Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 3;8(3):e251540.
doi: 10.1001/jamanetworkopen.2025.1540.

Breastfeeding Duration and Child Development

Inbal Goldshtein  1 , Yair Sadaka  1   2   3 , Guy Amit  1 , Nitsa Kasir  4 , Thomas Bourgeron  5 , Varun Warrier  6 , Pinchas Akiva  1 , Meytal Avgil Tsadok  7 , Deena R Zimmerman  8
Affiliations

Breastfeeding Duration and Child Development

Inbal Goldshtein et al. JAMA Netw Open. .

Abstract

Importance: Detecting and addressing potentially modifiable factors associated with healthy development is key to optimizing a child's potential. When investigating the outcomes of child development, it is important to account for disparities in feeding practices and avoid confounding bias.

Objectives: To estimate the independent association between breastfeeding and attainment of developmental milestones or neurodevelopmental conditions.

Design, setting, and participants: This retrospective cohort study used data from a national network for routine child development surveillance in Israel linked with national social insurance financial entitlements for neurodevelopmental deficiencies. Participants were children born between January 2014 and December 2020 after at least 35 weeks' gestation without severe morbidity and with at least 1 follow-up surveillance visit at 2 to 3 years of age. Outcome data were collected in March 2023.

Exposures: Duration and exclusivity of breastfeeding in infancy.

Main outcomes and measures: The primary outcomes were delays in attainment of developmental milestones and diagnosis of prespecified neurodevelopmental conditions. Multivariable regression, matching, and within-family analyses were used to estimate adjusted odds ratios (AORs) after accounting for potential confounding factors related to the child (gestational age, birth weight, multiple gestation, and child order in the family) and mother (age, socioeconomic status, educational level, marital status, employment, nationality, and postpartum depression).

Results: Of 570 532 children (291 953 [51.2%] male), 20 642 (3.6%) were preterm, 38 499 (6.7%) were small for gestational age, and 297 571 (52.1%) were breastfed for at least 6 months (123 984 [41.7%] were exclusively breastfed). Children who were breastfed for at least 6 months exhibited fewer delays in attaining language and social or motor developmental milestones compared with children exposed to less than 6 months of breastfeeding (AOR, 0.73 [95% CI, 0.71-0.76] for exclusive breastfeeding; AOR, 0.86 [95% CI, 0.83-0.88] for nonexclusive breastfeeding). Among 37 704 sibling pairs, children who were breastfed for at least 6 months were less likely to demonstrate milestone attainment delays (OR, 0.91 [95% CI, 0.86-0.97]) or be diagnosed with neurodevelopmental conditions (OR, 0.73 [95% CI, 0.66-0.82]) compared with their sibling with less than 6 months of breastfeeding or no breastfeeding.

Conclusions and relevance: In this cohort study, exclusive or longer duration of breastfeeding was associated with reduced odds of developmental delays and language or social neurodevelopmental conditions. These findings may guide parents, caregivers, and public health initiatives in promoting early child development.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Zimmerman reported being the director of the Maternal Child and Adolescent Department of the Public Health Directorate of the Israel Ministry of Health, which runs the maternal child health centers from which electronic medical record the data were derived. No other disclosures were reported.

Figures

Figure.
Figure.. Restricted Cubic Spline of Odds Ratios for Developmental Outcomes as a Function of Breastfeeding Duration
Analyses were adjusted for maternal-, birth-, and infant-related factors; 0 months was the reference. Shading indicates 95% CIs.
See this image and copyright information in PMC

References

    1. Meek JY, Noble L; Section on Breastfeeding . Policy statement: breastfeeding and the use of human milk. Pediatrics. 2022;150(1):e2022057988. doi:10.1542/peds.2022-057988 - DOI - PubMed
    1. Pereyra-Elías R, Quigley MA, Carson C. To what extent does confounding explain the association between breastfeeding duration and cognitive development up to age 14? findings from the UK Millennium Cohort Study. PLoS One. 2022;17(5):e0267326. doi:10.1371/journal.pone.0267326 - DOI - PMC - PubMed
    1. Jain A, Concato J, Leventhal JM. How good is the evidence linking breastfeeding and intelligence? Pediatrics. 2002;109(6):1044-1053. doi:10.1542/peds.109.6.1044 - DOI - PubMed
    1. Hair AB, Patel AL, Kiechl-Kohlendorfer U, et al. . Neurodevelopmental outcomes of extremely preterm infants fed an exclusive human milk-based diet versus a mixed human milk + bovine milk-based diet: a multi-center study. J Perinatol. 2022;42(11):1485-1488. doi:10.1038/s41372-022-01513-3 - DOI - PMC - PubMed
    1. Hua J, Barnett AL, Lin Y, et al. . Association of gestational age at birth with subsequent neurodevelopment in early childhood: a national retrospective cohort study in China. Front Pediatr. 2022;10:860192. doi:10.3389/fped.2022.860192 - DOI - PMC - PubMed

Publication types