Does breast milk increase a child's intelligence?

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Yes, breast milk does increase a child 's intelligence. While the bulk of the studies in this list for which we identified answers agrees with this conclusion, some studies came to different conclusions. We encourage you to consider each of the studies for yourself to understand why they differ. Note that some of the studies in this list have been critiqued. (Links to critiques appear on the corresponding study summaries below).
This short answer was generated by aggregating the answers that each of the 15 studies below gave to the question (as indicated by State of K members) and adjusting for source quality and other factors. If key studies are missing or the answers attributed to individual studies are incorrect, the above answer could be wrong.


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All answers are assigned by State of K users. The label Mixed means that a study found some evidence to indicate that the answer to the question is "yes" and some evidence to indicate that the answer is "no". This label is often applied when a study uses two or more proxies to study the same phenomenon (i.e. firearm sales figures and self-reported firearm ownership rates as proxies for the prevalence of firearms) and the proxies yield different results when looking for correlations with another phenomenon (i.e. firearm-related deaths). Alternatively, the label may be applied if the phenomenon under study (i.e. whether breast milk improves cognitive function) is true for one group, but not another (i.e. true for girls, but not for boys). The label Insuff. Evidence means that a study found there was insufficient evidence to reach a conclusion regarding the question. The label No Data means that State of K wasn't able to identify the study's response to the question based on the information that was available. This label is often applied when the person creating the list does not have access to the full text and the answer isn't clear from the abstract.

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Literature Reviews
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Breastfeeding, Cognitive and Noncognitive Development in Early Childhood: A Population Study.
"Background And Objectives: There is mixed evidence from correlational studies that breastfeeding impacts children's development. Propensity score matching with large samples can be an effective tool to remove potential bias from observed confounders in correlational studies. The aim of this study was to investigate the impact of breastfeeding on children's cognitive and noncognitive development at 3 and 5 years of age.Methods: Participants included ∼8000 families from the Growing Up in Ireland longitudinal infant cohort, who were identified from the Child Benefit Register and randomly selected to participate. Parent and teacher reports and standardized assessments were used to collect information on children's problem behaviors, expressive vocabulary, and cognitive abilities at age 3 and 5 years. Breastfeeding information was collected via maternal report. Propensity score matching was used to compare the average treatment effects on those who were breastfed.Results: Before matching, breastfeeding was associated with better development on almost every outcome. After matching and adjustment for multiple testing, only 1 of the 13 outcomes remained statistically significant: children's hyperactivity (difference score, -0.84; 95% confidence interval, -1.33 to -0.35) at age 3 years for children who were breastfed for at least 6 months. No statistically significant differences were observed postmatching on any outcome at age 5 years.Conclusions: Although 1 positive benefit of breastfeeding was found by using propensity score matching, the effect size was modest in practical terms. No support was found for statistically significant gains at age 5 years, suggesting that the earlier observed benefit from breastfeeding may not be maintained once children enter school."
AUTHORS
Lisa-Christine Girard
Orla Doyle
Richard E Tremblay
PUBLISHED
2017 in Pediatrics
No
Breast Milk Feeding, Brain Development, and Neurocognitive Outcomes: A 7-Year Longitudinal Study in Infants Born at Less Than 30 Weeks' Gestation.
"Objectives: To determine the associations of breast milk intake after birth with neurological outcomes at term equivalent and 7 years of age in very preterm infantsStudy Design: We studied 180 infants born at <30 weeks' gestation or <1250 grams birth weight enrolled in the Victorian Infant Brain Studies cohort from 2001-2003. We calculated the number of days on which infants received >50% of enteral intake as breast milk from 0-28 days of life. Outcomes included brain volumes measured by magnetic resonance imaging at term equivalent and 7 years of age, and cognitive (IQ, reading, mathematics, attention, working memory, language, visual perception) and motor testing at 7 years of age. We adjusted for age, sex, social risk, and neonatal illness in linear regression.Results: A greater number of days on which infants received >50% breast milk was associated with greater deep nuclear gray matter volume at term equivalent age (0.15 cc/d; 95% CI, 0.05-0.25); and with better performance at age 7 years of age on IQ (0.5 points/d; 95% CI, 0.2-0.8), mathematics (0.5; 95% CI, 0.1-0.9), working memory (0.5; 95% CI, 0.1-0.9), and motor function (0.1; 95% CI, 0.0-0.2) tests. No differences in regional brain volumes at 7 years of age in relation to breast milk intake were observed.Conclusion: Predominant breast milk feeding in the first 28 days of life was associated with a greater deep nuclear gray matter volume at term equivalent age and better IQ, academic achievement, working memory, and motor function at 7 years of age in very preterm infants."
AUTHORS
Victoria A Nowak
Katherine J Lee
Charlotte Molesworth
Deanne K Thompson
Lex W Doyle
Terrie E Inder et al
PUBLISHED
2016 in The Journal of pediatrics
Yes
Breastfeeding and IQ Growth from Toddlerhood through Adolescence.
"Objectives: The benefits of breastfeeding for cognitive development continue to be hotly debated but are yet to be supported by conclusive empirical evidence.Methods: We used here a latent growth curve modeling approach to test the association of breastfeeding with IQ growth trajectories, which allows differentiating the variance in the IQ starting point in early life from variance in IQ gains that occur later in childhood through adolescence. Breastfeeding (yes/ no) was modeled as a direct predictor of three IQ latent growth factors (i.e. intercept, slope and quadratic term) and adjusted for the covariates socioeconomic status, mother's age at birth and gestational stage. Data came from the Twins Early Development Study (TEDS), a prospective cohort study of twins born between 1996 and 1994 in the United Kingdom, who were assessed 9 times on IQ between age 2 and 16 years (N = 11,582).Results: Having been breastfed was associated with a small yet significant advantage in IQ at age 2 in girls (β = .07, CI 95% from 0.64 to 3.01; N = 3,035) but not in boys (β = .04, CI 95% from -0.14 to 2.41). Having been breastfeeding was neither associated with the other IQ growth factors in girls (slope: β = .02, CI 95% from -0.25 to 0.43; quadratic: β = .01, CI 95% from -0.02 to 0.02) nor in boys (slope: β = .02, CI 95% from -0.30 to 0.47; quadratic: β = -.01, CI 95% from -0.01 to 0.01).Conclusions: Breastfeeding has little benefit for early life intelligence and cognitive growth from toddlerhood through adolescence."
AUTHORS
Sophie von Stumm
Robert Plomin
PUBLISHED
2015 in PloS one
No
Breastfeeding and intelligence: a systematic review and meta-analysis.
"Aim: This study was aimed at systematically reviewing evidence of the association between breastfeeding and performance in intelligence tests.Methods: Two independent searches were carried out using Medline, LILACS, SCIELO and Web of Science. Studies restricted to infants and those where estimates were not adjusted for stimulation or interaction at home were excluded. Fixed- and random-effects models were used to pool the effect estimates, and a random-effects regression was used to assess potential sources of heterogeneity.Results: We included 17 studies with 18 estimates of the relationship between breastfeeding and performance in intelligence tests. In a random-effects model, breastfed subjects achieved a higher IQ [mean difference: 3.44 points (95% confidence interval: 2.30; 4.58)]. We found no evidence of publication bias. Studies that controlled for maternal IQ showed a smaller benefit from breastfeeding [mean difference 2.62 points (95% confidence interval: 1.25; 3.98)]. In the meta-regression, none of the study characteristics explained the heterogeneity among the studies.Conclusion: Breastfeeding is related to improved performance in intelligence tests. A positive effect of breastfeeding on cognition was also observed in a randomised trial. This suggests that the association is causal."
AUTHORS
Bernardo L Horta
Christian Loret de Mola
Cesar G Victora
PUBLISHED
2015 in Acta paediatrica (Oslo, Norway : 1992)
Yes
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 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."
AUTHORS
Christian Loret de Mola
Luciana Quevedo
Ricardo Tavares Pinheiro
Denise P Gigante
Helen Gonçalves
Fernando C Barros et al
PUBLISHED
2015 in The Lancet. Global health
Yes
Breast milk and cognitive development--the role of confounders: a systematic review.
"Objectives: The association between breastfeeding and child cognitive development is conflicted by studies reporting positive and null effects. This relationship may be confounded by factors associated with breastfeeding, specifically maternal socioeconomic class and IQ.Design: Systematic review of the literature.Setting And Participants: Any prospective or retrospective study, in any language, evaluating the association between breastfeeding and cognitive development using a validated method in healthy term infants, children or adults, was included.Primary And Secondary Outcome Measures: Extracted data included the study design, target population and sample size, breastfeeding exposure, cognitive development assessment tool used and participants' age, summary of the results prior to, and following, adjustment for confounders, and all confounders adjusted for. Study quality was assessed as well.Results: 84 studies met our inclusion criteria (34 rated as high quality, 26 moderate and 24 low quality). Critical assessment of accepted studies revealed the following associations: 21 null, 28 positive, 18 null after adjusting for confounders and 17 positive-diminished after adjusting for confounders. Directionality of effect did not correlate with study quality; however, studies showing a decreased effect after multivariate analysis were of superior quality compared with other study groupings (14/17 high quality, 82%). Further, studies that showed null or diminished effect after multivariate analysis corrected for significantly more confounders (7.7±3.4) as compared with those that found no change following adjustment (5.6±4.5, p=0.04). The majority of included studies were carried out during childhood (75%) and set in high-income countries (85.5%).Conclusions: Much of the reported effect of breastfeeding on child neurodevelopment is due to confounding. It is unlikely that additional work will change the current synthesis. Future studies should attempt to rigorously control for all important confounders. Alternatively, study designs using sibling cohorts discordant for breastfeeding may yield more robust conclusions."
AUTHORS
Asnat Walfisch
Corey Sermer
Alex Cressman
Gideon Koren
PUBLISHED
2013 in BMJ open
Insufficient Evidence
Impact of breastfeeding on the intelligence quotient of eight-year-old children.
"Objective: This study aimed to determine the influence of breastfeeding on the intellectual capacity of children from a cohort in a developing country, with a control for the main confounding factors.Methods: A prospective cohort study was performed including all infants born in the hospitals of a medium-size city, and a random sample of these newborns was monitored at 30, 90, and 180 days of life, and at age 8 years. Several aspects of breastfeeding were assessed in the follow-up and, at 8 years, general intellectual capacity was assessed through the Raven's Colored Progressive Matrices test. The statistical analyses used Student's t-test, ANOVA, and linear regression and logistics, considering p-values less than 0.05 as statistically significant associations.Results: At age 8 years, 560 children were assessed with Raven's Colored Progressive Matrices test. The average score was 22.56 points, with a standard deviation of 5.93. The difference in the averages found between the breastfed and non-breastfed groups at six months of age was 1.33 (p=0.008). Mother's and child's skin color, social and economic class, maternal education and smoking, and breastfeeding at six months of age (p=0.007) were still associated with the outcome.Conclusions: Children that were breastfed for six months or more had better performance in the general intellectual assessment, even after adjusting for the main confounding factors."
AUTHORS
Ana L M Fonseca
Elaine P Albernaz
Cristina C Kaufmann
Ivana H Neves
Vera L M de Figueiredo
PUBLISHED
2012 in Jornal de pediatria
Yes
Impact of Breast Milk on Intelligence Quotient, Brain Size, and White Matter Development
"Although observational findings linking breast milk to higher scores on cognitive tests may be confounded by factors associated with mothers' choice to breastfeed, it has been suggested that one or more constituents of breast milk facilitate cognitive development, particularly in preterms. Because cognitive scores are related to head size, we hypothesized that breast milk mediates cognitive effects by affecting brain growth. We used detailed data from a randomized feeding trial to calculate percentage of expressed maternal breast milk (%EBM) in the infant diet of 50 adolescents. MRI scans were obtained (mean age = 15 y 9 mo), allowing volumes of total brain (TBV) and white and gray matter (WMV, GMV) to be calculated. In the total group, %EBM correlated significantly with verbal intelligence quotient (VIQ); in boys, with all IQ scores, TBV and WMV. VIQ was, in turn, correlated with WMV and, in boys only, additionally with TBV. No significant relationships were seen in girls or with gray matter. These data support the hypothesis that breast milk promotes brain development, particularly white matter growth. The selective effect in males accords with animal and human evidence regarding gender effects of early diet. Our data have important neurobiological and public health implications and identify areas for future mechanistic study."
AUTHORS
Elizabeth B Isaacs
Bruce R Fischl
Brian T Quinn
Wui K Chong
David G Gadian
Alan Lucas
PUBLISHED
2010 in Pediatric Research
Mixed Results
Impact of breast milk on intelligence quotient, brain size, and white matter development.
"Although observational findings linking breast milk to higher scores on cognitive tests may be confounded by factors associated with mothers' choice to breastfeed, it has been suggested that one or more constituents of breast milk facilitate cognitive development, particularly in preterms. Because cognitive scores are related to head size, we hypothesized that breast milk mediates cognitive effects by affecting brain growth. We used detailed data from a randomized feeding trial to calculate percentage of expressed maternal breast milk (%EBM) in the infant diet of 50 adolescents. MRI scans were obtained (mean age=15 y 9 mo), allowing volumes of total brain (TBV) and white and gray matter (WMV, GMV) to be calculated. In the total group, %EBM correlated significantly with verbal intelligence quotient (VIQ); in boys, with all IQ scores, TBV and WMV. VIQ was, in turn, correlated with WMV and, in boys only, additionally with TBV. No significant relationships were seen in girls or with gray matter. These data support the hypothesis that breast milk promotes brain development, particularly white matter growth. The selective effect in males accords with animal and human evidence regarding gender effects of early diet. Our data have important neurobiological and public health implications and identify areas for future mechanistic study."
AUTHORS
Elizabeth B Isaacs
Bruce R Fischl
Brian T Quinn
Wui K Chong
David G Gadian
Alan Lucas
PUBLISHED
2010 in Pediatric research
Yes
Breastfeeding and child cognitive development: new evidence from a large randomized trial.
"Context: The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother's behavior or her interaction with the infant.Objective: To assess whether prolonged and exclusive breastfeeding improves children's cognitive ability at age 6.5 years.Design: Cluster-randomized trial, with enrollment from June 17, 1996, to December 31, 1997, and follow-up from December 21, 2002, to April 27, 2005.Setting: Thirty-one Belarussian maternity hospitals and their affiliated polyclinics.Participants: A total of 17,046 healthy breastfeeding infants were enrolled, of whom 13,889 (81.5%) were followed up at age 6.5 years.Intervention: Breastfeeding promotion intervention modeled on the Baby-Friendly Hospital Initiative by the World Health Organization and UNICEF.Main Outcome Measures: Subtest and IQ scores on the Wechsler Abbreviated Scales of Intelligence, and teacher evaluations of academic performance in reading, writing, mathematics, and other subjects.Results: The experimental intervention led to a large increase in exclusive breastfeeding at age 3 months (43.3% for the experimental group vs 6.4% for the control group; P < .001) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. The experimental group had higher means on all of the Wechsler Abbreviated Scales of Intelligence measures, with cluster-adjusted mean differences (95% confidence intervals) of +7.5 (+0.8 to +14.3) for verbal IQ, +2.9 (-3.3 to +9.1) for performance IQ, and +5.9 (-1.0 to +12.8) for full-scale IQ. Teachers' academic ratings were significantly higher in the experimental group for both reading and writing.Conclusion: These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development.Trial Registration: isrctn.org Identifier: ISRCTN37687716."
AUTHORS
Sergei Davidovsky
Oleg Skugarevsky
Oleg Trofimovich
Ludmila Kozlova
Stanley Shapiro
et al
PUBLISHED
2008 in Archives of general psychiatry
Yes
Breast-fed infants process speech differently from bottle-fed infants: evidence from neuroelectrophysiology.
"Numerous studies report positive effects of breast-feeding on infant development. Such effects are apparent early in development as well as in later years. Recently, elements in breast milk, polyunsaturatred fatty acids (PUFAs), have been identified as having great potential for increasing nutritional benefits. PUFAs are long-chain fatty acids containing two or more double bonds. While some scientists are enthusiastic about the long-term benefits of PUFAs on brain and cognitive development, many of the positive pharmacological effects attributed to PUFAs remain unsubstantiated. The present study investigated the differential impact of breast-feeding vs. PUFA-enriched formula in a small but well-matched population of 12 infants tested at 6 months of age. Event-related potential (ERP) and a range of behavior measures were recorded. ERP waveforms identified marked differences between the breast-fed and PUFA-fed infants by 6 months of age. When a range of biological, perinatal, and cognitive factors were equated between the two groups, only the ERPs recorded from breast-fed infants changed throughout their recorded period (700 msec), differentiated between all speech sounds, and generated differences in scalp recordings across all regions recorded across both hemispheres. Such differences in the range of their brain responses could signal an advantage for the breast-fed infants for later linguistic and cognitive development."
AUTHORS
Melissa Ferguson
Peter J Molfese
PUBLISHED
2007 in Developmental neuropsychology
Yes
Breast feeding and cognitive development at age 1 and 5 years.
"Aim: To examine whether duration of breast feeding has any effect on a child's cognitive or motor development in a population with favourable environmental conditions and a high prevalence of breast feeding.Methods: In 345 Scandinavian children, data on breast feeding were prospectively recorded during the first year of life, and neuromotor development was assessed at 1 and 5 years of age. Main outcome measures were Bayley's Scales of Infant Development at age 13 months (Mental Index, MDI; Psychomotor Index, PDI), Wechsler Preschool and Primary Scales of Intelligence (WPPSI-R), and Peabody Developmental Scales at age 5.Results: Children breast fed for less than 3 months had an increased risk, compared to children breast fed for at least 6 months, of a test score below the median value of MDI at 13 months and of WPPSI-R at 5 years. Maternal age, maternal intelligence (Raven score), maternal education, and smoking in pregnancy were significant confounders, but the increased risk of lower MDI and total IQ scores persisted after adjustment for each of these factors. We found no clear association between duration of breast feeding and motor development at 13 months or 5 years of age.Conclusion: Our data suggest that a longer duration of breast feeding benefits cognitive development."
AUTHORS
N K Angelsen
T Vik
G Jacobsen
L S Bakketeig
PUBLISHED
2001 in Archives of disease in childhood
Yes
Breast is best: human milk is the optimal food for brain development.
"The statement that breast-fed children score higher on tests of cognitive function than do formula-fed children is not universally accepted. The main criticism given by skeptics is that observational studies have been interpreted inappropriately and without sufficient adjustment for confounding variables such as socioeconomic status or maternal education.Anderson et al (1) compiled 20 studies published during the past 3 decades and selected results from 11 studies in order to perform a meta-analysis. Using this approach, they quantitated a 5.3-point intelligence quotient (IQ) difference in cognitive development favoring breast-fed children; after adjustment for covariates the difference dropped to 3.2 points. The IQ advantage increased with duration of breast-feeding, reaching a plateau at 4–6 mo. Low-birth-weight infants received the greatest benefits. The cognitive development of ≈10000 children per feeding category was evaluated at ages ranging from infancy to adolescence. The conclusion given by the authors is clear and simple, “breast-feeding was associated with significantly higher scores for cognitive development than was formula feeding.” We agree with this conclusion but must point out the main limitation of this meta-analysis study, namely, that none of the studies were randomized."
AUTHORS
R Uauy
P Peirano
PUBLISHED
1999 in The American journal of clinical nutrition
Yes
Breast-feeding and cognitive development: a meta-analysis.
"Background: Although the results of many clinical studies suggest that breast-fed children score higher on tests of cognitive function than do formula-fed children, some investigators have suggested that these differences are related to confounding covariables such as socioeconomic status or maternal education.Objective: Our objective was to conduct a meta-analysis of observed differences in cognitive development between breast-fed and formula-fed children.Design: In this meta-analysis we defined the effect estimate as the mean difference in cognitive function between breast-fed and formula-fed groups and calculated average effects using fixed-effects and random-effects models.Results: Of 20 studies meeting initial inclusion criteria, 11 studies controlled for >/=5 covariates and presented unadjusted and adjusted results. An unadjusted benefit of 5.32 (95% CI: 4.51, 6.14) points in cognitive function was observed for breast-fed compared with formula-fed children. After adjustment for covariates, the increment in cognitive function was 3.16 (95% CI: 2.35, 3.98) points. This adjusted difference was significant and homogeneous. Significantly higher levels of cognitive function were seen in breast-fed than in formula-fed children at 6-23 mo of age and these differences were stable across successive ages. Low-birth-weight infants showed larger differences (5.18 points; 95% CI: 3.59, 6.77) than did normal-birth-weight infants (2.66 points; 95% CI: 2.15, 3.17) suggesting that premature infants derive more benefits in cognitive development from breast milk than do full-term infants. Finally, the cognitive developmental benefits of breast-feeding increased with duration.Conclusion: This meta-analysis indicated that, after adjustment for appropriate key cofactors, breast-feeding was associated with significantly higher scores for cognitive development than was formula feeding."
AUTHORS
J W Anderson
B M Johnstone
D T Remley
PUBLISHED
1999 in The American journal of clinical nutrition
Yes
Breast milk and subsequent intelligence quotient in children born preterm.
"There is considerable controversy over whether nutrition in early life has a long-term influence on neurodevelopment. We have shown previously that, in preterm infants, mother's choice to provide breast milk was associated with higher developmental scores at 18 months. We now report data on intelligence quotient (IQ) in the same children seen at 7 1/2-8 years. IQ was assessed in 300 children with an abbreviated version of the Weschler Intelligence Scale for Children (revised Anglicised). Children who had consumed mother's milk in the early weeks of life had a significantly higher IQ at 7 1/2-8 years than did those who received no maternal milk. An 8.3 point advantage (over half a standard deviation) in IQ remained even after adjustment for differences between groups in mother's education and social class (p less than 0.0001). This advantage was associated with being fed mother's milk by tube rather than with the process of breastfeeding. There was a dose-response relation between the proportion of mother's milk in the diet and subsequent IQ. Children whose mothers chose to provide milk but failed to do so had the same IQ as those whose mothers elected not to provide breast milk. Although these results could be explained by differences between groups in parenting skills or genetic potential (even after adjustment for social and educational factors), our data point to a beneficial effect of human milk on neurodevelopment."
AUTHORS
A Lucas
R Morley
T J Cole
G Lister
C Leeson-Payne
PUBLISHED
1992 in Lancet (London, England)
Yes