Szoptatás és intelligencia

Breastfeeding and intelligence: a systematic review and meta-analysis

Horta BL, Loret de Mola C, Victora CG
Acta Paediatr. 2015 Dec;104(467):14-9.

AIM: This study was aimed at systematically reviewing evidence of the association between breastfeeding and performance in intelligence tests.

METHODS: Two independent searches were carried out using Medline, LILACS, SCIELO and Web of Science. Studies restricted to infants and those where estimates were not adjusted for stimulation or interaction at home were excluded. Fixed- and random-effects models were used to pool the effect estimates, and a random-effects regression was used to assess potential sources of heterogeneity.

Long-term effects of breastfeeding - A systematic review

Breastfeeding has well-established short-term benefits, particularly the reduction of morbidity and mortality due to infectious diseases in childhood. A pooled analysis of studies carried out in middle/ low income countries showed that breastfeeding substantially lowers the risk of death from infectious diseases in the first two years of life.

Based on data from the United Kingdom Millennium Cohort, Quigley et al estimated that optimal breastfeeding practices could prevent a substantial proportion of hospital admissions due to diarrhea and lower respiratory tract infection. A systematic review by Kramer et al confirmed that exclusive breastfeeding in the first 6 months decreases morbidity from gastrointestinal and allergic diseases, without any negative effects on growth. Given such evidence, it has been recommended that in the first six months of life, every child should be exclusively breastfed, with partial breastfeeding continued until two years of age.

What are the causal effects of breastfeeding on IQ, obesity and blood pressure? Evidence from comparing high-income with middle-income cohorts.

Brion MJ, Lawlor DA, Matijasevich A, Horta B, Anselmi L, Araújo CL, Menezes AM, Victora CG, Smith GD.
Int J Epidemiol. 2011 Jun;40(3):670-80.

Abstract

BACKGROUND: A novel approach is explored for improving causal inference in observational studies by comparing cohorts from high-income with low- or middle-income countries (LMIC), where confounding structures differ. This is applied to assessing causal effects of breastfeeding on child blood pressure (BP), body mass index (BMI) and intelligence quotient (IQ).

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.

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.

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.

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.

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.

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.

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.

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.

SETTING: Intervention phase in two neonatal units; follow up in a clinic or school setting.

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