title: Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil.
abstract: BACKGROUND
  Breastfeeding has clear short-term benefits, but its long-term consequences on human capital are yet to be established. We aimed to assess whether breastfeeding duration was associated with intelligence quotient (IQ), years of schooling, and income at the age of 30 years, in a setting where no strong social patterning of breastfeeding exists.
  
  
  METHODS
  A prospective, population-based birth cohort study of neonates was launched in 1982 in Pelotas, Brazil. Information about breastfeeding was recorded in early childhood. At 30 years of age, we studied the IQ (Wechsler Adult Intelligence Scale, 3rd version), educational attainment, and income of the participants. For the analyses, we used multiple linear regression with adjustment for ten confounding variables and the G-formula.
  
  
  RESULTS
  From June 4, 2012, to Feb 28, 2013, of the 5914 neonates enrolled, information about IQ and breastfeeding duration was available for 3493 participants. In the crude and adjusted analyses, the durations of total breastfeeding and predominant breastfeeding (breastfeeding as the main form of nutrition with some other foods) were positively associated with IQ, educational attainment, and income. We identified dose-response associations with breastfeeding duration for IQ and educational attainment. In the confounder-adjusted analysis, participants who were breastfed for 12 months or more had higher IQ scores (difference of 3·76 points, 95% CI 2·20-5·33), more years of education (0·91 years, 0·42-1·40), and higher monthly incomes (341·0 Brazilian reals, 93·8-588·3) than did those who were breastfed for less than 1 month. The results of our mediation analysis suggested that IQ was responsible for 72% of the effect on income.
  
  
  CONCLUSIONS
  Breastfeeding is associated with improved performance in intelligence tests 30 years later, and might have an important effect in real life, by increasing educational attainment and income in adulthood.
  
  
  BACKGROUND
  Wellcome Trust, International Development Research Center (Canada), CNPq, FAPERGS, and the Brazilian Ministry of Health.
authors: Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, Brazil.
authors: Cesar G
authors: CG
authors: Victora
authors: Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, Brazil. Electronic address: blhorta@gmail.com.
authors: Bernardo Lessa
authors: BL
authors: Horta
authors: Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, Brazil.
authors: Christian
authors: C
authors: Loret de Mola
authors: Postgraduate Programme in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brazil.
authors: Luciana
authors: L
authors: Quevedo
authors: Postgraduate Programme in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brazil.
authors: Ricardo Tavares
authors: RT
authors: Pinheiro
authors: Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, Brazil.
authors: Denise P
authors: DP
authors: Gigante
authors: Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, Brazil.
authors: Helen
authors: H
authors: Gonçalves
authors: Postgraduate Programme in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brazil.
authors: Fernando C
authors: FC
authors: Barros
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001938:Brazil; D001942:Breast Feeding; D002657:Child Development / Q000502:physiology; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D007360:Intelligence; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis