Breast feeding and infant development in a cohort with sibling pair analysis: The Japan Environment and Children's Study

Masafumi Sanefuji, Ayako Senju, Masayuki Shimono, Masanobu Ogawa, Yuri Sonoda, Michiko Torio, Yuko Ichimiya, Reiko Suga, Yasunari Sakai, Satoshi Honjo, Koichi Kusuhara, Shouichi Ohga

Research output: Contribution to journalReview articlepeer-review

Abstract

Objectives To investigate the association between breast feeding and infant development during the first year of life using sibling comparison. Design Nationwide prospective birth cohort study with sibling pair analysis. Setting 15 regional centres that participated in the Japan Environment and Children's Study. Participants This study included 77 119 children (singleton, term birth and no malformation/severe diseases) whose mothers were registered between January 2011 and March 2014, including 3521 duos or trios of siblings. Primary outcome measures The primary outcome was developmental delay at 6 and 12 months of age, assessed using the Japanese translation of the Ages and Stages Questionnaires, third edition. Multivariable regression analyses adjusted for confounders were performed to estimate the risk ratios of delay associated with any or exclusive breast feeding. Pairs of siblings discordant for statuses were selected, and conditional regression analyses were conducted with a matched cohort design. Results Developmental delay was identified in 6162 (8.4%) and 10 442 (14.6%) children at 6 and 12 months of age, respectively. Any breast feeding continued until 6 months or 12 months old was associated with reduced developmental delay at 12 months of age (adjusted risk ratio (95% CI): 0.81 (0.77 to 0.85) and 0.81 (0.78 to 0.84), respectively). Furthermore, exclusive breast feeding until 3 months was associated with reduced developmental delay at 12 months of age (adjusted risk ratio, 0.86 (95% CI 0.83 to 0.90)). In sibling pair analysis, the association between any breast feeding until 12 months and reduced developmental delay at 12 months of age persisted (adjusted risk ratio, 0.64 (95% CI 0.43 to 0.93)). Conclusions The present study demonstrated the association of continuous breast feeding with reduced developmental delay at 1 year of age using sibling pair analysis, in which unmeasured confounding factors are still present but less included. This may provide an argument to promote breastfeeding continuation.

Original languageEnglish
Article numbere043202
JournalBMJ open
Volume11
Issue number8
DOIs
Publication statusPublished - Aug 11 2021

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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