Recalled Initiation and Duration of Maternal Breastfeeding Among Children with and Without ADHD in a Well Characterized Case-Control Sample.
Early environmental influences are increasingly of interest in understanding ADHD as a neurodevelopmental condition, particularly in light of recognition that gene by environment interplay are likely involved in this condition. Breastfeeding duration predicts cognitive development, as well as development of brain white matter connectivity, in areas similar to those seen in ADHD. Prior studies show an association between breastfeeding and ADHD but without adequate evaluation of ADHD. A case control cohort of 474 children aged 7-13 years was examined, 291 with well characterized ADHD (71.5 % male) and the rest typically developing controls (51.9 % male). Mothers retrospectively reported on breast feeding initiation and duration. Initiation of breastfeeding was not associated with child ADHD, but shorter duration of breastfeeding was associated with child ADHD with a medium effect size (d = 0.40, p < 0.05); this effect held after covarying a broad set of potential confounders, including child oppositional defiant and conduct problems and including maternal and paternal ADHD symptoms. Effects were replicated across both parent and teacher ratings of child ADHD symptoms. Shorter duration of breastfeeding is among several risk factors in early life associated with future ADHD, or else longer duration is protective. The direction of this effect is unknown, however. It may be that some children are more difficult to breastfeed or that breastfeeding provides nutrients or other benefits that reduce future chance of ADHD.
Graduate Programs in Human Nutrition, Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR, 97239-3098, USA. stadlerd@ohsu.edu.
Diane D
DD
Stadler
Department of Psychology, Florida International University, Miami, FL, USA. emusser@fiu.edu.
Erica D
ED
Musser
School of Education, Teaching and Health, American University, Washington, DC, USA. holton@american.edu.
Kathleen F
KF
Holton
Public Health & Preventive Medicine, Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR, 97239-3098, USA. shannonja@ohsu.edu.
Jackilen
J
Shannon
Department of Psychiatry, Oregon Health & Science University, 3181 Sam Jackson Park Road, Mail Code DC7P, Portland, OR, 97239-3098, USA. niggj@ohsu.edu.
Joel T
JT
Nigg
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000209:etiology; D001942:Breast Feeding / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D059647:Gene-Environment Interaction; D006801:Humans; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data*; D012307:Risk Factors; D013997:Time Factors
ADHD; ADHD and depression; Breastfeeding; Case–control study; Child ADHD; Child ADHD symptoms; Environmental influences; Maternal ADHD; Neurodevelopmental condition