Nandi Arindam, Lutter Randall, Laxminarayan Ramanan
1 Tata Centre for Development, University of Chicago, Chicago, IL, USA.
2 Center for Disease Dynamics, Economics & Policy, Washington, DC, USA.
Food Nutr Bull. 2017 Dec;38(4):528-541. doi: 10.1177/0379572117733100. Epub 2017 Oct 4.
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.
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.
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.
Breastfeeding duration was associated with small gains in educational outcomes for boys but not for girls in India.
在低收入和中等收入国家，关于延长母乳喂养的长期教育益处存在显著的证据空白。我们估计了（任何形式的）母乳喂养时长与印度儿童教育成果之间的关联。
我们运用回归分析，基于两个数据集来检验母乳喂养时长（以月为单位）与未来教育成果之间的关联：（1）来自一项后续调查的数据，即1987年至1990年期间在印度南部进行的一项对照营养试验中1165名13至18岁儿童的安得拉邦儿童与家长研究（APCAPS，2003 - 2005）；（2）来自印度人类发展调查（IHDS - 2，2011 - 2012）的全国代表性数据，涉及6121名6至12岁儿童。
在APCAPS中，母乳喂养超过36个月的儿童在测试中的得分比母乳喂养时长至多12个月的儿童高0.28（95%置信区间[95%CI]：0.00 - 0.56；P <.05）。在具有全国代表性的IHDS - 2数据中，母乳喂养时长高于中位数与教育程度提高0.1年（95%CI：0.04 - 0.16；P <.01）相关。在IHDS - 2中，母乳喂养12至24个月以上和24个月以上的儿童，其教育程度分别比母乳喂养时长至多6个月的儿童高0.12年（95%CI：0.01 - 0.23；P <.05）和0.19年（95%CI：0.05 - 0.34；P <.05）。在按性别进行的额外分析中，我们发现母乳喂养的益处主要体现在男孩身上。
在印度，母乳喂养时长与男孩教育成果的小幅提升相关，但与女孩无关。
