(P24-040-24) Associations Between Duration of Exclusive or Predominant Breastfeeding and Cognition: A Longitudinal Study of 9–11 Year Old Ghanaian Adolescents

Objectives: To investigate the association of exclusive or predominant breastfeeding (EBF or PBF) from 0 to 5 mo of age with cognitive outcomes in 9-11 yr old Ghanaian children.

Methods: This is a secondary analysis using data from the 9-11 y follow-up study of the International Lipid-based Nutrient Supplement (iLiNS)-DYAD trial in Ghana that evaluated the impact of small-quantity lipid-based nutrient supplements or multiple micronutrient supplements during the first 1000 days on child growth and development. Maternal report of breastfeeding and complementary feeding practices was elicited at birth and monthly up to 6 months using food frequency questionnaires and 24-hour recalls. EBF was defined as the infant receiving no other liquids or foods other than breastmilk, with the exception of medicines and supplements; PBF allowed for water-based drinks. We created binary indicators of EBF and PBF from 0-5 mo and continuous indicators for duration of EBF and PBF, defined as the youngest age at which the infant was no longer exclusively or predominantly breastfed. When the children were 9-11 y old, cognitive tests were administered to measure general intellectual ability, literacy, arithmetic ability, declarative memory, procedural memory and executive function. We examined the association between 0-5 mo EBF/PBF or duration of EBF/PBF and cognitive outcomes using linear regression controlling for child age, sex, and outcome assessment enumerator.

Results: In our study sample (n=1187), 695 (61%) had been EBF, 876 (77%) had been PBF, and 1115 (99.6%) had been breastfed for 5 mo. The median durations of EBF and PBF were 5.1 and 6.0 mo, respectively. Neither duration of EBF nor of PBF was significantly associated with age-adjusted z-scores of the 6 cognitive outcomes at 9-11 yrs. Similarly, the binary indicators for EBF/PBF 0 to 5 mo were not associated with the outcomes.

Conclusions: In a population with high breastfeeding rates from 0-5 months, exclusivity and duration of breastfeeding were not associated with cognitive outcomes in 9-11 yr old Ghanaian children.

Funding Sources: Bill & Melinda Gates Foundation, NICHD, and Fogarty International Center