Szoptatás és intelligencia

Breastfeeding, Long-Chain Polyunsaturated Fatty Acids in Colostrum, and Infant Mental Development

Guxens M, Mendez MA, Moltó-Puigmartí C, Julvez J, García-Esteban R, Forns J, Ferrer M, Vrijheid M, López-Sabater MC, Sunyer J.
Pediatrics. 2011 Sep 19.

Abstract

Background: Breastfeeding has been associated with improved neurodevelopment in children. However, it remains unknown to what extent nutritional advantages of breast milk may explain this relationship.

Objective: We assessed the role of parental psychosocial factors and colostrum long-chain polyunsaturated fatty acid (LC-PUFA) levels in the relationship between breastfeeding and children's neurodevelopment.

Breastfeeding Duration and Academic Achievement at 10 Years

Oddy WH, Li J, Whitehouse AJ, Zubrick SR, Malacova E.
Pediatrics. 2011 Jan;127(1):e137-45.

Abstract

INTRODUCTION: The aim of this study was to examine the relationship between duration of breastfeeding and educational outcomes. We hypothesized that longer periods of breastfeeding would predict better educational outcomes in middle childhood.

Impact of breast milk on IQ, brain size and white matter development

Isaacs, Elizabeth B.; Fischl, Bruce R.; Quinn, Brian T.; Chong, Wui K.; Gadian, David G.; Lucas, Alan
Pediatr Res. 2009 Dec 22. [Epub ahead of print]

Abstract

Although observational findings linking breast milk to higher scores on cognitive tests may be confounded by factors associated with mothers' choice to breastfeed, it has been suggested that one or more constituents of breast milk facilitate cognitive development, particularly in preterms. Because cognitive scores are related to head size, we hypothesised that breast milk mediates cognitive effects by affecting brain growth.

Breastfeeding is associated with improved child cognitive development: evidence from the UK Millennium Cohort Study

M. A. Quigley, C. Hockley, C. Carson, Y. Kelly, M. Renfrew, A. Sacker
J Epidemiol Community Health 2009;63(Suppl2):8

Abstract

Objective To assess the relationship between breastfeeding and child cognitive development, and whether this relationship varies according to prematurity.

Design Population-based cohort (Sweeps 1 and 3 of the UK Millennium Cohort Study).

Setting UK.

Participants 11 801 white singleton children born in 2000–2002.

Comparison Groups Children were grouped according to their breastfeeding status (ever vs never; and duration of any and exclusive breastfeeding). Results were stratified according to gestational age at birth: 37–42 weeks (term); 33–36 weeks (moderately preterm); and 28–32 weeks (very preterm).

Breastfeeding and Child Cognitive Development - New Evidence From a Large Randomized Trial

Kramer MS, Aboud F, Mironova E, Vanilovich I, Platt RW, Matush L, Igumnov S, Fombonne E, Bogdanovich N, Ducruet T, Collet JP, Chalmers B, Hodnett E, Davidovsky S, Skugarevsky O, Trofimovich O, Kozlova L, Shapiro S; Promotion of Breastfeeding Intervention Trial (PROBIT) Study Group.

Arch Gen Psychiatry. 2008;65(5):578-584.

Abstract

Context The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother's behavior or her interaction with the infant.

Objective To assess whether prolonged and exclusive breastfeeding improves children's cognitive ability at age 6.5 years.

Moderation of breastfeeding effects on the IQ by genetic variation in fatty acid metabolism

Caspi A, Williams B, Kim-Cohen J, Craig IW, Milne BJ, Poulton R, Schalkwyk LC, Taylor A, Werts H, Moffitt TE.
Proc Natl Acad Sci U S A. 2007 Nov 20;104(47):18860-5.

Abstract

Children's intellectual development is influenced by both genetic inheritance and environmental experiences. Breastfeeding is one of the earliest such postnatal experiences. Breastfed children attain higher IQ scores than children not fed breast milk, presumably because of the fatty acids uniquely available in breast milk. Here we show that the association between breastfeeding and IQ is moderated by a genetic variant in FADS2, a gene involved in the genetic control of fatty acid pathways.

A szoptatás hatása a gyermekek intelligenciájára: prospektív tanulmány, testvérpár analízis és metaanalízis

(Effect of breast feeding on intelligence in children: prospective study, sibling pairs analysis, and meta-analysis
Geoff Der, G David Batty, Ian J Deary
BMJ 2006;333:945 (4 November)
)

Bevezető

A bevezetőben a szerzők megállapítják, hogy 1929 óta sok tanulmány készült, amely a szoptatás és az intelligencia összefüggését vizsgálja, és a legtöbb arra a következtetésre jut, hogy a szoptatott gyerekek IQ-ja magasabb. Viszont – szerintük – a (helyes) következtetések levonását gátolja, ha az egyéb tényezőket nem veszik figyelembe, mivel alapvető különbségek vannak a szoptatást választó és a nem szoptató anyák között.(!) Ezért azok a tanulmányok, amelyek nem zárják ki megfelelően a zavaró tényezőket (hatásokat), elhibázhatják a következtetést a szoptatás valódi hatását illetően.

Sok befolyásoló tényező szerepel a különböző tanulmányokban, pl: a szoptatási időszak hossza, gyermek neme, anya dohányzása, anya életkora, anya intelligenciája, anya iskolai végzettsége, anya neveltetésa, apa iskolai végzettsége, rassz, társadalmi-anyagi helyzet, család mérete, születési sorrend, születési súly, terhességi kor, gyermekkori élmények/tapasztalatok.

Azt, hogy viszonylag kevés tanulmányban veszik figyelembe az anyai intelligenciát, a szerzők meglepőnek találják „figyelembe véve, hogy az intelligencia öröklődik, és hogy mind a szoptatás megkezdése, mind a szoptatási időszak időtartama összefügg az anya intelligenciájával.”

Éppen ezért ők megvizsgálták az anya IQ-jának és más tényezőknek a szerepét, mégpedig részben klasszikus módszerekkel, részben testvérpár-analízissel. A testvérpár-analízis előnye, hogy bármilyen olyan tényező, ami azonos a testvérek esetében, automatikusan és teljesen ki van zárva mint zavaró hatás.

Evidence on the long-term effects of breastfeeding: systematic review and meta-analyses

Bernardo L. Horta, Rajiv Bahl, José C. Martines, Cesar G. Victora
World Health Organization 2007

Executive summary

Background: Breastfeeding presents clear short-term benefits for child health, mainly protection against morbidity and mortality from infectious diseases. On the other hand, there is some controversy on the long-term consequences of breastfeeding. Whereas some studies reported that breastfed subjects present a higher level of school achievement and performance in intelligence
tests, as well as lower blood pressure, lower total cholesterol and a lower prevalence of overweight
and obesity, others have failed to detect such associations.

Breastfeeding and verbal ability of 3-year-olds in a multicity sample

Gibson-Davis CM, Brooks-Gunn J.
Pediatrics. 2006 Nov;118(5):e1444-51.

Abstract

OBJECTIVES: Our goal was to analyze the effect of maternal verbal ability and education on the association between breastfeeding and children's cognitive functioning. First, we hypothesized that maternal verbal abilities account for a large portion of the association between breastfeeding and child verbal abilities. Second, we hypothesized that after adjusting for maternal verbal abilities, a positive effect of breastfeeding will be most evident among highly educated mothers, because these mothers may have more opportunity to engage in cognitively stimulating parenting than do mothers with less education.

Effect of breast feeding on intelligence in children: prospective study, sibling pairs analysis, and meta-analysis

Geoff Der, G David Batty, Ian J Deary

BMJ 2006;333:945 (4 November)

Abstract

Objective To assess the importance of maternal intelligence, and the effect of controlling for it and other important confounders, in the link between breast feeding and children's intelligence.

Design Examination of the effect of breast feeding on cognitive ability and the impact of a range of potential confounders, in particular maternal IQ, within a national database. Additional analyses compared pairs of siblings from the sample who were and were not breast fed. The results are considered in the context of other studies that have also controlled for parental intelligence via meta-analysis.

The Association Between Duration of Breastfeeding and Adult Intelligence

Mortensen EL, Michaelsen KF, Sanders SA, Reinisch JM.
JAMA. 2002 May 8;287(18):2365-71.

Abstract

CONTEXT: A number of studies suggest a positive association between breastfeeding and cognitive development in early and middle childhood. However, the only previous study that investigated the relationship between breastfeeding and intelligence in adults had several methodological shortcomings.

OBJECTIVE: To determine the association between duration of infant breastfeeding and intelligence in young adulthood.

Breast-feeding and cognitive development: a meta-analysis.

Anderson JW, Johnstone BM, Remley DT.
Am J Clin Nutr. 1999 Oct;70(4):525-35.

Abstract

BACKGROUND: Although the results of many clinical studies suggest that breast-fed children score higher on tests of cognitive function than do formula-fed children, some investigators have suggested that these differences are related to confounding covariables such as socioeconomic status or maternal education.

OBJECTIVE: Our objective was to conduct a meta-analysis of observed differences in cognitive development between breast-fed and formula-fed children.

DESIGN: In this meta-analysis we defined the effect estimate as the mean difference in cognitive function between breast-fed and formula-fed groups and calculated average effects using fixed-effects and random-effects models.

Randomised trial of early diet in preterm babies and later intelligence quotient

Lucas A, Morley R, Cole TJ.
BMJ. 1998 Nov 28;317(7171):1481-7.

Abstract

OBJECTIVES: To determine whether perinatal nutrition influences cognitive function at 7 1/2 - 8 years in children born preterm.

DESIGN: Randomised, blinded nutritional intervention trial. Blinded follow up at 7 1/2 - 8 years.

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