Breastfeeding Duration and Adolescent Educational Outcomes: Longitudinal Evidence From India.

OBJECTIVE

There is a significant evidence gap on the long-term educational benefits of longer breastfeeding in low- and middle-income countries. We estimated the association between duration of (any) breastfeeding and educational outcomes of Indian children.

METHODS

We used regression analysis to examine the association between the length of breastfeeding (in months) and future education outcomes on the basis of 2 data sets: (1) data from a follow-up survey known as the Andhra Pradesh Children and Parents Study (APCAPS, 2003-2005) of 1165 children aged 13 to 18 years from a controlled nutrition trial originally conducted in South India during the period of 1987 to 1990; and (2) nationally representative data from the India Human Development Survey (IHDS-2, 2011-2012) of 6121 children aged 6 to 12 years.

RESULTS

In APCAPS, children with >36 months of breastfeeding scored 0.28 (95% confidence interval [95% CI]: 0.00-0.56; P < .05) higher on tests than those with up to 12 months of breastfeeding. In the nationally representative IHDS-2 data, above-median breastfeeding duration was associated with 0.1 year (95% CI: 0.04-0.16; P < .01) higher educational attainment. In IHDS-2, >12 to 24 months and >24 months of breastfeeding were associated with 0.12 (95% CI: 0.01-0.23; P < .05) and 0.19 years of (95% CI: 0.05-0.34; P < .05) higher educational attainment, respectively, than for those with up to 6 months of breastfeeding. In additional analyses by sex, we found that the benefits of breastfeeding accrued primarily to boys.

CONCLUSION

Breastfeeding duration was associated with small gains in educational outcomes for boys but not for girls in India.