESULTS Breastmilk feeding for ≥12 months was associated with better general knowledge, numeracy, and language at age 4 compared to shorter durations of breastmilk feeding (Cohen's d: 1.53-17.44). Linear regression showed that breastmilk duration was negatively and positively associated with low- (i.e., delta, theta) and high-frequency power (i.e., gamma), respectively (Cohen's f2: 0.03-0.09). After adjusting for demographic and child baseline covariates, a decrease in absolute and relative delta, as well as relative theta was associated with better general knowledge and numeracy (Cohen's f2: 0.16-0.25). Relative delta power provided an indirect path between breastmilk duration and early academic skills (x2: 18.390, p = 0.010; CFI: 0.978; TLI: 0.954; RMSEA: 0.040). CONCLUSIONS Extended breastmilk feeding is associated with reduced low-frequency power and better early academic skills, suggesting benefits to brain development. Additional research to confirm this finding is warranted.
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Affiliation(s)
- Syeda Fabeha Husain
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shuping Lim
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wei Wei Pang
- Global Centre for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Bia-Echo Asia Centre for Reproductive Longevity & Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Yi Ying Ong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Doris Fok
- Department of Neonatology, National University Hospital, Singapore
| | - Anne Rifkin-Graboi
- National Institute of Education (NIE), Nanyang Technological University (NTU), Singapore
| | - Mary F-F Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yap Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Mei Chien Chua
- Kandang Kerbau Women's and Children's Hospital (KKH), Singapore; Duke-NUS Graduate Medical School, Singapore
| | - L Mary Daniel
- Kandang Kerbau Women's and Children's Hospital (KKH), Singapore; Duke-NUS Graduate Medical School, Singapore
| | - Mary E Wlodek
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
| | - Evelyn C Law
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore.
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Devita S, Deforges C, Bickle-Graz M, Tolsa JF, Sandoz V, Horsch A. Maternal childbirth-related posttraumatic stress symptoms, bonding, and infant development: a prospective study. J Reprod Infant Psychol 2023:1-15. [PMID: 37740725 DOI: 10.1080/02646838.2023.2261057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/15/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Childbirth-related posttraumatic stress symptoms (CB-PTSS) including general symptoms (GS, i.e., mainly negative cognitions and mood and hyperarousal symptoms) and birth-related symptoms (BRS, i.e., mostly re-experiencing and avoidance symptoms) may disrupt mother-infant bonding and infant development. This study investigated prospective and cross-sectional associations between maternal CB-PTSS and mother-infant bonding or infant development (language, motor, and cognitive). METHOD We analysed secondary data of the control group of a randomised control trial (NCT03576586) with full-term French-speaking mother-infant dyads (n = 55). Maternal CB-PTSS and mother-infant bonding were assessed via questionnaires at six weeks (T1) and six months (T2) postpartum: PTSD Checklist for DSM-5 (PCL-5) and Mother-Infant Bonding Scale (MIBS). Infant development was assessed with the Bayley Scales of Infant Development at T2. Sociodemographic and medical data were collected from questionnaires and medical records. Bivariate and multivariate regression were used. RESULTS Maternal total CB-PTSS score at T1 was associated with poorer bonding at T2 in the unadjusted model (B = 0.064, p = 0.043). In the adjusted model, cross-sectional associations were found at T1 between a higher total CB-PTSS score and poorer bonding (B = 0.134, p = 0.017) and between higher GS and poorer bonding (B = 0.306, p = 0.002). Higher BRS at T1 was associated with better infant cognitive development at T2 in the unadjusted model (B = 0.748, p = 0.026). CONCLUSIONS Results suggest that CB-PTSS were associated with mother-infant bonding difficulties, while CB-PTSS were not significantly associated with infant development. Additional studies are needed to increase our understanding of the intergenerational consequences of perinatal trauma.
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Affiliation(s)
- Sella Devita
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Myriam Bickle-Graz
- Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-François Tolsa
- Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vania Sandoz
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
- Department Woman-Mother-Child, Child Abuse and Neglect Team, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
- Department Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Calder SD, Brennan‐Jones CG, Robinson M, Whitehouse A, Hill E. The prevalence of and potential risk factors for Developmental Language Disorder at 10 years in the Raine Study. J Paediatr Child Health 2022; 58:2044-2050. [PMID: 35922883 PMCID: PMC9804624 DOI: 10.1111/jpc.16149] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/22/2022] [Accepted: 07/20/2022] [Indexed: 01/07/2023]
Abstract
AIM This study sought to determine the prevalence of Developmental Language Disorder (DLD) in Australian school-aged children and associated potential risk factors for DLD at 10 years. METHODS This study used a cross-sectional design to estimate the prevalence of DLD in Generation 2 of the prospective Raine Study. Participants included 1626 children aged 10 years with available language data. Primary outcomes included variables matching diagnostic criteria for DLD. Associations of other potential prenatal and environmental variables were analysed as secondary outcomes. RESULTS The prevalence of DLD in this sample was 6.4% (n = 104) at 10 years. This sub-cohort comprised 33.7% (n = 35) with expressive language deficits, 20.2% (n = 21) with receptive language deficits, and 46.2% (n = 48) with receptive-expressive deficits. No significant difference in sex distribution was observed (52.9% male, p = 0.799). Children who were exposed to smoke in utero at 18 weeks gestation were at increased risk of DLD at 10 years (OR = 2.56, CI = 1.23-5.35, p = 0.012). CONCLUSIONS DLD is a relatively prevalent condition in Australian children, even when assessed in middle childhood years. These findings can inform future research priorities, and public health and educational policy which account for the associations with potential risk factors.
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Affiliation(s)
- Samuel D Calder
- School of Allied Health, Faculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia,Health Sciences, College of Health and MedicineUniversity of TasmaniaLauncestonTasmaniaAustralia
| | - Christopher G. Brennan‐Jones
- School of Allied Health, Faculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia,Telethon Kids Institute, The University of Western AustraliaPerthWestern AustraliaAustralia
| | - Monique Robinson
- Telethon Kids Institute, The University of Western AustraliaPerthWestern AustraliaAustralia
| | - Andrew Whitehouse
- Telethon Kids Institute, The University of Western AustraliaPerthWestern AustraliaAustralia
| | - Elizabeth Hill
- School of Allied Health, Faculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia
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Hou L, Li X, Yan P, Li Y, Wu Y, Yang Q, Shi X, Ge L, Yang K. Impact of the Duration of Breastfeeding on the Intelligence of Children: A Systematic Review with Network Meta-Analysis. Breastfeed Med 2021; 16:687-696. [PMID: 34077234 DOI: 10.1089/bfm.2020.0364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To evaluate the impact of the duration of breastfeeding on the intelligence of children. Materials and Methods: Eight electronic databases were searched to identify studies that investigated the impact of breastfeeding on the intelligence of children. Data were pooled, and the ratio of means (RoM) and the corresponding 95% confidence interval (95% CI) were calculated using a pairwise meta-analysis and network meta-analysis. Risk of bias was assessed using a tool developed by the CLARITY group. Data were analyzed using R version 3.5.1. Results: A total of 15 studies with 12,316 subjects were included in the review. Half of the studies were at low risk of bias. A meta-analysis indicated that breastfed children had a score 1.04-fold higher in intelligence tests compared with those that had never been breastfed (RoM: 1.04, 95% CI: 1.02-1.06, p < 0.05). Evidence from a network meta-analysis indicated that breastfeeding for ≤6 months resulted in score 1.04-fold higher in intelligence tests (RoM: 1.04, 95% CI: 1.03-1.06, p < 0.05) and children breastfed for >6 months had a score 1.06-fold higher (RoM: 1.06, 95% CI: 1.05-1.08, p < 0.05) than children that had never been breastfed. Thus, breastfeeding for >6 months demonstrated a slightly higher score than breastfeeding for ≤6 months (RoM: 1.02, 95% CI: 1.00-1.04, p < 0.05). Conclusion: Breastfeeding could significantly improve the intelligence of children, with a duration of >6 months showing a slight but significantly higher intelligence score than for ≤6 months.
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Affiliation(s)
- Liangying Hou
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xiuxia Li
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Peijing Yan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yanfei Li
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Yiting Wu
- The Zhongshan Affiliated Hospital, Fudan University, Shanghai, China
| | - Qingxia Yang
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiue Shi
- Institute for Evidence Based Rehabilitation Medicine of Gansu Province, Lanzhou, China
| | - Long Ge
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Kehu Yang
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.,Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
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Attitudes and Barriers to Breastfeeding among Mothers in Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia. ScientificWorldJournal 2021; 2021:5585849. [PMID: 34381319 PMCID: PMC8352701 DOI: 10.1155/2021/5585849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 07/04/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Breastfeeding provides unsurpassed natural nutrition to the newborn and infant. It has a nearly perfect mix of food elements and vitamins that infants need to grow up. Nonetheless, the tendency for breastfeeding remains below the expected levels. Objectives To explore the attitudes and barriers to breastfeeding among mothers in Princess Nourah Abdulrahman University (PNU), Riyadh, Saudi Arabia. Methods A cross-sectional study was conducted, from January to April 2019; 399 PNU students, employees, and faculty mothers aged 18 years and above with experience of childbirth and breastfeeding were included in the study using a predesigned validated questionnaire. The questionnaire consisted of four scales: sociodemographic, attitude toward breastfeeding, barriers to breastfeeding, and induced lactation knowledge. Results The participants' mean age was 34.1 ± 10.4 years; most (87.8%) were Saudi; 92.8% were married; 62% had a bachelor's degree; and 43% had "enough income." While 40% of the mothers reported >6 months "exclusive breastfeeding" for the first baby, only 34.8% did so for the last baby, and 54.5% did so for most of all babies altogether. The mothers' parity ranged between 1 birth and 4 births in 23.5% and 17.5% of the participants, respectively. An overall score of breastfeeding attitude averaged 59.6 ± 7.3. The tendency for scoring a negative attitude to breastfeeding was significantly reported (p < 0.5) among 127 (31.8%) 31- to 40-year-old mothers; 153 (38.3%) bachelor's degree holders; and 157 (39.3%) employees (χ 2 (4) 14.6, p = 0.006; χ 2 (4) 10.4, p = 0.034; and χ 2 (4) 20.4, p < 0.001, respectively). "Mother's illness" was the most commonly (63%) reported barrier to "not to breastfeed," followed by "work" (45.5%) and "father not supporting breastfeeding" (14.8%). Conclusions An overall negative attitude toward breastfeeding among PNU mothers was noted. Barriers included mother's sickness and work. Efforts to minimize such negative attitudes and barriers among susceptible mothers are warranted.
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Sanefuji M, Senju A, Shimono M, Ogawa M, Sonoda Y, Torio M, Ichimiya Y, Suga R, Sakai Y, Honjo S, Kusuhara K, Ohga S. Breast feeding and infant development in a cohort with sibling pair analysis: the Japan Environment and Children's Study. BMJ Open 2021; 11:e043202. [PMID: 34380712 PMCID: PMC8359520 DOI: 10.1136/bmjopen-2020-043202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To investigate the association between breast feeding and infant development during the first year of life using sibling comparison. DESIGN Nationwide prospective birth cohort study with sibling pair analysis. SETTING 15 regional centres that participated in the Japan Environment and Children's Study. PARTICIPANTS This study included 77 119 children (singleton, term birth and no malformation/severe diseases) whose mothers were registered between January 2011 and March 2014, including 3521 duos or trios of siblings. PRIMARY OUTCOME MEASURES The primary outcome was developmental delay at 6 and 12 months of age, assessed using the Japanese translation of the Ages and Stages Questionnaires, third edition. Multivariable regression analyses adjusted for confounders were performed to estimate the risk ratios of delay associated with any or exclusive breast feeding. Pairs of siblings discordant for statuses were selected, and conditional regression analyses were conducted with a matched cohort design. RESULTS Developmental delay was identified in 6162 (8.4%) and 10 442 (14.6%) children at 6 and 12 months of age, respectively. Any breast feeding continued until 6 months or 12 months old was associated with reduced developmental delay at 12 months of age (adjusted risk ratio (95% CI): 0.81 (0.77 to 0.85) and 0.81 (0.78 to 0.84), respectively). Furthermore, exclusive breast feeding until 3 months was associated with reduced developmental delay at 12 months of age (adjusted risk ratio, 0.86 (95% CI 0.83 to 0.90)). In sibling pair analysis, the association between any breast feeding until 12 months and reduced developmental delay at 12 months of age persisted (adjusted risk ratio, 0.64 (95% CI 0.43 to 0.93)). CONCLUSIONS The present study demonstrated the association of continuous breast feeding with reduced developmental delay at 1 year of age using sibling pair analysis, in which unmeasured confounding factors are still present but less included. This may provide an argument to promote breastfeeding continuation.
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Affiliation(s)
- Masafumi Sanefuji
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ayako Senju
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masayuki Shimono
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masanobu Ogawa
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuri Sonoda
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michiko Torio
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuko Ichimiya
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Reiko Suga
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yasunari Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Honjo
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | - Koichi Kusuhara
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shouichi Ohga
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Speyer LG, Hall HA, Ushakova A, Murray AL, Luciano M, Auyeung B. Longitudinal effects of breast feeding on parent-reported child behaviour. Arch Dis Child 2021; 106:355-360. [PMID: 33168523 DOI: 10.1136/archdischild-2020-319038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 08/12/2020] [Accepted: 08/23/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Shorter breastfeeding duration has been linked to a range of difficulties in children. However, evidence linking shorter breastfeeding duration to child behavioural problems has been inconclusive. Owing to an almost exclusive focus on early childhood in previous research, little is known about breastfeeding effects on behaviour throughout childhood and adolescence. This study examines the longitudinal effect of breast feeding on parent-reported behaviour in children aged 3-14. DESIGN Data come from the Millennium Cohort Study, a large, prospective, UK birth cohort study. PARTICIPANTS 11 148 children, their parents and teachers. METHODS This study maps the effect of breastfeeding duration on parent-reported child behaviour longitudinally, using latent growth curve modelling and on teacher-reported child behaviour using multiple regression analyses. Breastfeeding duration was assessed through parent interviews when the child was 9 months old. Children's behavioural development was measured using parent-reported Strengths and Difficulties Questionnaires (SDQ) at 3, 5, 7, 11 and 14 years and teacher-reported SDQs at 7 and 11 years. RESULTS Breast feeding was associated with fewer parent-reported behavioural difficulties at all ages even after adjusting for potential confounders (<2 months: B=-0.22, 95% CI -0.39 to -0.04; 2-4 months: B=-0.53, 95% CI -0.75 to -0.32; 4-6 months: B=-1.07, 95% CI -1.33 to -0.81; >6 months: B=-1.24, 95% CI -1.44 to -1.04; B=adjusted mean difference of raw SDQ scores at age 3, reference: never breast fed). CONCLUSION This study provides further evidence supporting links between breastfeeding duration and children's socioemotional behavioural development. Potential implications include intervention strategies encouraging breast feeding.
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Affiliation(s)
- Lydia Gabriela Speyer
- School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, Edinburgh, UK
| | - Hildigunnur Anna Hall
- School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, Edinburgh, UK
| | - Anastasia Ushakova
- School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, Edinburgh, UK.,Department of Psychology, Lancaster University, Lancaster, UK
| | - Aja Louise Murray
- School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, Edinburgh, UK
| | - Michelle Luciano
- School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, Edinburgh, UK
| | - Bonnie Auyeung
- School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, Edinburgh, UK.,Department of Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK
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Workplace programmes for supporting breast-feeding: a systematic review and meta-analysis. Public Health Nutr 2020; 24:1501-1513. [PMID: 33050979 DOI: 10.1017/s1368980020004012] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To critically review the literature regarding workplace breast-feeding interventions and to assess their impact on breast-feeding indicators. DESIGN A systematic review and meta-analysis was conducted. Electronic searches for workplace intervention studies to support breast-feeding, without restriction on language or study design, were performed in PubMed, CENTRAL, CINAHL, Embase, Web of Science, Business Source Complete, ProQuest-Sociology and ProQuest-Social Science to 13 April 2020. A meta-analysis of the pooled effect of the programmes on breast-feeding indicators was conducted. RESULTS The search identified 10 215 articles; fourteen studies across eighteen publications met eligibility criteria. Programmes were delivered in the USA (n 10), Turkey (n 2), Thailand (n 1) or Taiwan (n 1). There were no randomised controlled trials. The pooled OR for exclusive breast-feeding at 3 or 6 months for participants v. non-participants of three non-randomised controlled studies was 3·21 (95 % CI 1·70, 6·06, I2 = 22 %). Despite high heterogeneity, other pooled outcomes were consistently in a positive direction with acceptable CI. Pooled mean duration of breast-feeding for five single-arm studies was 9·16 months (95 % CI 8·25, 10·07). Pooled proportion of breast-feeding at 6 months for six single-arm studies was 0·76 (95 % CI 0·66, 0·84) and breast-feeding at 12 months for three single-arm studies was 0·41 (95 % CI 0·22, 0·62). Most programmes were targeted at mothers; two were targeted at expectant fathers. CONCLUSIONS Workplace programmes may be effective in promoting breast-feeding among employed mothers and partners of employed fathers. However, no randomised controlled trials were identified, and better-quality research on workplace interventions to improve breast-feeding is needed.
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Kim KM, Choi JW. Associations between breastfeeding and cognitive function in children from early childhood to school age: a prospective birth cohort study. Int Breastfeed J 2020; 15:83. [PMID: 32993704 PMCID: PMC7526146 DOI: 10.1186/s13006-020-00326-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 09/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite evidences of breastfeeding for preventing acute physical illnesses in infants, the evidence for the association between breastfeeding and long-term cognitive development is not yet convincing. METHODS The data of nationwide representative sample of 1752 children born between 2008 and 2009 in Korea were prospectively assessed from the fetal period to examine the benefits of breastfeeding and cognitive development. Breastfeeding duration was prospectively assessed by parents. The Korean Ages and Stages Questionnaire and the Korean version of Denver II were used to assess early development annually from 5.5 to 26.2 months of age. Language development at 3 years of age was assessed with Receptive and Expressive Vocabulary Tests. Cognitive function at 8 years of age was assessed using multifactorial intelligence test. RESULTS In the analysis of categorical variables, children who were breastfed for > 1 and ≤ 3 months displayed significantly higher odds ratios for delayed development assessed with Korean Ages and Stages Questionnaire at 14.1 months than those breastfed for > 3 and ≤ 6 months (OR = 2.21; 95% CI: 1.08, 4.50), but no significant differences in other rounds of assessments. In the analysis with continuous variables, there were significant differences among six groups of breastfeeding duration in communication (F = 3.72; p < 0.002) and problem solving (F = 3.09; p < 0.009) at 14.1 months, expressive language (F = 3.74; p = 0.002) at 3 years, and calculation (F = 2.43; p < 0.033) at 8 years. When analyzed by two groups, children breastfed for > 3 months scored significantly higher on the communication (F = 17.71; p < 0.001) and problem-solving (F = 11.26; p < 0.001) subscales at 14.1 months, and expressive language (F = 12.85; p < 0.001) at 3 years, and vocabulary (F = 6.78; p = 0.009) and language inference (F = 5.62; p = 0.018) at 8 years, compared to children breastfed for 3 months or less. CONCLUSION We found that cognitive development was improved in children that were breastfed for > 3 months. Although these results are supported by previous studies, it is important to note that other factors were reported as larger determinants of cognitive development than breastfeeding. Future studies that examine the underlying mechanism for the association between breastfeeding and cognitive development are warranted.
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Affiliation(s)
- Kyoung Min Kim
- Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea. .,Department of Psychiatry, Dankook University College of Medicine, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam-do, 31116, Republic of Korea.
| | - Jae-Won Choi
- Department of Psychiatry, Gyeongsang National University Hospital, 79, Gangnam-ro, Jinju-si, Gyeongsangnam-do, 52727, Republic of Korea.
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Sepehrmanesh Z, Moraveji A, Ahmadvand A, Mehri Z. The Duration of Breastfeeding and Attention-Deficit Hyperactivity Disorder in School-Aged Children. Compr Child Adolesc Nurs 2020; 45:1-9. [PMID: 32841578 DOI: 10.1080/24694193.2020.1797236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood-onset neurodevelopmental disorders. In some recent studies breastfeeding had positive effects on physical health and mental development of children and these studies have recommended further studies in this issue. This study evaluated the relationship between duration of breastfeeding and ADHD. This case-control study was carried out in 2017 on 404 children aged 7-12 (196 children with ADHD and 208 children without ADHD). The questionnaire included items on the risk factors such as the child's sex, age, delivery method, birth weight, birth rank, gestational age, age of mother, duration of breastfeeding, history of neonatal hospitalization, history of drug use in neonatal period, history of drug use in pregnancy, history of hypothyroidism and hyperthyroidism in pregnancy, history of neonatal icter, history of neonatal blood exchange. Data were analyzed using t-test, chi-square and logistic regression. The mean of breastfeeding duration in children with ADHD was 17.05 ± 7.52 months compared with 18.59 ± 6.74 months in control group (p = .03). A stepwise logistic regression that included the variables was found to be significant in univariate analysis, demonstrating a significant association between ADHD and breastfeeding duration (p = .01), male gender (OR = 2.8), mother hypothyroidism(OR = 4.5) and history of drug use in neonatal period (OR = 1.9). Long-term duration of breastfeeding (more than 12 months) could be a protective factor in ADHD. However, further studies are required.
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Affiliation(s)
- Zahra Sepehrmanesh
- Department of Psychiatry, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Alireza Moraveji
- Department of Epidemiology, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Afshin Ahmadvand
- Department of Psychiatry, Clinical Research Development Unit Matini/Kargarnejad Hospitals, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Zohreh Mehri
- Department of Psychiatry, Kashan University of Medical Sciences, Kashan, I.R. Iran
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Association of infant and young child feeding practices with cognitive development at 10–12 years: a birth cohort in rural Western China. Br J Nutr 2019; 123:768-779. [DOI: 10.1017/s0007114519003271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractWe aimed to comprehensively examine the association of breast-feeding, types and initial timing of complementary foods with adolescent cognitive development in low- and middle-income countries. We conducted a prospective cohort study of 745 adolescents aged 10–12 years who were born to women who participated in a randomised trial of prenatal micronutrient supplementation in rural Western China. An infant feeding index was constructed based on the current WHO recommendations. Full-scale intelligence quotient (FSIQ) was assessed and derived by the fourth edition of the Wechsler Intelligence Scale for Children. The duration of exclusive or any breast-feeding was not significantly associated with adolescent cognitive development. Participants who regularly consumed Fe-rich or Fe-fortified foods during 6–23 months of age had higher FSIQ than those who did not (adjusted mean differences 4·25; 95 % CI 1·99, 6·51). For cows’/goats’ milk and high protein-based food, the highest FSIQ was found in participants who initially consumed at 10–12 and 7–9 months, respectively. A strong dose–response relationship of the composite infant feeding index was also identified, with participants in the highest tertile of overall feeding quality having 3·03 (95 % CI 1·37, 4·70) points higher FSIQ than those in the lowest tertile. These findings suggest that appropriate infant feeding practices (breast-feeding plus timely introduction of appropriate complementary foods) were associated with significantly improved early adolescent cognitive development scores in rural China. In addition, improvement in Fe-rich or Fe-fortified foods complementary feeding may produce better adolescent cognitive development outcomes.
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Strøm M, Mortensen EL, Kesmodel US, Halldorsson T, Olsen J, Olsen SF. Is breast feeding associated with offspring IQ at age 5? Findings from prospective cohort: Lifestyle During Pregnancy Study. BMJ Open 2019; 9:e023134. [PMID: 31152024 PMCID: PMC6549733 DOI: 10.1136/bmjopen-2018-023134] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/26/2019] [Accepted: 05/01/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Breast feeding is associated with health benefits for both mother and child, but many studies focusing on neurodevelopment have lacked information on important confounders and few randomised trials exist. Our objective was to examine the influence of breast feeding on child IQ at 5 years of age while taking maternal IQ and other relevant factors into account. DESIGN Prospective observational study. SETTING Population-based birth cohort in Denmark. PARTICIPANTS We used data from The Lifestyle During Pregnancy Study 1782 mother-child pairs sampled from the Danish National Birth Cohort (n=101 042). OUTCOME MEASURES Child IQ was assessed at age 5 years by the Wechsler Primary and Preschool Scales of Intelligence-Revised. On the same occasion maternal intelligence was assessed by Wechsler Adult Intelligence Scale and Raven's Standard Progressive Matrices. Exposure data on duration of breast feeding (n=1385) were extracted from telephone interviews conducted when the child was 6 and 18 months, and analyses were weighted by relevant sampling fractions. RESULTS In multivariable linear regression analyses adjusted for potential confounders breast feeding was associated with child IQ at 5 years (categorical χ2 test for overall association p=0.03). Compared with children who were breast fed ≤1 month, children breast fed for 2-3, 4-6, 7-9 and 10 or more months had 3.06 (95% CI 0.39 to 5.72), 2.03 (95% CI -0.38 to 4.44), 3.53 (95% CI 1.18 to 5.87) and 3.28 (95% CI 0.88 to 5.67) points higher IQ after adjustment for core confounders, respectively. There was no dose-response relation and further analyses indicated that the main difference in IQ was between breast feeding ≤1 month versus >1 month. CONCLUSIONS Breastfeeding duration of 1 month or shorter compared with longer periods was associated with approximately three points lower IQ, but there was no evidence of a dose-response relation in this prospective birth cohort, where we were able to adjust for some of the most critical confounders, including maternal intelligence.
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Affiliation(s)
- Marin Strøm
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Erik Lykke Mortensen
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Schiøler Kesmodel
- Department of Obstetrics of Gynecology, Herlev University Hospital, Herlev, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thorhallur Halldorsson
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavík, Iceland
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavík, Iceland
| | - Jørn Olsen
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Sjurdur F Olsen
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Martins BP, Bandarra NM, Figueiredo-Braga M. The role of marine omega-3 in human neurodevelopment, including Autism Spectrum Disorders and Attention-Deficit/Hyperactivity Disorder – a review. Crit Rev Food Sci Nutr 2019; 60:1431-1446. [DOI: 10.1080/10408398.2019.1573800] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Bárbara P. Martins
- Department of Clinical Neurosciences and Mental Health, Medical Psychology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Narcisa M. Bandarra
- Department of Sea and Marine Resources, Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
| | - Margarida Figueiredo-Braga
- Department of Clinical Neurosciences and Mental Health, Medical Psychology, Faculty of Medicine, University of Porto, Porto, Portugal
- Research Group: Metabolism, Nutrition & Endocrinology, i3S Instituto de Investigação e Inovação em Saúde, Porto, Portugal
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Fallon B, Filippelli J, Joh-Carnella N, Milne E, Carradine J. Promoting Protective Factors in Environments of Risk for Young Children: An Organizing Framework for Practice, Policy, and Research. GENDER AND THE GENOME 2018. [DOI: 10.1177/2470289718820843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Early childhood is an important developmental period, which lays the foundation for future learning, behaviour, physical and mental health and gene expression. The most vulnerable children in society are often referred to and receive services from the child welfare system because of a concern of abuse and neglect and/or a poor developmental trajectory. This paper presents an organizing framework for how the child welfare system, in concert with allied partners, can support interventions for young children and families by acknowledging its crucial role in improving their development and well-being. The framework is informed by research amassed from numerous disciplines, including child welfare, development, neuroscience, neurobiology and epigenetics. Although the notions of protection and well-being are central considerations in child welfare legislation in Ontario, Canada, the operationalization of wellbeing has proven challenging in child welfare practice, policy and research. The framework proposes ten key indicators and priorities for identifying and promoting optimal child development. Findings from the 2013 cycle of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS-2013), the only provincial source of aggregated child welfare investigation data, are presented to articulate the divide between the environmental context of a population of at-risk children and the conditions that both protect children and increase the likelihood that they will thrive in adulthood. This paper argues there are different points of entry and intervention across sectors and provides a foundation for further discussion on how to promote well-being for society's most vulnerable children.
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Affiliation(s)
- Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Joanne Filippelli
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | | | - Elizabeth Milne
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Jessica Carradine
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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Garthus-Niegel S, Horsch A, Ayers S, Junge-Hoffmeister J, Weidner K, Eberhard-Gran M. The influence of postpartum PTSD on breastfeeding: A longitudinal population-based study. Birth 2018; 45:193-201. [PMID: 29265443 DOI: 10.1111/birt.12328] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND In most Western countries, breastfeeding rates are lower than what is recommended by the World Health Organization. Depression has been shown to influence breastfeeding outcomes; however, there is very little research on the role of postpartum posttraumatic stress disorder (PTSD). This study examined to what extent maternal postpartum PTSD predicted breastfeeding initiation, exclusive breastfeeding during the first 6 months, and continuation up to 1 and 2 years. METHODS The study is part of the large, population-based Akershus Birth Cohort. Data from the hospital's birth record and questionnaire data from 8 weeks and 2 years postpartum were used (n = 1480). All breastfeeding variables significantly correlated with postpartum PTSD were entered into stepwise logistic regression analyses. RESULTS Although most mothers (97.1%) initiated breastfeeding, considerably fewer adhered to the World Health Organization's breastfeeding guidelines about exclusive breastfeeding during the first 6 months (13.4%) or continued breastfeeding for 12 or 24 months postpartum (37.7% and 4.2%, respectively). Even after adjustment for important confounding variables, maternal postpartum PTSD was significantly associated with not initiating breastfeeding (aOR 5.98 [95% CI 1.79-19.97]). Postpartum PTSD was also significantly related to not continuing breastfeeding up to 12 months, although this association did not hold after adjusting for confounding variables. CONCLUSION Identifying women at risk of not initiating breastfeeding is crucial to prevent a negative influence on infant development and the development of the mother-infant bond. Early screening and treatment of women at risk of developing postpartum PTSD might be a way forward.
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Affiliation(s)
- Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.,Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Antje Horsch
- Department Woman-Mother-Child, University Hospital Lausanne, Lausanne, Switzerland.,Institute of Higher Education in Healthcare Research (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Juliane Junge-Hoffmeister
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Malin Eberhard-Gran
- Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway.,HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Lørenskog, Norway
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The Relationship Between Breastfeeding Duration and Preschooler Problem Behavior:
The Mediating Role of Cognitive Development. ADONGHAKOEJI 2017. [DOI: 10.5723/kjcs.2017.38.6.63] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abstract
In Spain, immigrant women have high rates for initiating breastfeeding. In contrast, the case of immigrant Chinese mothers stands out, due to the low rate. In China, breastfeeding has historically been the cultural norm. An ethnographic study was conducted to explore aspects related to the low rate of breastfeeding. Field observations and informal interviews were conducted in two hospitals and a primary care center. Semi-structured interviews were performed with Chinese mothers and health workers. Among Spanish health workers, there is a belief that Chinese women do not breastfeed due to cultural reasons. The rapid return to work and the popular phenomenon of sending babies back to China for grandparents to raise constitute barriers for breastfeeding. Although in China breastfeeding is common practice, in Madrid the prioritization of productivity over reproduction and the existence of the so-called "satellite babies" and transnational maternity make the establishment and maintenance of breastfeeding difficult.
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Albeshan SM, Mackey MG, Hossain SZ, Alfuraih AA, Brennan PC. Breast Cancer Epidemiology in Gulf Cooperation Council Countries: A Regional and International Comparison. Clin Breast Cancer 2017; 18:e381-e392. [PMID: 28781021 DOI: 10.1016/j.clbc.2017.07.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/03/2017] [Accepted: 07/09/2017] [Indexed: 01/25/2023]
Abstract
Breast cancer is the most frequently diagnosed noncutaneous malignancy in women living in Gulf Cooperation Council countries. The present report aimed to highlight the similarities and variations in breast cancer incidence, age at diagnosis, clinicopathologic features, molecular characteristics, and lifestyle factors that contribute to an increasing incidence of breast cancer compared with neighboring Arab and westernized countries. The data presented, although having important implications for policy makers, also highlights the need for further research. Such research would ensure that effective prevention and detection strategies are tailored to the specific needs of the Gulf women such that the management of breast cancer is optimized.
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Affiliation(s)
- Salman M Albeshan
- Medical Radiation Sciences, Medical Image Optimization and Perception Group, University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia; Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
| | - Martin G Mackey
- Discipline of Physiotherapy, University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
| | - Syeda Z Hossain
- Discipline of Behavioral and Social Sciences in Health, University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
| | - Abdulrahman A Alfuraih
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Patrick C Brennan
- Medical Radiation Sciences, Medical Image Optimization and Perception Group, University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
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19
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Breastfeeding and motor development: A longitudinal cohort study. Hum Mov Sci 2017; 51:9-16. [DOI: 10.1016/j.humov.2016.10.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/17/2016] [Accepted: 10/03/2016] [Indexed: 01/18/2023]
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Thomas-Jackson SC, Bentley GE, Keyton K, Reifman A, Boylan M, Hart SL. In-hospital Breastfeeding and Intention to Return to Work Influence Mothers' Breastfeeding Intentions. J Hum Lact 2016; 32:NP76-NP83. [PMID: 26243753 DOI: 10.1177/0890334415597636] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Research continues to demonstrate that formula feeding is associated with numerous long-term negative outcomes for a mother and her infant. However, many women cease breastfeeding sooner than intended and recommended. Breastfeeding has been found to be related to demographics, maternal mood, and returning to work outside the home. OBJECTIVES This study aimed to shed light on the woman's perception of the effect of working on intended breastfeeding duration. This study used intentions to return to work and in-hospital breastfeeding to predict breastfeeding intentions. METHODS Women (N = 160) were surveyed during the first 48 hours postdelivery of healthy, full-term infants. Survey instruments included demographics (socioeconomic status, maternal age, education, and marital status), depression, fetal attachment, current exclusive breastfeeding status, as well as breastfeeding and return-to-work intentions for the next year. A path analysis was used to explore relationships and predictors of breastfeeding intentions. RESULTS The model had a good fit and breastfeeding intentions were predicted by exclusive breastfeeding in the hospital (β = 0.21, P < .01) and negatively predicted by return to work (β = -0.18, P < .05). CONCLUSION Exclusive breastfeeding in the hospital within the first 48 hours postpartum and intention to return to work influence how long a mother intends to breastfeed. Attention to these areas can be provided immediately postpartum to support exclusive breastfeeding and provide informational support on continuing to breastfeed/express milk upon return to work if the mother intends to return to work.
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Abstract
AIM This study was aimed at systematically reviewing evidence of the association between breastfeeding and performance in intelligence tests. METHODS Two independent searches were carried out using Medline, LILACS, SCIELO and Web of Science. Studies restricted to infants and those where estimates were not adjusted for stimulation or interaction at home were excluded. Fixed- and random-effects models were used to pool the effect estimates, and a random-effects regression was used to assess potential sources of heterogeneity. RESULTS We included 17 studies with 18 estimates of the relationship between breastfeeding and performance in intelligence tests. In a random-effects model, breastfed subjects achieved a higher IQ [mean difference: 3.44 points (95% confidence interval: 2.30; 4.58)]. We found no evidence of publication bias. Studies that controlled for maternal IQ showed a smaller benefit from breastfeeding [mean difference 2.62 points (95% confidence interval: 1.25; 3.98)]. In the meta-regression, none of the study characteristics explained the heterogeneity among the studies. CONCLUSION Breastfeeding is related to improved performance in intelligence tests. A positive effect of breastfeeding on cognition was also observed in a randomised trial. This suggests that the association is causal.
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Affiliation(s)
- Bernardo L Horta
- Postgraduate Program in Epidemiology; Universidade Federal de Pelotas; Pelotas Brazil
| | | | - Cesar G Victora
- Postgraduate Program in Epidemiology; Universidade Federal de Pelotas; Pelotas Brazil
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Smith JM. Breastfeeding and language outcomes: A review of the literature. JOURNAL OF COMMUNICATION DISORDERS 2015; 57:29-40. [PMID: 26028604 DOI: 10.1016/j.jcomdis.2015.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 04/10/2015] [Accepted: 04/19/2015] [Indexed: 05/15/2023]
Abstract
UNLABELLED Many researchers have investigated the potential impact of breastfeeding in infancy on a child's subsequent development, but only a small subset of these studies considers language development and impairment. This paper reviews that literature, discussing postnatal neurodevelopment, potential mechanisms for dietary influences on communication outcomes, studies of typically developing children, and studies of children with communication concerns. For population based studies of language development, a modest but statistically robust relationship is seen across large samples that account for breastfeeding exclusivity. A similar protective relationship is seen in studies that evaluate the relationship between breastfeeding and language disorders; effect sizes are typically larger in these papers. Implications for researchers and service providers are reviewed. LEARNING OUTCOMES Readers will be able to describe possible mechanisms by which early diet might influence neurodevelopment. They will be able to describe the relationships observed between diet in infancy and language outcomes in large population-based studies, as well as the trends observed in studies of the relationship between infant diet and communication impairment.
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Nyaradi A, Oddy WH, Hickling S, Li J, Foster JK. The Relationship between Nutrition in Infancy and Cognitive Performance during Adolescence. Front Nutr 2015; 2:2. [PMID: 26082928 PMCID: PMC4451795 DOI: 10.3389/fnut.2015.00002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 01/21/2015] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES In this study, we aimed to investigate the long-term associations between breastfeeding duration during infancy, diet quality as measured by a diet score at 1 year of age, and cognitive performance during adolescence. METHODS Participants (n = 717) were recruited from the West Australian Pregnancy Cohort (Raine) Study, a prospective longitudinal study of 2868 children and their families based in Perth, WA, Australia. Breastfeeding duration and an early diet score at age 1 year were used as the main predictor variables, while a computerized cognitive battery (CogState) was used to assess adolescents' cognitive performance at 17 years. The diet score, which has seven food group components, was based on a 24-h recall questionnaire completed by the mother at 1 year of age. A higher diet score represents a better, more nutritious eating pattern. Associations between breastfeeding duration, diet score, and cognitive performance were assessed in multivariable regression models. RESULTS Higher diet scores at 1 year representing better diet quality were significantly associated with faster reaction times in cognitive performance at 17 years [Detection Task (DET): β = -0.004, 95% CI: -0.008; 0.000, p = 0.036; Identification Task (IDN): β = -0.004, 95% CI: -0.008; 0.000, p = 0.027]. Breastfeeding duration (≥4 months) was also significantly associated with a shorter reaction time, but only for males (DET: β = -0.026, 95% CI: -0.046; -0.006, p = 0.010). CONCLUSION Nutrition in early childhood may have a long-term association with fundamental cognitive processing speed, which is likely to be related to enhanced brain development in the first year of life.
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Affiliation(s)
- Anett Nyaradi
- School of Population Health, The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Wendy H. Oddy
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Siobhan Hickling
- School of Population Health, The University of Western Australia, Perth, WA, Australia
| | - Jianghong Li
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- WZB Berlin Social Research Center, Berlin, Germany
- Faculty of Health Sciences, Centre for Population Health Research, Curtin University, Perth, WA, Australia
| | - Jonathan K. Foster
- School of Psychology and Speech Pathology, Curtin University, Perth, WA, Australia
- Neurosciences Unit, Health Department of Western Australia, Perth, WA, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia
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Park S, Kim BN, Kim JW, Shin MS, Yoo HJ, Cho SC. Protective effect of breastfeeding with regard to children's behavioral and cognitive problems. Nutr J 2014; 13:111. [PMID: 25433771 PMCID: PMC4280748 DOI: 10.1186/1475-2891-13-111] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 10/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breastfeeding has been associated with a lower risk for behavioral problems in childhood. However, it is uncertain whether these associations are mediated by the mother's or child's IQ. We examined the association between breastfeeding and attention-deficit hyperactivity disorder (ADHD) and other behavioral problems in childhood and assessed the role of the child's IQ and the mother's IQ in generating this association. FINDINGS The current study included 874 children (8-11 years) recruited from schools in five Korean cities. Mothers were asked about nursing, and the prevalence of attention-deficit hyperactivity disorder (ADHD) and behavioral problems were compared between children who were breastfed and those who were not breastfed. After adjusting for age, gender, area of residence, and yearly family income, a lack of breastfeeding was associated with increased internalizing, externalizing, and overall behavioral problems as well as the diagnosis of ADHD. These associations weakened but mostly remained significant after adjusting for child's IQ and maternal IQ. In addition, a lack of breastfeeding was associated with low child's IQ and this association weakened, but remained significant even after adjusting for maternal IQ and the diagnosis of ADHD. CONCLUSIONS This study suggests that there is a protective effect of breastfeeding on childhood behavioral outcomes with a partial mediation of this effect by the child's IQ, and there is a positive effect of breastfeeding on childhood intelligence with a partial mediation of this effect by the child's attention problem.
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Affiliation(s)
| | | | | | | | | | - Soo-Churl Cho
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 101 Daehak-No, Chongno-Gu, Seoul, Korea.
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Breastfeeding and behavioral development: a nationwide longitudinal survey in Japan. J Pediatr 2014; 164:1019-1025.e3. [PMID: 24529622 DOI: 10.1016/j.jpeds.2014.01.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 12/10/2013] [Accepted: 01/07/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To prospectively examine the prolonged effect of breastfeeding on behavioral development. STUDY DESIGN We used a large, nationwide Japanese population-based longitudinal survey that began in 2001. We restricted participants to term singletons with birth weight >2500 g (n = 41 188). Infant feeding practice was queried at age 6-7 months. Responses to survey questions about age-appropriate behaviors at age 2.5 and 5.5 years were used as indicators of behavioral development. We conducted logistic regression analyses, controlling for potential child and parental confounding factors, with formula feeding as the reference group. RESULTS We observed a dose-response relationship between breastfeeding status and an inability to perform age-appropriate behaviors at both ages. With a single exception, all ORs for outcomes for exclusive breastfeeding were smaller than those for partial feeding of various durations. The protective associations did not change after adjustment for an extensive list of confounders or in the sensitivity analyses. CONCLUSION We observed prolonged protective effects of breastfeeding on developmental behavior skills surveyed at age 2.5 and 5.5 years. Beneficial effects were most likely in children who were breastfed exclusively, but whether a biological ingredient in breast milk or extensive interactions through breastfeeding, or both, is beneficial is unclear.
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Hsi HC, Jiang CB, Yang TH, Chien LC. The neurological effects of prenatal and postnatal mercury/methylmercury exposure on three-year-old children in Taiwan. CHEMOSPHERE 2014; 100:71-76. [PMID: 24461425 DOI: 10.1016/j.chemosphere.2013.12.068] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 12/16/2013] [Accepted: 12/20/2013] [Indexed: 06/03/2023]
Abstract
This study attempts to elucidate the relationship between neurological effects and mercury/methylmercury concentrations in various biomarkers, including meconium, hair, fingernail, and toenail. Eight-three mother-infant pairs were recruited between August 2008 and December 2009, and follow-up examinations on these children were completed after three years. The Bayley Scales of Infant and Toddler Development (Bayley-III) for evaluating the cognitive, language, and motor development of three-year-old children were calculated and validated. The geometric mean of the total mercury concentration in meconium was 89.6 ng g(-1). The methylmercury concentrations in hair, fingernail, and toenail samples were 1.96, 0.64, and 0.55 μg g(-1), respectively. Seventy percent of children had hair methylmercury concentrations exceeding the U.S. environmental protection agency (EPA) reference of 1 μg g(-1). A significantly positive correlation was obtained between methylmercury levels in hair, fingernail, and toenail. These methylmercury levels were also significantly positively correlated with the children's fish intake and negatively correlated with a Bayley-III scale score of expressive language. The prenatal mercury exposure, however, did not show significant influence on neurological development. High fish consumption appears to be a critical risk factor for methylmercury levels in children and may cause a lower expressive language score.
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Affiliation(s)
- Hsing-Cheng Hsi
- Graduate Institute of Environmental Engineering, National Taiwan University, Taiwan
| | - Chuen-Bin Jiang
- Department of Pediatrics, Taipei Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Tzu-Hsuan Yang
- School of Public Health, Taipei Medical University, Taiwan
| | - Ling-Chu Chien
- School of Public Health, Taipei Medical University, Taiwan.
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Peyre H, Bernard JY, Forhan A, Charles MA, De Agostini M, Heude B, Ramus F. Predicting changes in language skills between 2 and 3 years in the EDEN mother-child cohort. PeerJ 2014; 2:e335. [PMID: 24749012 PMCID: PMC3976115 DOI: 10.7717/peerj.335] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 03/16/2014] [Indexed: 11/20/2022] Open
Abstract
Objective. To examine the factors predicting changes in language skills between 2 and 3 years. Methods. By using longitudinal data concerning 1002 children from the EDEN study, linear regression was used to predict 3-year language performance from 2-year language performance and the risk factors associated with language delays. Logistic regressions were performed to examine two change trajectories: children who fall below the 10th percentile of language skills between 2 and 3 years (declining trajectory), and those who rose above the 10th percentile (resilient trajectory). Results. The final linear model accounted for 43% of the variance in 3-year language scores, with 2-year language scores accounting for 22%. Exposure to alcohol during pregnancy, earlier birth term, lower level of parental education and lower frequency of maternal stimulation were associated with the declining trajectory. Breastfeeding was associated with the resilient trajectory. Conclusions. This study provides a better understanding of the natural history of early language delays by identifying biological and social factors that predict changes in language skills between the ages of 2 and 3 years.
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Affiliation(s)
- Hugo Peyre
- Laboratoire de Sciences Cognitives et Psycholinguistique, Ecole Normale Supérieure, CNRS, EHESS , Paris , France ; Hôpital Robert Debré, Service de Psychopathologie de l'Enfant et de l'Adolescent, APHP , Paris , France
| | - Jonathan Y Bernard
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), Epidemiology of Diabetes and Renal Diseases Lifelong Approach Team , Villejuif , France ; University Paris-Sud, UMRS , Villejuif , France
| | - Anne Forhan
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), Epidemiology of Diabetes and Renal Diseases Lifelong Approach Team , Villejuif , France ; University Paris-Sud, UMRS , Villejuif , France
| | - Marie-Aline Charles
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), Epidemiology of Diabetes and Renal Diseases Lifelong Approach Team , Villejuif , France ; University Paris-Sud, UMRS , Villejuif , France
| | - Maria De Agostini
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), Epidemiology of Diabetes and Renal Diseases Lifelong Approach Team , Villejuif , France ; University Paris-Sud, UMRS , Villejuif , France
| | - Barbara Heude
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), Epidemiology of Diabetes and Renal Diseases Lifelong Approach Team , Villejuif , France ; University Paris-Sud, UMRS , Villejuif , France
| | - Franck Ramus
- Laboratoire de Sciences Cognitives et Psycholinguistique, Ecole Normale Supérieure, CNRS, EHESS , Paris , France
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Breastfeeding, parenting, and early cognitive development. J Pediatr 2014; 164:487-93. [PMID: 24268637 DOI: 10.1016/j.jpeds.2013.10.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/26/2013] [Accepted: 10/04/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To explain why breastfeeding is associated with children's cognitive development. STUDY DESIGN By using a nationally representative longitudinal survey of early childhood (N = 7500), we examined how breastfeeding practices, the early introduction of solid foods, and putting an infant to bed with a bottle were associated with cognitive development across early childhood. We also explored whether this link can be explained by parenting behaviors and maternal education. RESULTS There is a positive relationship between predominant breastfeeding for 3 months or more and child reading skills, but this link is the result of cognitively supportive parenting behaviors and greater levels of education among women who predominantly breastfed. We found little-to-no relationship between infant feeding practices and the cognitive development of children with less-educated mothers. Instead, reading to a child every day and being sensitive to a child's development were significant predictors of math and reading readiness outcomes. CONCLUSIONS Although breastfeeding has important benefits in other settings, the encouragement of breastfeeding to promote school readiness does not appear to be a key intervention point. Promoting parenting behaviors that improve child cognitive development may be a more effective and direct strategy for practitioners to adopt, especially for disadvantaged children.
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Liu J, Leung P, Yang A. Breastfeeding and active bonding protects against children's internalizing behavior problems. Nutrients 2013; 6:76-89. [PMID: 24368674 PMCID: PMC3916850 DOI: 10.3390/nu6010076] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 12/04/2013] [Accepted: 12/10/2013] [Indexed: 02/04/2023] Open
Abstract
Breastfeeding is associated with numerous health benefits to offspring and mothers and may improve maternal-infant bonding. Ample evidence suggests breastfeeding can improve child neurodevelopment, but more research is needed to establish whether breastfeeding is linked to the development of child psychopathology. This paper aims to explore the effects of both breastfeeding and mother-child interactions on child behavioral outcomes at a later age. Children from the China Jintan Child Cohort Study (N = 1267), at age six years old were assessed, along with their parents. Children who were breastfed exclusively for a period of time in the presence of active bonding were compared to those who were breastfed in the absence of active bonding as well as to children who were not exclusively breastfed, with or without active bonding. Results from ANOVA and GLM, using SPSS20, indicate that children who were breastfed and whose mothers actively engaged with them displayed the lowest risk of internalizing problems (mean = 10.01, SD = 7.21), while those who were neither exclusively breastfed nor exposed to active bonding had the least protection against later internalizing problems (mean = 12.79, SD = 8.14). The effect of breastfeeding on internalizing pathology likely represents a biosocial and holistic effect of physiological, and nutritive, and maternal-infant bonding benefits.
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Affiliation(s)
- Jianghong Liu
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-215-898-8293
| | - Patrick Leung
- Department of Psychology, Chinese University of Hong Kong, Hong Kong, China; E-Mail:
| | - Amy Yang
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA 19104, USA; E-Mail:
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Nyaradi A, Li J, Hickling S, Whitehouse AJO, Foster JK, Oddy WH. Diet in the early years of life influences cognitive outcomes at 10 years: a prospective cohort study. Acta Paediatr 2013; 102:1165-73. [PMID: 23879236 DOI: 10.1111/apa.12363] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/01/2013] [Accepted: 07/17/2013] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to investigate the association between diet during the first 3 years of life and cognitive outcomes at 10 years of age. METHODS The Raine Study is a longitudinal study of 2868 children and their families. Based on the foods reported to be eaten at age one, two and three, an Eating Assessment in Toddlers diet score was developed, consisting of seven components. Cognition was measured by the Peabody Picture Vocabulary Test-III (PPVT-III) and the Raven's Coloured Progressive Matrices at the 10-year follow-up. Associations were assessed in multivariate regression models. RESULTS A higher Eating Assessment in Toddlers diet score at age one was associated with higher PPVT-III [β = 0.12 (0.05, 0.19), p = 0.001] and Raven's Coloured Progressive Matrices scores [β = 0.17 (0.02, 0.33), p = 0.025] at age ten after adjustments. Increased fruit consumption at age one was positively associated, while increased sweetened beverage consumption was negatively associated with cognitive development. Dairy consumption at ages two and three had positive associations with the PPVT-III and at age two with the Raven's Coloured Progressive Matrices. CONCLUSION A better diet quality during the early years of life may have a positive effect on cognitive ability later in childhood.
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Affiliation(s)
- Anett Nyaradi
- School of Population Health; The University of Western Australia; Perth WA Australia
- Telethon Institute for Child Health Research; Centre for Child Health Research; The University of Western Australia; Perth WA Australia
| | - Jianghong Li
- Telethon Institute for Child Health Research; Centre for Child Health Research; The University of Western Australia; Perth WA Australia
- Centre for Population Health Research; The Faculty of Health Sciences; Curtin University; Perth WA Australia
- WZB Berlin Social Research Center; Berlin Germany
| | - Siobhan Hickling
- School of Population Health; The University of Western Australia; Perth WA Australia
- Telethon Institute for Child Health Research; Centre for Child Health Research; The University of Western Australia; Perth WA Australia
| | - Andrew JO Whitehouse
- Telethon Institute for Child Health Research; Centre for Child Health Research; The University of Western Australia; Perth WA Australia
| | - Jonathan K Foster
- Telethon Institute for Child Health Research; Centre for Child Health Research; The University of Western Australia; Perth WA Australia
- School of Psychology & Speech Pathology; Curtin University; Perth WA Australia
- Neurosciences Unit; Health Department of Western Australia; Perth WA Australia
- School of Paediatrics & Child Health; The University of Western Australia; Perth WA Australia
| | - Wendy H Oddy
- Telethon Institute for Child Health Research; Centre for Child Health Research; The University of Western Australia; Perth WA Australia
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Jonsdottir OH, Thorsdottir I, Gunnlaugsson G, Fewtrell MS, Hibberd PL, Kleinman RE. Exclusive breastfeeding and developmental and behavioral status in early childhood. Nutrients 2013; 5:4414-28. [PMID: 24284608 PMCID: PMC3847739 DOI: 10.3390/nu5114414] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/30/2013] [Accepted: 10/31/2013] [Indexed: 11/18/2022] Open
Abstract
Breastfeeding during infancy may have beneficial effects on various developmental outcomes in childhood. In this study, exclusively breastfed infants were randomly assigned to receive complementary foods from the age of 4 months in addition to breast milk (CF, n = 60), or to exclusively breastfeed to 6 months (EBF, n = 59). At 18 months and again at 30–35 months of age, the children were evaluated with the Parent’s Evaluation of Developmental Status questionnaire (PEDS) and the Brigance Screens-II. The parents completed the PEDS questionnaire at both time intervals and the children underwent the Brigance Screens-II at 30–35 months. At 30–35 months, no significant differences were seen in developmental scores from the Brigance screening test (p = 0.82). However, at 30–35 months a smaller percentage of parents in group CF (2%) had concerns about their children’s gross motor development compared to those in group EBF (19%; p = 0.01), which remained significant when adjusted for differences in pre-randomization characteristics (p = 0.03). No sustained effect of a longer duration of exclusive breastfeeding was seen on selected measures of developmental and behavioral status at 18 months, although at 30–35 months, a smaller percentage of parents of children introduced to complementary foods at four months of age expressed concerns about their gross motor development.
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Affiliation(s)
- Olof H. Jonsdottir
- Unit for Nutrition Research, Landspitali—The National University Hospital of Iceland and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Eiriksgata 29, Reykjavik 101, Iceland; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +354-543-1452; Fax: +354-543-4824
| | - Inga Thorsdottir
- Unit for Nutrition Research, Landspitali—The National University Hospital of Iceland and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Eiriksgata 29, Reykjavik 101, Iceland; E-Mail:
| | - Geir Gunnlaugsson
- Directorate of Health and Reykjavik University, Reykjavik 101, Iceland; E-Mail:
| | - Mary S. Fewtrell
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London WC1N 1EH, UK; E-Mail:
| | - Patricia L. Hibberd
- Division of Global Health, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA 02114, USA; E-Mail:
| | - Ronald E. Kleinman
- Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA 02114, USA; E-Mail:
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Walfisch A, Sermer C, Cressman A, Koren G. Breast milk and cognitive development--the role of confounders: a systematic review. BMJ Open 2013; 3:e003259. [PMID: 23975102 PMCID: PMC3753522 DOI: 10.1136/bmjopen-2013-003259] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The association between breastfeeding and child cognitive development is conflicted by studies reporting positive and null effects. This relationship may be confounded by factors associated with breastfeeding, specifically maternal socioeconomic class and IQ. DESIGN Systematic review of the literature. SETTING AND PARTICIPANTS Any prospective or retrospective study, in any language, evaluating the association between breastfeeding and cognitive development using a validated method in healthy term infants, children or adults, was included. PRIMARY AND SECONDARY OUTCOME MEASURES Extracted data included the study design, target population and sample size, breastfeeding exposure, cognitive development assessment tool used and participants' age, summary of the results prior to, and following, adjustment for confounders, and all confounders adjusted for. Study quality was assessed as well. RESULTS 84 studies met our inclusion criteria (34 rated as high quality, 26 moderate and 24 low quality). Critical assessment of accepted studies revealed the following associations: 21 null, 28 positive, 18 null after adjusting for confounders and 17 positive-diminished after adjusting for confounders. Directionality of effect did not correlate with study quality; however, studies showing a decreased effect after multivariate analysis were of superior quality compared with other study groupings (14/17 high quality, 82%). Further, studies that showed null or diminished effect after multivariate analysis corrected for significantly more confounders (7.7±3.4) as compared with those that found no change following adjustment (5.6±4.5, p=0.04). The majority of included studies were carried out during childhood (75%) and set in high-income countries (85.5%). CONCLUSIONS Much of the reported effect of breastfeeding on child neurodevelopment is due to confounding. It is unlikely that additional work will change the current synthesis. Future studies should attempt to rigorously control for all important confounders. Alternatively, study designs using sibling cohorts discordant for breastfeeding may yield more robust conclusions.
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Affiliation(s)
- Asnat Walfisch
- The Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario, Canada
| | - Corey Sermer
- University of Western Ontario, London, Ontario, Canada
| | - Alex Cressman
- The Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario, Canada
| | - Gideon Koren
- The Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario, Canada
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Bernard JY, De Agostini M, Forhan A, Alfaiate T, Bonet M, Champion V, Kaminski M, de Lauzon-Guillain B, Charles MA, Heude B. Breastfeeding duration and cognitive development at 2 and 3 years of age in the EDEN mother-child cohort. J Pediatr 2013; 163:36-42.e1. [PMID: 23312681 DOI: 10.1016/j.jpeds.2012.11.090] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 10/23/2012] [Accepted: 11/30/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate the dose-response relationship between breastfeeding duration and cognitive development in French preschool children. STUDY DESIGN In the French EDEN Mother-Child Cohort Study, we evaluated language ability with the Communicative Development Inventory (CDI) in 1387 2-year-old children and overall development with the Ages and Stages Questionnaire (ASQ) in 1199 3-year-old children. Assessments were compared between breastfed and non-breastfed children and also according to breastfeeding duration in multivariable linear models, controlling for a wide range of potential confounders. We tested departure from linearity. RESULTS After adjustments, ever-breastfed children scored 3.7 ± 1.8 (P = .038) points higher than never-breastfed children on the CDI and 6.2 ± 1.9 (P = .001) points higher on the ASQ. Among breastfed children, exclusive and any-breastfeeding durations were positively associated with both CDI and ASQ scores. The fine motor domain of ASQ was associated with any-breastfeeding duration, and the problem solving domain with exclusive-breastfeeding duration. We did not observe significant departures from linearity. No interactions were found between the child's sex, parental education or socioeconomic status, and breastfeeding duration. CONCLUSION Longer breastfeeding duration was associated with better cognitive and motor development in 2- and 3-year-old children and a dose-response relationship was suggested.
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Affiliation(s)
- Jonathan Y Bernard
- Inserm, Center for Research in Epidemiology and Population Health, U1018, Epidemiology of Diabetes, Obesity and Renal Diseases, Lifelong Approach Team, F-94807 Villejuif, France.
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Hörnell A, Lagström H, Lande B, Thorsdottir I. Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations. Food Nutr Res 2013; 57:20823. [PMID: 23589711 PMCID: PMC3625706 DOI: 10.3402/fnr.v57i0.20823] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 03/06/2013] [Accepted: 03/08/2013] [Indexed: 01/01/2023] Open
Abstract
The present systematic literature review is part of the 5th revision of the Nordic Nutrition Recommendations. The overall aim was to review recent scientific data valid in a Nordic setting on the short- and long-term health effects of breastfeeding (duration of both any and exclusive breastfeeding) and introduction of foods other than breast milk. The initial literature search resulted in 2,011 abstracts; 416 identified as potentially relevant. Full paper review resulted in 60 quality assessed papers (6A, 48B, and 6C). A complementary search found some additional papers. The grade of evidence was classified as convincing, probable, limited-suggestive, and limited-no conclusion. The evidence was convincing of a protective dose/duration effect of breastfeeding against overweight and obesity in childhood and adolescence, overall infections, acute otitis media, and gastrointestinal and respiratory tract infections. The evidence was probable that exclusive breastfeeding for longer than 4 months is associated with slower weight gain during the second half of the first year which could be part of the reason behind the reduced risk of later overweight or obesity. There was also probable evidence that breastfeeding is a protective factor against inflammatory bowel disease, celiac disease, and diabetes (type 1 and 2), provides beneficial effects on IQ and developmental scores of children as well as a small reductive effect on blood pressure and blood cholesterol levels in adulthood. Other associations explored were limited-suggestive or inconclusive. In conclusion, convincing and probable evidence was found for benefits of breastfeeding on several outcomes. The recommendation in NNR2004 about exclusive breastfeeding for 6 months and continued partial breastfeeding thereafter can stand unchanged. The relatively low proportion of infants in the Nordic countries following this recommendation indicates that strategies that protect, support and promote breastfeeding should be enhanced, and should also recognize the benefits for long-term health.
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Affiliation(s)
- Agneta Hörnell
- Department of Food and Nutrition, Umeå, University, Umeå Sweden
| | - Hanna Lagström
- Turku Institute for Child and Youth Research, University of Turku, Turku, Finland
| | - Britt Lande
- Division of Public Health, Norwegian Directorate of Health, Oslo, Norway
| | - Inga Thorsdottir
- Unit for Nutrition Research, School of Health Sciences, University of Iceland and Landspitali National University Hospital, Reykjavik, Iceland
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Zhu Q, Li Y, Li N, Han Q, Liu Z, Li Z, Qiu J, Zhang G, Li F, Tian N. Prolonged exclusive breastfeeding, autumn birth and increased gestational age are associated with lower risk of fever in children with hand, foot, and mouth disease. Eur J Clin Microbiol Infect Dis 2012; 31:2197-202. [PMID: 22278296 DOI: 10.1007/s10096-012-1555-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Accepted: 01/07/2012] [Indexed: 11/26/2022]
Abstract
Epidemics of hand, foot, and mouth disease (HFMD) have been emerging and reemerging in recent years. This study aims to investigate whether breastfeeding and other factors may affect the profile of fever and disease course in children with HFMD. Three hundred seventy-two preschool children with HFMD were included. The demographics, environmental factors, and delivery- and feeding-associated factors in the children were obtained and their effects on the profile of fever and disease course were analyzed. Of the 372 children, 139 (37.37%) had fever during the disease course. Gender, breastfeeding pattern, birth season and gestational age were significantly different between the children with and without fever (p = 0.034, p < 0.0001, p = 0.035 and p = 0.013, respectively). After multivariate-adjusted analysis, prolonged exclusive breastfeeding (p = 0.001, OR 0.401, 95% CI 0.229-0.704), autumn birth (p = 0.007, OR 0.409, 95% CI 0.214-0.784) and higher gestational age (p = 0.029, OR 0.089, 95% CI 0.010-0.781) were protective factors for the incidence of fever.
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Affiliation(s)
- Q Zhu
- Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
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Quigley MA, Hockley C, Carson C, Kelly Y, Renfrew MJ, Sacker A. Breastfeeding is associated with improved child cognitive development: a population-based cohort study. J Pediatr 2012; 160:25-32. [PMID: 21839469 DOI: 10.1016/j.jpeds.2011.06.035] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Revised: 05/31/2011] [Accepted: 06/23/2011] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the association between breastfeeding and child cognitive development in term and preterm children. STUDY DESIGN We analyzed data on white singleton children from the United Kingdom Millennium Cohort Study. Children were grouped according to breastfeeding duration. Results were stratified by gestational age at birth: 37 to 42 weeks (term, n = 11,101), and 28 to 36 weeks (preterm, n = 778). British Ability Scales tests were administered at age 5 years (naming vocabulary, pattern construction, and picture similarities subscales). RESULTS The mean scores for all subscales increased with breastfeeding duration. After adjusting for confounders, there was a significant difference in mean score between children who were breastfed and children who were never breastfed: in term children, a two-point increase in score for picture similarities (when breastfed ≥ 4 months) and naming vocabulary (when breastfed ≥ 6 months); in preterm children, a 4-point increase for naming vocabulary (when breastfed ≥ 4 months) and picture similarities (when breastfed ≥ 2 months) and a 6-point increase for pattern construction (when breastfed ≥ 2 months). These differences suggest that breastfed children will be 1 to 6 months ahead of children who were never breastfed. CONCLUSIONS In white, singleton children in the United Kingdom, breastfeeding is associated with improved cognitive development, particularly in children born preterm.
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Affiliation(s)
- Maria A Quigley
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
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Jedrychowski W, Perera F, Jankowski J, Butscher M, Mroz E, Flak E, Kaim I, Lisowska-Miszczyk I, Skarupa A, Sowa A. Effect of exclusive breastfeeding on the development of children's cognitive function in the Krakow prospective birth cohort study. Eur J Pediatr 2012; 171:151-8. [PMID: 21660433 PMCID: PMC3747316 DOI: 10.1007/s00431-011-1507-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 05/30/2011] [Indexed: 11/26/2022]
Abstract
The main goal of the study was to assess the effect of exclusive breastfeeding on the neurodevelopment of children over a 7-year follow-up period and to test the hypothesis that the observed cognitive gain in breastfed children in the first years of life is a strong predictor of their cognitive development trajectory, which may be continued in later life. The analysis is based on data from the 7-year follow-up of 468 term babies (>36 weeks of gestation) born to non-smoking mothers participating in an ongoing prospective cohort study. The cognitive function of children was assessed by psychometric tests performed five times at regular intervals from infancy through the preschool age. The study included valid neurodevelopmental assessment of the children-443 participants were evaluated least twice; 425, three times; and 307, five times in the follow-up period. The association between the cognitive achievements of preschool age children and exclusive breastfeeding of various durations was performed using the generalized estimating equation longitudinal model, adjusted for major confounders such as maternal education, gender, parity, and weight gain in pregnancy. Children breastfed exclusively for up to 3 months had intelligence quotients (IQs) that were on average 2.1 points higher compared to the others (95% confidence interval (CI), 0.24-3.9); children breastfed for 4-6 months scored higher by 2.6 points (95% CI, 0.87-4.27); and the benefit for children breastfed even longer (>6 months) increased by 3.8 points (95% CI, 2.11-5.45). Other predictors were maternal education, gender of the child, having an older sibling, and weight gain during pregnancy. The results of the study support the WHO expert recommendations on exclusive breastfeeding for 6 months; moreover, they provide evidence that even a shorter duration of exclusive breastfeeding in early infancy produces beneficial effects on the cognitive development of children. The breastfeeding-related IQ gain observed already at the age of 1 was sustained through preschool age, and the difference in terms of IQ score between breastfed children and the reference group (mixed breastfeeding) held constant over the whole preschool period.
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McCrory C, Layte R. The effect of breastfeeding on children's educational test scores at nine years of age: results of an Irish cohort study. Soc Sci Med 2011; 72:1515-21. [PMID: 21474223 DOI: 10.1016/j.socscimed.2011.03.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 01/19/2011] [Accepted: 03/02/2011] [Indexed: 11/17/2022]
Abstract
This retrospective cross-sectional paper examines the relationship between early breastfeeding exposure and children's academic test scores at nine years of age independent of a wide range of possible confounders. The final sample comprised 8226 nine-year-old school children participating in the first wave of the Growing Up in Ireland study. The children were selected through the Irish national school system using a 2-stage sampling method and were representative of the nine-year population. Information relating to breastfeeding initiation and exposure duration was obtained retrospectively at nine years of age via parental recall and children's academic performance was assessed using standardised reading and mathematics tests. Hierarchical linear regression analysis with robust standard errors to control for clustering at the school level was used to quantify the effect of breastfeeding on children's test scores. Propensity score matching was used to compare treatment effects across groups defined by their propensity to breastfeed. In unadjusted analysis, children who were breastfed scored 8.67 percentage points higher on reading and 7.42 percentage points higher on mathematics compared to those who were never breastfed. While the breastfeeding advantage attenuated appreciably when adjusted for a range of child, maternal, socio-economic and socio-environmental characteristics, children who were breastfed continued to enjoy a significant test score advantage of 3.24 (p<0.001) and 2.23 (p<0.001) percentage points on reading and mathematics respectively compared to those who were never breastfed. Any amount of breastfeeding was associated with significantly higher test scores than no exposure, but evidence of a dose-response relationship was weak. The results of the propensity score matching analysis indicated that the test score advantage of breastfed children is robust and that the magnitude of the effect varies across groups defined by their propensity to breastfeed, being largest amongst the most socially disadvantaged and falling to near zero among the most advantaged group.
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Affiliation(s)
- Cathal McCrory
- The Economic and Social Research Institute, National Longitudinal Study of Children in Ireland, Whitaker Square, Sir John Rogerson's Quay, Dublin 2, Ireland.
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