Published online February 1, 2007
PEDIATRICS Vol. 119 Supplement February 2007, pp. S92-S98 (doi:10.1542/peds.2006-2089N)
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SUPPLEMENT ARTICLE


Associations Between Breastfeeding Practices and Young Children's Language and Motor Skill Development

Deborah L. Dee, MPHa, Ruowei Li, MD, PhDb, Li-Ching Lee, PhD, ScMc and Laurence M. Grummer-Strawn, PhDb

a Department of Maternal and Child Health, School of Public Health, and the Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
b Maternal and Child Nutrition Branch, Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
c Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

OBJECTIVES. We examined the associations of breastfeeding initiation and duration with language and motor skill development in a nationally representative sample of US children aged 10 to 71 months.

METHODS. Using cross-sectional data on 22399 children from the 2003 National Survey of Children's Health, we examined relationships between breastfeeding practices and children's language and motor skills development. Outcomes were based on each mother's response to questions regarding her level of concern (a lot, a little, not at all) about her child's development of expressive language, receptive language, fine motor skills, and gross motor skills. Breastfeeding data were based on mothers' recall. Methods of variance estimation were applied and multivariate polynomial regression modeling was done to estimate the effects of breastfeeding initiation and duration on children's development after adjustment for confounders.

RESULTS. Mean age of the sample was 2.79 years; 67% were non-Hispanic white, 16% were Hispanic, and 9% were non-Hispanic black. Approximately 17% of mothers reported concerns about their child's expressive language development; ~10% had receptive language concerns; ~6% had concerns about fine motor skills; and 5% reported general motor skills concerns. Multivariate analysis revealed that mothers who initiated breastfeeding were less likely than mothers of never-breastfed children to be concerned a lot about their child's expressive and receptive language development and fine and general motor skills. Mothers of children breastfed 3 to 5.9 months were less likely than mothers of never-breastfed children to be concerned a lot about their child's expressive and receptive language and fine and general motor skills.

CONCLUSIONS. As with all cross-sectional data, results should be interpreted with caution. Our findings suggest breastfeeding may protect against delays in young children's language and motor skill development. Fewer concerns about language and motor skill development were evident for children breastfed ≥3 months, and concerns generally decreased as breastfeeding continued ≥9 months.

Key Words: breastfeeding • initiation • duration • language development • motor skills

Abbreviations: AAP—American Academy of Pediatrics • NSCH—National Survey of Children's Health • DHA—docosahexaenoic acid • OR—odds ratio • CI—confidence interval

Accepted Sep 15, 2006.