Effect Of Breastfeeding On Childhood Health And Cognitive Ability

OBJECTIVE This study analyses the influence of duration of breastfeeding on health and cognitive ability among children at community-level and individual-level.METHODS A multi-level statistical model was established using children's data of China Family Panel Studies(2014-2016).SPSS24.0 was used to analyze the relationship between medical conditions,environmental factors at community-level,personal characteristics,economic status at individual level and children's health indicators(a month illness,frequency of going to the hospital to see a doctor within a year,hospitalization within a year),children's cognitive index(vocabulary test,math test,memory test,number series test score)with two-level logistic regression model.RESULTS Children's health clustered at the community-level(high level variance of a month sickness was 0.295,Z=7.101,P<0.001;high level variance of frequency of going to the hospital to see a doctor within a year was 1.104,Z=9.407,P<0.001;high level variance of hospitalization within a year was 0.602,Z=5.234,P<0.001).After controlling for personal characteristics,economic level and the hierarchy of the data,continued breastfeeding was a protective factor for children's health(a month illness: ?=-0.280,t=-2.837,P=0.005;frequency of going to the hospital to see a doctor within a year: ?=-0.356,t=-3.342,P=0.001).Children's cognitive ability also clustered at the community-level.The scores of two tests on children's crystallized intelligence: vocabulary test(high level variance of primary school group was 0.492,Z=5.211,P<0.001;high level variance of middle school group was 0.616,Z=4.189,P<0.001),math test(high level variance of primary school group was 0.500,Z=4.982,P<0.001;high level variance of middle school group was 0.215,Z=2.036,P=0.042).After controlling personal characteristics,maternal-related factors and the hierarchy of the data,it was found that the duration of breastfeeding had no significant effect on the scores of two tests on children's crystallized intelligence: Primary school group(vocabulary test?=-0.099,95%CI-0.508-0.832,P=0.832;math test ?=0.113,95%CI-0.178-0.403,P=0.446);Middle school group(vocabulary test ?=-0.228,95%CI-0.619-0.163,P=0.252;math test?=0.145,95%CI-0.223-0.512,P=0.441);High school group(vocabulary test OR=0.432,95%CI 0.055-3.366,P=0.423;math test OR=0.634,95%CI 0.080-5.046,P=0.667).The duration of breastfeeding also had no significant effect on the test scores of children's fluid intelligence(immediate word recall test ?=0.269,95%CI-0.054-0.591,P=0.102;delayed word recall test ?=0.123,95%CI-0.166-0.411,P=0.405;number series test ?=-0.192,95%CI-0.492-0.108,P=0.211).CONCLUSION Children's health showed aggregation at community-level,which could be affected by diet and environment of life.Longer breastfeeding duration contribute to children's health.This study advocates extending the duration of breastfeeding to 8 months or more.Breastfeeding has no obvious effect on the improvement of children's cognitive ability,but other factors,such as mother's education level and parental emotional support,have significant influence on children's cognition.