title: Effect of breastfeeding and sociodemographic factors on visual outcome in childhood and adolescence.
abstract: BACKGROUND
  It has been suggested that early life factors, including breastfeeding and birth weight, program childhood myopia.
  
  
  OBJECTIVE
  We examined the relation of reduced unaided vision (indicative of myopia) in childhood and adolescence with infant feeding, parental education, maternal age at birth, birth weight, sex, birth order, and socioeconomic status.
  
  
  METHODS
  Three British cohorts recruited infants born in 1946 (n = 5362), 1958 (n = 18,558), and 1970 (n = 16,567). Adjusted odds ratios (ORs) for unaided vision of 6/12 or worse at ages 10-11 and 15-16 y from each cohort were pooled by using fixed-effects meta-analyses.
  
  
  RESULTS
  The prevalence of reduced vision ranged from 4.4% to 6.5% at 10-11 y and from 9.4% to 11.4% at 16 y, with marginally higher levels in later cohorts. Breastfeeding declined across successive cohorts (65%, 43%, and 22% in those breastfed for >1 mo, respectively). Pooled ORs showed no associations between infant feeding and vision after adjustment at either age. Parental education (OR: 1.48, high versus low education; 95% CI: 1.23, 1.79), maternal age (OR: 1.10, per 5-y increase; 95% CI: 1.04, 1.17), birth weight (OR: 0.85, per 1-kg rise; 95% CI: 0.76, 0.95), number of older siblings (OR: 0.89, per older sibling; 95% CI: 0.83, 0.94), and sex (OR: 1.10, girls versus boys; 95% CI: 0.98, 1.23) were related to adverse visual outcome in childhood. Stronger associations were observed in adolescence, except that the association with birth weight was null.
  
  
  CONCLUSIONS
  Infant feeding does not appear to influence visual development. Consistent associations of reduced vision with parental education, sex, maternal age, and birth order suggest that other environmental factors are important for visual development and myopia in early life.
authors.affiliation: Division of Community Health Sciences, St George's, University of London, London, United Kingdom. arudnick@sgul.ac.uk
authors.forename: Alicja R
authors.initials: AR
authors.lastname: Rudnicka
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Owen
authors.forename: Marcus
authors.initials: M
authors.lastname: Richards
authors.forename: Michael E J
authors.initials: ME
authors.lastname: Wadsworth
authors.forename: David P
authors.initials: DP
authors.lastname: Strachan
mesh_terms: D000293:Adolescent; D001722:Birth Order; D001724:Birth Weight; D001942:Breast Feeding; D002648:Child; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology*; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008423:Maternal Age; D009216:Myopia / Q000453:epidemiology* / Q000209:etiology*; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class