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© 2023. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Breastfeeding has been consistently associated with higher intelligence since childhood. However, this relation could be confounded due to maternal selection bias. We estimated the association between predominant breastfeeding and intelligence in school-age children considering potential selection bias and we simulated the intelligence gap reduction between low versus higher socioeconomic status children by increasing breastfeeding. We analysed predominant breastfeeding practices (breastmilk and water-based liquids) of children 0–3 years included in the Mexican Family Life Survey (MxFLS-1). Intelligence was estimated as the z-score of the abbreviated Raven score, measured at 6–12 years in the MxFLS-2 or MxFLS-3. We predicted breastfeeding duration among children with censored data with a Poisson model. We used the Heckman selection model to assess the association between breastfeeding and intelligence, correcting for selection bias and stratified by socioeconomic status. Results show after controlling for selection bias, a 1-month increase in predominant breastfeeding duration was associated with a 0.02 SD increase in the Raven z-score (p < 0.05). The children who were predominantly breastfed for 4–6 months versus <1 month had 0.16 SD higher Raven z-score (p < 0.05). No associations were found using multiple linear regression models. Among low socioeconomic status children, increasing predominantly breastfeeding duration to 6 months would increase their mean Raven z-score from −0.14 to −0.07 SD and reduce by 12.5% the intelligence gap with high socioeconomic status children. In conclusion, predominant breastfeeding duration was significantly associated with childhood intelligence after controlling for maternal selection bias. Increased breastfeeding duration may reduce poverty-driven intelligence inequities.

Details

Title
Breastfeeding is associated with the intelligence of school-age children in Mexico
Author
Peña-Ruiz, Lidia Sarahi 1   VIAFID ORCID Logo  ; Unar-Munguía, Mishel 1   VIAFID ORCID Logo  ; Colchero, Mónica Arantxa 2   VIAFID ORCID Logo  ; Alarid-Escudero, Fernando 3   VIAFID ORCID Logo  ; Pérez-Escamilla, Rafael 4   VIAFID ORCID Logo 

 Department of Maternal, Child and Adolescent Nutrition, Center for Research on Health and Nutrition, National Institute of Public Health, Cuernavaca, Morelos, Mexico 
 Department of Health Economics, Center for Research on Health Systems, National Institute of Public Health, Cuernavaca, Morelos, Mexico 
 Department of Health Policy, School of Medicine, Stanford University, CA, US; Center for Health Policy, Freeman Spogli Institute, Stanford University, CA, US 
 Department of Social and Behavioral Science, Yale School of Public Health, Yale University, New Haven, Connecticut, USA 
Section
ORIGINAL ARTICLES
Publication year
2023
Publication date
Oct 2023
Publisher
John Wiley & Sons, Inc.
ISSN
17408695
e-ISSN
17408709
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3084721371
Copyright
© 2023. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.