title: A cohort study on full breastfeeding and child neuropsychological development: the role of maternal social, psychological, and nutritional factors.
abstract: OBJECTIVE
  This study investigated whether duration of full breastfeeding is associated with child neuropsychological development and whether this association is explained by social, psychological, and nutritional factors within families.
  
  
  METHODS
  Participants in this study were a population-based birth cohort in the city of Sabadell (Catalonia, Spain). Females were recruited during the first trimester of pregnancy between July 2004 and July 2006. Information about parental characteristics and breastfeeding was obtained through questionnaires. Full breastfeeding was categorized as never, short term (≤4mo), long term (4-6mo), or very long term (>6mo). A trained psychologist assessed the neuropsychological development of children at 4 years of age (n=434) using the McCarthy Scales of Children's Abilities (MSCA).
  
  
  RESULTS
  Full breastfeeding showed an independent association with child general MSCA scores after adjusting for a range of social, psychological, and nutritional factors (>6mo, coefficient=7.4 [95% confidence interval=2.8-12.0], p=0.011). Maternal social class, education level, and IQ were also associated with child neuropsychological scores, but did not explain breastfeeding associations. Omega-3 (n3) fatty acid levels were not associated with child neuropsychological scores.
  
  
  CONCLUSIONS
  Very long-term full breastfeeding was independently associated with neuropsychological functions of children at 4 years of age. Maternal indicators of intelligence, psychopathology, and colostrum n3 fatty acids did not explain this association.
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Research Institute (IMIM), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Julvez
authors.forename: Monica
authors.initials: M
authors.lastname: Guxens
authors.forename: Anne-Elie
authors.initials: AE
authors.lastname: Carsin
authors.forename: Joan
authors.initials: J
authors.lastname: Forns
authors.forename: Michelle
authors.initials: M
authors.lastname: Mendez
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Turner
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
mesh_terms: D000328:Adult; D001076:Aptitude; D001942:Breast Feeding; D002675:Child, Preschool; D015331:Cohort Studies; D003126:Colostrum / Q000737:chemistry; D004522:Educational Status; D015525:Fatty Acids, Omega-3 / Q000032:analysis; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008425:Maternal Behavior; D009034:Mother-Child Relations; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009752:Nutritional Status; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012923:Social Class; D012931:Social Environment; D013030:Spain
chemical_list: D015525:Fatty Acids, Omega-3