Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland.
Department of Metabolism, Digestion and Reproduction, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.
BMC Pregnancy Childbirth. 2021 Jan 18;21(1):62. doi: 10.1186/s12884-020-03520-8.
We aimed to determine the associations between breastfeeding and children's neurodevelopment indexed by intelligence quotient (IQ) and emotional and behavioural problems through mid-childhood adjusting for prenatal and postnatal depression and multiple confounders; and to test the novel hypothesis that breastfeeding may moderate the effects of prenatal depression and anxiety on children's neurodevelopment.
The study is based on women and their children from the longitudinal Avon Longitudinal Study of Parents and Children (n=11,096). Children's IQ was derived from standardized in-person testing; behaviour problems were assessed according to parent-report; information on breastfeeding, prenatal depression and anxiety and multiple confounders were derived from self-report questionnaires. We conducted hierarchical multiple regression adjusting for several covariates.
43% women were exclusively breastfeeding at 1 month and an additional 16.8% were engaged in mixed or partial breastfeeding. Both exclusive breastfeeding (B = 2.19; SD = 0.36, p =.00) and mixed feeding (B = 1.59; SD= 0.52; p=.00) were positively associated with IQ at 8 years of age, after adjusting for covariates. Exclusive breastfeeding was negatively associated with hyperactivity/attention deficit at 4 years (B = -.30, SD = .05; p < .01); mixed feeding was related to hyperactivity/attention deficit at age 9 (B = .20; SD = .08; p = .03) after adjustments. There was no association between breastfeeding and emotional or conduct problems. Breastfeeding did not moderate the association between prenatal depression and anxiety and children's neurodevelopment.
The selective association between breastfeeding and neurodevelopmental measures suggests a nutritional rather than broader beneficial psychological effect on child neurodevelopment. Breastfeeding did not moderate the associations between prenatal depression and anxiety and child neurodevelopment, suggesting separate mechanisms of action.
本研究旨在通过调整产前和产后抑郁以及多种混杂因素，确定母乳喂养与儿童在中期的智商（IQ）和情绪与行为问题相关的关联，并检验母乳喂养可能调节产前抑郁和焦虑对儿童神经发育影响的新假设。
本研究基于纵向雅芳父母与子女纵向研究（Avon Longitudinal Study of Parents and Children，ALSPAC）中的妇女及其子女（n=11096）。儿童的智商通过标准化的现场测试得出；行为问题根据家长报告进行评估；母乳喂养、产前抑郁和焦虑以及多种混杂因素的信息均来自自我报告问卷。我们通过分层多元回归，调整了多个协变量。
43%的女性在 1 个月时进行纯母乳喂养，另有 16.8%的女性进行混合或部分母乳喂养。在调整了协变量后，纯母乳喂养（B=2.19；SD=0.36，p=.00）和混合喂养（B=1.59；SD=0.52；p=.00）均与 8 岁时的 IQ 呈正相关。纯母乳喂养与 4 岁时的多动/注意力缺陷呈负相关（B=-.30，SD=0.05；p<.01）；混合喂养与 9 岁时的多动/注意力缺陷呈正相关（B=0.20；SD=0.08；p=0.03）。母乳喂养与情绪或行为问题之间无关联。母乳喂养并未调节产前抑郁和焦虑与儿童神经发育之间的关联。
母乳喂养与神经发育指标之间的选择性关联表明，母乳喂养对儿童神经发育的影响可能是营养性的，而不是更广泛的有益心理影响。母乳喂养并未调节产前抑郁和焦虑与儿童神经发育之间的关联，这表明其作用机制不同。
