Breastfeeding Produces Smarter,
Healthier Babies

Breast Milk Found Good for Babies' Brains

By Marc Kaufman
Washington Post Staff Writer
Tuesday, May 7, 2002; 4:06 PM

Infants breastfed for nine months grew up to be
significantly more intelligent than infants breastfed
for one month or less, according to a new study in the
Journal of the American Medical Association.

Results from the study of more than 3,000 young men
and women from Copenhagen, Denmark, strongly support
the long suggested, but never proven, conclusion that
the act of breastfeeding not only makes babies
healthier, but smarter, too.

"We are really quite certain that what we are seeing
here is the effect of the duration of breastfeeding on
an individual's intelligence," said June Machover
Reinisch of the Kinsey Institute for Research in Sex,
Gender and Reproduction, one of the authors of the
study. "The question that remains is what exactly is
the aspect of breastfeeding that results in the
greater intelligence."

"The evidence is growing that breastfeeding is among
the most important lifelong benefits a mother can give
to her child," she said.

Reinisch also said that the study, which is the first
to measure the effects of breastfeeding well beyond
childhood, found that those who scored lowest in
intelligence tests were disproportionately in the
group that was breastfed one month or less.

Although public health officials, and even the infant
formula industry, recommend breastfeeding as the best
way to nourish an infant for the first six to 12
months, most American babies are still bottle-fed
during much of their infancy. The number of mothers
who begin breastfeeding has been increasing in recent
years to almost 70 percent, but an infant formula
industry study found that only 31 percent of all
infants are still being breastfed at 6 months.

The JAMA findings, and related conclusions about the
health and development benefits of breastfeeding, will
add to the already active public debate over how to
encourage breastfeeding ? which is most common among
white and wealthier women and least common among
minority and poorer women.

Studies have shown that many women never breastfeed or
stop quickly because of a wide range of ambivalent or
negative signals from society. Researchers have
identified reasons including cultural biases against
the practice, serious difficulties experienced by some
mothers when they return to work, a limited
availability of training in how to breastfeed, and the
sometimes aggressive advertising and promotion of the
infant formula industry. About half of all the infant
formula used in the United States is purchased for
poor women through the federal Special Supplemental
Nutrition Program for Women, Infants and Children

The study could have an impact as well on the dynamics
of the infant formula market. A new type of infant
formula, supplemented with two beneficial compounds
found in breastmilk but not traditional formula, that
has recently come onto the market. Makers of the new
formula believe their studies have shown the added
ingredients could be responsible for some of the
benefits of breastmilk on intelligence.

While some previous studies have suggested an
association between breastfeeding and improved
intelligence, the new study appears to provide the
strongest indication of an effect.

The research, funded primarily by the National
Institutes of Health, used two large groups of Danish
men and women who had been studied since their mothers
were pregnant with them between 1959 and 1961. When
the children were one year old, the mothers were
questioned about how long they breastfeed their

One group of 973 was given a Wechsler IQ test, an
intensive one-on-one assessment, while the other
sample of 2,280 men were given intelligence tests when
they entered the Danish military. In both groups,
those breastfed nine months scored significantly
higher than those breastfed for less than one month.

Further supporting the conclusion that breastfeeding
improved intelligence, researchers found a strong
"dose effect" ? a gradual improvement based on the
number of months of breastfeeding up to nine months,
when the effect ended. Because of previously studied
health effects, the American Academy of Pediatrics
recommends one year of breastfeeding as optimal.

Other studies have shown a correlation between
breastfeeding and scores on intelligence tests, but
some of that relationship disappeared when
complicating factors were taken into account. For
instance, the children of mothers who are better
educated and wealthier would be expected to be
healthier and to score higher on intelligence tests
however they were fed as infants. Their mothers
would be statistically less likely to smoke, to be
overweight, and to have large families ? all
associated with less healthy children who do
less well on intelligence tests.

But the new Danish study took into account 13 similar
factors related to the mother's health, wealth and
behavior when analyzing the difference between the
scores of more-breastfed and less-breastfed young
adults. The significant differences held up after they
were factored in.

In addition, the Danish study looked at the effect of
breastfeeding on young adults in their late teens and
twenties. Researchers said the results were
potentially more meaningful than earlier studies that
looked at intelligence in young children, which is
less stable and more difficult to test with confidence.
Nonetheless, some of the earlier studies also
showed significant results. A recent study, led
by Malla Rao of the NIH, found that babies born
small but at term scored an average of 11 point higher
on intelligence tests than those breastfed for 3 months.
The IQ tests were given at 5 years old.

The JAMA report offers three possible explanations for
the association between breastfeeding and higher
scores on intelligence tests. The first is that two
fatty acids associated with the development of nerve
cells and the brain are present in breast milk but are
absent in infant formula and cow's milk. The two,
docosahexaenoic acid and aracidonic acid, have been
shown in experiments to improve eyesight and some
motor responses in infants and young children.

According to author Reinisch, these two compounds
are among hundreds found in breastmilk, but not in
substitutes. Other substances found in breast milk
have been shown to improve a child's respiratory and
gastro-intestinal health as well.

The authors also suggest that the mother-infant bond
can be deepened through breastfeeding and that contact
may affect the intellectual development of the child.
They report as well the hypothesis that how long a
mother breastfeeds is an "indicator of the interest,
time and energy that the mother is able to invest in
the child during the whole upbringing period."

The new formula with DHA and ARA was recently
introduced to the market, after being approved by the
Food and Drug Administration. According to Christine
Taylor, director of the FDA's Office of Nutritional
Products, Labelling and Dietary Supplements, the
agency concluded that the supplemented formula was
safe, but made no effort to determine whether it was
effective in increasing infant health or intelligence.

Peter Paradossi of Mead Johnson Nutritionals, which
began selling formula supplemented by DHA and ARA in
February, said the company does not make any direct
health claim on its label, only reporting that it
contains "nutrients found in breastmilk." On a side
panel, the label describes DHA and ARA as "important
building blocks for baby's brain and eyes."

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