Gibson-Davis Christina M, Brooks-Gunn Jeanne
Terry Sanford Institute of Public Policy, Duke University, PO Box 90245, Durham, NC 27708, USA.
Pediatrics. 2006 Nov;118(5):e1444-51. doi: 10.1542/peds.2006-0072.
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.
With data on 1645 American-born mothers participating in a longitudinal birth cohort study, we used linear regression to determine the influence of breastfeeding for at least 1 month on the Peabody Picture Vocabulary Test-Third Edition scores of 3-year-old children. Models were adjusted for an extensive set of demographic characteristics, including mother's Peabody Picture Vocabulary Test and the Home Observation for Measurement of the Environment score. Mothers were categorized into 1 of 3 educational-status groups: no high school diploma, high school diploma, and some post-secondary education.
In unadjusted mean comparisons, breastfed children had Peabody Picture Vocabulary Test scores that were 6.6 points higher than children who were not breastfed. After adjusting for demographic characteristics and maternal verbal ability, the coefficient dropped to 1.72. Among mothers with education beyond high school, the children's Peabody Picture Vocabulary Test scores in adjusted models were 2.2 points higher for breastfed children. Among mothers with a high school diploma or less, there were no significant differences in the children's Peabody Picture Vocabulary Test scores by breastfeeding status. These results were consistent in white, black, and Hispanic children.
Maternal Peabody Picture Vocabulary Test scores mediate much of the association between breastfeeding and child verbal abilities. The beneficial effects of breastfeeding on children's cognition may emerge only when breastfeeding is done in conjunction with other positive parenting behaviors. The advantageous effects of breastfeeding do not seem to be solely attributable to the superior nutrient content of breast milk.
我们的目标是分析母亲的语言能力和教育程度对母乳喂养与儿童认知功能之间关联的影响。首先，我们假设母亲的语言能力在很大程度上解释了母乳喂养与儿童语言能力之间的关联。其次，我们假设在调整母亲的语言能力后，母乳喂养的积极影响在受过高等教育的母亲中最为明显，因为与受教育程度较低的母亲相比，这些母亲可能有更多机会参与能激发认知的育儿活动。
利用参与纵向出生队列研究的1645名美国出生母亲的数据，我们使用线性回归来确定至少母乳喂养1个月对3岁儿童皮博迪图片词汇测试第三版分数的影响。模型针对一系列广泛的人口统计学特征进行了调整，包括母亲的皮博迪图片词汇测试和家庭环境观察评分。母亲被分为3个教育状况组之一：没有高中文凭、高中文凭、有一些高等教育经历。
在未调整的均值比较中，母乳喂养的儿童皮博迪图片词汇测试分数比未母乳喂养的儿童高6.6分。在调整了人口统计学特征和母亲的语言能力后，系数降至1.72。在受过高中以上教育的母亲中，调整模型中母乳喂养儿童的皮博迪图片词汇测试分数高2.2分。在有高中文凭或更低学历的母亲中，根据母乳喂养状况，儿童的皮博迪图片词汇测试分数没有显著差异。这些结果在白人、黑人和西班牙裔儿童中是一致的。
母亲的皮博迪图片词汇测试分数在很大程度上介导了母乳喂养与儿童语言能力之间的关联。母乳喂养对儿童认知的有益影响可能只有在母乳喂养与其他积极的育儿行为相结合时才会显现。母乳喂养的有利影响似乎并非仅仅归因于母乳中优越的营养成分。
