Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil

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 wh...

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Main Authors: Prof. Cesar G Victora, PhD, Dr. Bernardo Lessa Horta, PhD, Christian Loret de Mola, PhD, Luciana Quevedo, PhD, Ricardo Tavares Pinheiro, PhD, Denise P Gigante, PhD, Helen Gonçalves, PhD, Fernando C Barros, PhD
Format: Article
Language:English
Published: Elsevier 2015-04-01
Series:The Lancet Global Health
Online Access:http://www.sciencedirect.com/science/article/pii/S2214109X15700021
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author Prof. Cesar G Victora, PhD
Dr. Bernardo Lessa Horta, PhD
Christian Loret de Mola, PhD
Luciana Quevedo, PhD
Ricardo Tavares Pinheiro, PhD
Denise P Gigante, PhD
Helen Gonçalves, PhD
Fernando C Barros, PhD
author_facet Prof. Cesar G Victora, PhD
Dr. Bernardo Lessa Horta, PhD
Christian Loret de Mola, PhD
Luciana Quevedo, PhD
Ricardo Tavares Pinheiro, PhD
Denise P Gigante, PhD
Helen Gonçalves, PhD
Fernando C Barros, PhD
author_sort Prof. Cesar G Victora, PhD
collection DOAJ
description 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. Findings: 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. Interpretation: 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. Funding: Wellcome Trust, International Development Research Center (Canada), CNPq, FAPERGS, and the Brazilian Ministry of Health.
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spelling doaj.art-f578ae0321fd4960a8ab690aacd2bcd72022-12-21T19:10:16ZengElsevierThe Lancet Global Health2214-109X2015-04-0134e199e20510.1016/S2214-109X(15)70002-1Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from BrazilProf. Cesar G Victora, PhD0Dr. Bernardo Lessa Horta, PhD1Christian Loret de Mola, PhD2Luciana Quevedo, PhD3Ricardo Tavares Pinheiro, PhD4Denise P Gigante, PhD5Helen Gonçalves, PhD6Fernando C Barros, PhD7Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, BrazilPostgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, BrazilPostgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, BrazilPostgraduate Programme in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, BrazilPostgraduate Programme in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, BrazilPostgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, BrazilPostgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, BrazilPostgraduate Programme in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, BrazilBackground: 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. Findings: 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. Interpretation: 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. Funding: Wellcome Trust, International Development Research Center (Canada), CNPq, FAPERGS, and the Brazilian Ministry of Health.http://www.sciencedirect.com/science/article/pii/S2214109X15700021
spellingShingle Prof. Cesar G Victora, PhD
Dr. Bernardo Lessa Horta, PhD
Christian Loret de Mola, PhD
Luciana Quevedo, PhD
Ricardo Tavares Pinheiro, PhD
Denise P Gigante, PhD
Helen Gonçalves, PhD
Fernando C Barros, PhD
Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil
The Lancet Global Health
title Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil
title_full Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil
title_fullStr Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil
title_full_unstemmed Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil
title_short Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil
title_sort association between breastfeeding and intelligence educational attainment and income at 30 years of age a prospective birth cohort study from brazil
url http://www.sciencedirect.com/science/article/pii/S2214109X15700021
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