Breastfeeding and behavioural problems: Propensity score matching with a national cohort of infants in Chile

Lisa-Christine Girard, Chamarrita Farkas

Research output: Contribution to journalArticlepeer-review

Abstract

Importance: Potential effects of breastfeeding on children’s behaviour remains an elusive debate given inherent methodological challenges. Propensity score matching affords benefits by ensuring greate requivalence on observable social and health determinants, helping to reduce bias between groups.Objectives: We examined whether duration of breastfeeding had an impact on children’s externalising and internalising behaviours. Study Design: A cohort study (Encuesta Longitudinal de la Primera Infancia cohort) that included 3,037 Chilean families who were enrolled in 2010. Follow-up data was collected in 2012.Setting: General community.Participants: Population-based sample. Eligibility criteria: children born full-term with complete data on matching variables. Matching variables included: healthcare system as a proxy of income, presence of a partner/spouse in the household, maternal age, educational level, IQ, working status, type of work, diagnosis of prenatal depression by a healthcare professional, smoking during pregnancy, delivery type, child sex,weight at birth, incubation following delivery, and child age.Exposure: Duration of breastfeeding.Main Outcomes and Measures: Externalising and internalising problems assessed using the ChildBehaviour Checklist.Results: Matched results revealed benefits of any breastfeeding, up to six months, on emotional reactivity and somatic complaints, (mean difference of -1.00, 95% CI, -1.84 to -0.16 and -1.02, 95% CI, -1.76 to -0.28,respectively). Children breastfed between 7-12 months also had reduced scores on emotional reactivity, inaddition to attention problems (mean difference of -0.86, 95% CI, -1.66 to -0.06 and -0.50, 95% CI, -0.93 to -0.07, respectively). No benefits were observed for children breastfed 13 months or more.Conclusion: Reduced internalising difficulties and inattention were found in children breastfed up to a year,suggesting that breastfeeding may have beneficial impacts on these areas of development. The magnitude of effect was modest. Extended durations of breastfeeding did not appear to offer any benefits.
Original languageEnglish
Article numbere025058
JournalBMJ Open
Volume9
Early online date15 Feb 2019
DOIs
Publication statusE-pub ahead of print - 15 Feb 2019

Keywords

  • breastfeeding
  • behaviour problems
  • propensity score matching
  • epidemiology
  • developmental cohort

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