Breastfeeding, the use of docosahexaenoic acid-fortified formulas in infancy and neuropsychological function in childhood.
OBJECTIVE
To investigate the relation between breastfeeding, use of docosahexaenoic acid (DHA)-fortified formula and neuropsychological function in children.


METHODS
Prospective cohort study.


METHODS
Southampton, UK.


METHODS
241 children aged 4 years followed up from birth.


METHODS
IQ measured by the Wechsler Pre-School and Primary Scale of Intelligence (3rd edn), visual attention, visuomotor precision, sentence repetition and verbal fluency measured by the NEPSY, and visual form-constancy measured by the Test of Visual-Perceptual Skills (Non-Motor).


RESULTS
In unadjusted analyses, children for whom breast milk or DHA-fortified formula was the main method of feeding throughout the first 6 months of life had higher mean full-scale and verbal IQ scores at age 4 years than those fed mainly unfortified formula. After adjustment for potential confounding factors, particularly maternal IQ and educational attainment, the differences in IQ between children in the breast milk and unfortified formula groups were severely attenuated, but children who were fed DHA-fortified formula had full-scale and verbal IQ scores that were respectively 5.62 (0.98 to 10.2) and 7.02 (1.56 to 12.4) points higher than children fed unfortified formula. However, estimated total intake of DHA in milk up to age 6 months was not associated with subsequent IQ or with score on any other test.


CONCLUSIONS
Differences in children's intelligence according to type of milk fed in infancy may be due more to confounding by maternal or family characteristics than to the amount of long-chain polyunsaturated fatty acids they receive in milk.
MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK. crg@mrc.soton.ac.uk
Catharine R
CR
Gale
Lynne D
LD
Marriott
Christopher N
CN
Martyn
Jennifer
J
Limond
Hazel M
HM
Inskip
Keith M
KM
Godfrey
Catherine M
CM
Law
Cyrus
C
Cooper
Carolyn
C
West
Siân M
SM
Robinson
D000328:Adult; D001942:Breast Feeding; D002657:Child Development; D003071:Cognition; D015986:Confounding Factors, Epidemiologic; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D005527:Food, Fortified; D006801:Humans; D041943:Infant Formula / Q000737:chemistry*; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007360:Intelligence; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012923:Social Class; D055815:Young Adult
D004281:Docosahexaenoic Acids