Breastfeeding, Polyunsaturated Fatty Acid Levels in Colostrum and Child Intelligence Quotient at Age 5-6 Years.

OBJECTIVE: To examine the relationship of polyunsaturated fatty acid (PUFA) in breast milk with children's IQ. STUDY DESIGN: In the French Etude des Déterminants pré- et postnatals précoces du développement et de la santé de l'Enfant (EDEN) mother-child cohort, colostrum samples were collected at the maternity unit. Colostrum omega-6 and omega-3 PUFA were analyzed by gas chromatography. At age 5-6 years, the IQs of 1080 children were assessed using the Wechsler Preschool and Primary Scale of Intelligence-III. The relationships of breastfeeding duration and PUFA levels with children's IQs were examined by linear regression. RESULTS: Full scale IQ of ever breastfed children was 4.5 (95% CI: 2.7, 6.2) higher than never breastfed children in the unadjusted model, but this was not statistically significant in the adjusted model (1.3 points higher [-0.4, 3.0]). Any breastfeeding duration was associated with full scale (0.20 [0.00, 0.41] points/month) and verbal (0.31 [0.09, 0.52]) IQ. Colostrum linoleic acid (LA) levels were negatively associated with Verbal IQ (-0.6 [-1.1, 0.0] points per 1% level increase). Children exposed to colostrum high in LA and low in docosahexaenoic acid (DHA) had lower IQs than those exposed to colostrum high in DHA (3.0 [0.5, 5.5] points) and those exposed to colostrum low in LA and DHA (4.4 [1.6, 7.3] points). Finally, the association between breastfeeding duration and child IQ was stronger when LA levels were high. CONCLUSIONS: Duration of breastfeeding and colostrum PUFA levels were associated with children's IQs in the EDEN cohort. These data support breastfeeding and add evidence for the role of early PUFA exposure on childhood cognition.

Birth weight and eating behaviors of young children.

OBJECTIVE: To evaluate the relationships prospectively between birth weight (standardized for gestational age) and problematic eating behaviors, as reported by the parents, at different ages in 3 birth cohorts: Generation XXI (Portugal), Avon Longitudinal Study of Parents and Children (United Kingdom), and Etude des Déterminants pre et postnatals précoces du développement et de la santé de l'ENfant study (France) - HabEat project. We also aimed to explore the effect of child's current body mass index (BMI) in these relationships. STUDY DESIGN: Problematic eating behaviors were assessed at 4-6, 12-15, 24, and 48-54 months, based on caregiver's perception. Children born small, appropriate, and large for gestational age were defined based on sex-specific Kramer growth references. Associations were tested by logistic regression (OR, 95% CI) adjusted for maternal age, education, BMI, smoking, breastfeeding duration, older siblings, birth type and, in a second step, for child's current BMI World Health Organization z-score. RESULTS: Parents of children born small for gestational age (compared with appropriate gestational age) reported more often feeding difficulties and poor eating patterns (eating small quantities or needing stimulation to eat) at 4-6 months (Generation XXI: OR 2.02, 95% CI 1.40-2.94; Avon Longitudinal Study of Parents and Children: OR 1.36, 95% CI 1.14-1.62; Etude des Déterminants pre et postnatals précoces du développement et de la santé de l'ENfant OR 3.24, 95% CI 1.50-6.96), but this effect was weaker at older ages. Overall, the effects decreased, after adjustment for child's BMI, but remained significant. CONCLUSIONS: Low birth weight for gestational age was related to later difficulty in eating behaviors, primarily in the first 4-6 months.

Breastfeeding duration and cognitive development at 2 and 3 years of age in the EDEN mother-child cohort.

OBJECTIVE: To investigate the dose-response relationship between breastfeeding duration and cognitive development in French preschool children. STUDY DESIGN: In the French EDEN Mother-Child Cohort Study, we evaluated language ability with the Communicative Development Inventory (CDI) in 1387 2-year-old children and overall development with the Ages and Stages Questionnaire (ASQ) in 1199 3-year-old children. Assessments were compared between breastfed and non-breastfed children and also according to breastfeeding duration in multivariable linear models, controlling for a wide range of potential confounders. We tested departure from linearity. RESULTS: After adjustments, ever-breastfed children scored 3.7 ± 1.8 (P = .038) points higher than never-breastfed children on the CDI and 6.2 ± 1.9 (P = .001) points higher on the ASQ. Among breastfed children, exclusive and any-breastfeeding durations were positively associated with both CDI and ASQ scores. The fine motor domain of ASQ was associated with any-breastfeeding duration, and the problem solving domain with exclusive-breastfeeding duration. We did not observe significant departures from linearity. No interactions were found between the child's sex, parental education or socioeconomic status, and breastfeeding duration. CONCLUSION: Longer breastfeeding duration was associated with better cognitive and motor development in 2- and 3-year-old children and a dose-response relationship was suggested.