• Shirong Cai, Wei Wei Pang, Yen Ling Low, Lit Wee Sim, Suet Chian Sam, Michaela Bianka Bruntraeger, Eric Qinlong Wong, Doris Fok, Birit F P Broekman, Leher Singh, Jenny Richmond, Pratibha Agarwal, Anqi Qiu, Seang Mei Saw, Fabian Yap, Keith M Godfrey, Peter D Gluckman, Yap-Seng Chong, Michael J Meaney, Michael S Kramer, Anne Rifkin-Graboi, and GUSTO Study Group.
• From the Departments of Obstetrics and Gynecology (SC, WWP, DF, Y-SC, and MSK) and Psychological Medicine (BFPB), Yong Loo Lin School of Medicine; the Departments of Psychology (LS) and Biomedical Engineering and Clinical Imaging Research Centre (AQ); and the Saw Swee Hock School of Public Health (SMS), National University of Singapore, National University Health System, Singapore; the Abbott Nutrition Research and Development Asia-Pacific Center, Singapore (YLL); the Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (ASTAR), Singapore (LWS, SCS, MBB, EQW, AQ, BFPB, PDG, Y-SC, MJM, and AR-G); the School of Psychology, University of New South Wales, Sydney, Australia (JR); the Departments of Neonatology (PA) and Pediatrics (FY), Kandang Kerbau Women's and Children's Hospital, Singapore; the Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK (KMG); Liggins Institute, University of Auckland, Auckland, New Zealand (PDG); and the Departments of Epidemiology, Biostatistics, and Occupational Health (MSK), Pediatrics (MSK), and Psychiatry and Neurology and Neurosurgery (MJM), McGill University, Montreal, Canada.
• Am. J. Clin. Nutr. 2015 Feb 1; 101 (2): 326-36.

BackgroundBreastfeeding has been shown to enhance global measures of intelligence in children. However, few studies have examined associations between breastfeeding and specific cognitive task performance in the first 2 y of life, particularly in an Asian population.ObjectiveWe assessed associations between early infant feeding and detailed measures of cognitive development in the first 2 y of life in healthy Asian children born at term.DesignIn a prospective cohort study, neurocognitive testing was performed in 408 healthy children (aged 6, 18, and 24 mo) from uncomplicated pregnancies (i.e., birth weight >2500 and <4000 g, gestational age ≥37 wk, and 5-min Apgar score ≥9). Tests included memory (deferred imitation, relational binding, habituation) and attention tasks (visual expectation, auditory oddball) as well as the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Children were stratified into 3 groups (low, intermediate, and high) on the basis of breastfeeding duration and exclusivity.ResultsAfter potential confounding variables were controlled for, significant associations and dose-response relations were observed for 4 of the 15 tests. Higher breastfeeding exposure was associated with better memory at 6 mo, demonstrated by greater preferential looking toward correctly matched items during early portions of a relational memory task (i.e., relational binding task: P-trend = 0.015 and 0.050 for the first two 1000-ms time bins, respectively). No effects of breastfeeding were observed at 18 mo. At 24 mo, breastfed children were more likely to display sequential memory during a deferred imitation memory task (P-trend = 0.048), and toddlers with more exposure to breastfeeding scored higher in receptive language [+0.93 (0.23, 1.63) and +1.08 (0.10, 2.07) for intermediate- and high-breastfeeding groups, respectively, compared with the low-breastfeeding group], as well as expressive language [+0.58 (-0.06, 1.23) and +1.22 (0.32, 2.12) for intermediate- and high-breastfeeding groups, respectively] assessed via the BSID-III.ConclusionsOur findings suggest small but significant benefits of breastfeeding for some aspects of memory and language development in the first 2 y of life, with significant improvements in only 4 of 15 indicators. Whether the implicated processes confer developmental advantages is unknown and represents an important area for future research. This trial was registered at www.clinicaltrials.gov as NCT01174875.© 2015 American Society for Nutrition.

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