This study examined the relationship between breastfeeding and verbal ability in 3-year-olds, as measured by the Peabody Picture Vocabulary Test (PPVT). The study used data from 1,645 mothers in the Fragile Families and Child Wellbeing Study. It found that after adjusting for maternal verbal ability scores on the PPVT, the positive association between breastfeeding and child verbal scores was reduced. The benefits of breastfeeding on cognition were only seen for children of mothers with more than a high school education. For less educated mothers, breastfeeding status did not impact child verbal scores. The results suggest maternal verbal skills mediate the link between breastfeeding and child development, and the cognitive benefits of breastfeeding depend on other
This is the first of four articles from my doctoral research. Research indicates the more fathers are involved in care giving of their infants the higher the levels of oxytocin in thier bodies! In my research Attachment and Bonding Constructs were supported by data analysis.
Aleitamento materno e adiposidade adultaLaped Ufrn
Aleitamento materno e adiposidade adulta (JPed 2014) - Artigo apresentado em Reunião Científica da Liga Acadêmica de Pediatria da UFRN - LAPED UFRN - Natal - RN - Brasil.
Encouraging Appropriate Infant Feeding Practices in Slums: A Positive Devian...Siddharth Agarwal
Abstract:
Nutritional Positive Deviant (PD) infants grow ‘bigger’ and ‘faster’ than other infants living in a similarly socio-economically deprived environment. Certain positive feeding and care giving practices adopted by mothers of PD infants enable them rear better nourished and active infants. Limited data is available on using PD mothers as counselors encouraging appropriate and feasible infant feeding practices (IFP) in India. Hence, the present study was undertaken. The study was conducted in a slum of Delhi (India). Twenty-Five infants aged 6-12 months were weighed. Three infants with normal weight for age status (as per Gomez classification) were classified as PD infants. A PD inquiry (PDI) was conducted on current IFP
in these families to identify PD behaviours adopted and determinants for the same. PD behaviours identified
included:feeding modified family pot (energy dense) complementary food at least two times a day,
supervised bowl feeding by the mother and father support to the mother in infant feeding and care giving.
Two,of these three PD mothers volunteered to discuss the benefits of PD behaviours they had been
practicing with the other 22 members of the group. The strategy promoted collective dialogue and discussion
to try the PD behaviours through weekly group discussions over a period of four weeks. After four weeks,
feeding modified family pot food with addition of 1 tea spoon of ghee (milk fat) in food (10/22), feeding an extra
mid-day cereal snack (12/22) were PD behaviours adopted by other members of the group (22). It can be
concluded that i) behaviours requiring least preparation time were easily adopted and ii) PD mothers can
be effective counselors to encourage appropriate IFP
Objective: Food habits may be associated with inflammation, but there is little information about processed and ultra-processed foods in children. Thus, our aim was to investigate the relationship between processed and ultra-processed foods, energy intake, total fat and saturated fats intake and high sensitivity C - reactive protein levels (hs - CRP) in children.
Design: A cross-sectional study with a population-based cluster sample.
CLARITY BPA: a Novel Approach to study EDCsDES Daughter
by the Collaborative on Health and the Environment
On this call Retha Newbold, MS, Researcher Emeritus, National Toxicology Program, National Institute of Environmental Health Sciences, discussed the program called “The Consortium Linking Academic and Regulatory Insights on the Toxicity of Bisphenol A (CLARITY-BPA)” which is an interagency agreement, conducted under the auspices of the National Toxicology Program (NTP), between The National Institute of Environmental Health Sciences (NIEHS) supported grantees, the staff of the Division of the National Toxicology Program (DNTP) at NIH/NIEHS, and the Food and Drug Administration at the National Center for Toxicological Research (FDA/NCTR). The goals of the consortium are to enhance the utility of a perinatal 2-year GLP chronic toxicity study on BPA for regulatory decision-making by incorporating a wide range of doses and some additional disease-related endpoints that are not usually covered.
To this end, 12 NIEHS grantees are studying hypothesis-driven mechanisms by investigating specific endpoints that maybe altered by BPA including behavioral/neuroendocrine, immune function, cardiac, reproductive tract, cancer, thyroid, and other organ systems. This consortium is unique in that it combines the knowledge and skills of the NTP staff with experts from the academic field who are covering more mechanistic studies. Although this program focuses on BPA, it may provide an example of how to better study effects of other endocrine disrupting chemicals especially since numerous organ systems may be involved.
Sources: http://www.healthandenvironment.org/partnership_calls/14639
After two long years in total frame-off restoration, my 1968 SS/RS 396 Camaro convertible is REBORN!!!!!! This was a TRUE barn-find. and is numbers matching, original big block classic muscle car! Yeah Baby!!!!!
:)
Chris
This is the first of four articles from my doctoral research. Research indicates the more fathers are involved in care giving of their infants the higher the levels of oxytocin in thier bodies! In my research Attachment and Bonding Constructs were supported by data analysis.
Aleitamento materno e adiposidade adultaLaped Ufrn
Aleitamento materno e adiposidade adulta (JPed 2014) - Artigo apresentado em Reunião Científica da Liga Acadêmica de Pediatria da UFRN - LAPED UFRN - Natal - RN - Brasil.
Encouraging Appropriate Infant Feeding Practices in Slums: A Positive Devian...Siddharth Agarwal
Abstract:
Nutritional Positive Deviant (PD) infants grow ‘bigger’ and ‘faster’ than other infants living in a similarly socio-economically deprived environment. Certain positive feeding and care giving practices adopted by mothers of PD infants enable them rear better nourished and active infants. Limited data is available on using PD mothers as counselors encouraging appropriate and feasible infant feeding practices (IFP) in India. Hence, the present study was undertaken. The study was conducted in a slum of Delhi (India). Twenty-Five infants aged 6-12 months were weighed. Three infants with normal weight for age status (as per Gomez classification) were classified as PD infants. A PD inquiry (PDI) was conducted on current IFP
in these families to identify PD behaviours adopted and determinants for the same. PD behaviours identified
included:feeding modified family pot (energy dense) complementary food at least two times a day,
supervised bowl feeding by the mother and father support to the mother in infant feeding and care giving.
Two,of these three PD mothers volunteered to discuss the benefits of PD behaviours they had been
practicing with the other 22 members of the group. The strategy promoted collective dialogue and discussion
to try the PD behaviours through weekly group discussions over a period of four weeks. After four weeks,
feeding modified family pot food with addition of 1 tea spoon of ghee (milk fat) in food (10/22), feeding an extra
mid-day cereal snack (12/22) were PD behaviours adopted by other members of the group (22). It can be
concluded that i) behaviours requiring least preparation time were easily adopted and ii) PD mothers can
be effective counselors to encourage appropriate IFP
Objective: Food habits may be associated with inflammation, but there is little information about processed and ultra-processed foods in children. Thus, our aim was to investigate the relationship between processed and ultra-processed foods, energy intake, total fat and saturated fats intake and high sensitivity C - reactive protein levels (hs - CRP) in children.
Design: A cross-sectional study with a population-based cluster sample.
CLARITY BPA: a Novel Approach to study EDCsDES Daughter
by the Collaborative on Health and the Environment
On this call Retha Newbold, MS, Researcher Emeritus, National Toxicology Program, National Institute of Environmental Health Sciences, discussed the program called “The Consortium Linking Academic and Regulatory Insights on the Toxicity of Bisphenol A (CLARITY-BPA)” which is an interagency agreement, conducted under the auspices of the National Toxicology Program (NTP), between The National Institute of Environmental Health Sciences (NIEHS) supported grantees, the staff of the Division of the National Toxicology Program (DNTP) at NIH/NIEHS, and the Food and Drug Administration at the National Center for Toxicological Research (FDA/NCTR). The goals of the consortium are to enhance the utility of a perinatal 2-year GLP chronic toxicity study on BPA for regulatory decision-making by incorporating a wide range of doses and some additional disease-related endpoints that are not usually covered.
To this end, 12 NIEHS grantees are studying hypothesis-driven mechanisms by investigating specific endpoints that maybe altered by BPA including behavioral/neuroendocrine, immune function, cardiac, reproductive tract, cancer, thyroid, and other organ systems. This consortium is unique in that it combines the knowledge and skills of the NTP staff with experts from the academic field who are covering more mechanistic studies. Although this program focuses on BPA, it may provide an example of how to better study effects of other endocrine disrupting chemicals especially since numerous organ systems may be involved.
Sources: http://www.healthandenvironment.org/partnership_calls/14639
After two long years in total frame-off restoration, my 1968 SS/RS 396 Camaro convertible is REBORN!!!!!! This was a TRUE barn-find. and is numbers matching, original big block classic muscle car! Yeah Baby!!!!!
:)
Chris
Notes from Stanford conference: Advancing Socially and Environmentally Responsible Supply Chains (Stanford Center for Social Innovation & Stanford Global Supply Chain Management Forum) and Greener by Design (GreenBiz.com)
Innovation webinar - Three ways erp will change - dan matthewsIFS
Compared to those used in the 90’s, today’s ERP systems have many things in common—but also significant differences. In this webinar you are welcome to listen to IFS Chief Technology Officer Dan Matthews talk about three ways in which ERP will change over the next 15 years.
Effects of preterm birth on school readiness part iOzella Brundidge
Preterm and low birth-weight born school-age children experience difficulties with complex language functions which can negatively effect social skills, communication abilities, and academic performance. Children born very low birth-weight (VLBW) from lower socioeconomic status (SES) households performed significantly poorer on intellectual ability and academic achievement. However, VLBW first grade children from higher SES households performed similar to their siblings. Parents, pediatricians, and early childcare providers play a critical role in obtaining critical early intervention for this heterogeneous cohort. Preschool enrollment improved verbal and nonverbal cognitive school readiness skills from socially disadvantaged families. Preschool enrollment had no significant effect on cognitive and behavioral skills for moderate preterm (MPT) and very preterm (VPT) born children by family SES. Although preschool enrollment did not moderate the relationship between premature birth and school readiness, enrollment did moderate the relationship between small for gestational age (SGA) and school readiness. Preschool enrollment has a positive effect on language skills and verbal school readiness outcome.
I provided background information and research on child nutrition, and I related it to child development theories and application to research, teaching, and working with children. This research paper encompasses human growth and development by sharing how a child's ecological system impacts their wellbeing, such as food programs, school, or family.
The Effect of Breastfeeding on Children’s CognitionAlgham.docxcherry686017
The Effect of Breastfeeding on
Children’s Cognition
Alghamdi
Comparative Analysis
Research Question what are the effects of breastfeeding on children’s cognition?
This analysis is intended to summarize the two studies of interest and attempt to answer the research question.
Study one: Breastfeeding and child cognitive outcomes
Study two: The effect of breastfeeding on child development at 5 years: A cohort study
Article #1 Summary
Conducted by: Jiang, M., Foster, E., & Gibson-Davis
Purpose: To investigate the the effects of breastfeeding duration and initiation on children’s cognition (perception).
This study took into account previous studies, and it intended to discover the deficiencies that other studies have on the same topic area.
This study focused on confounding variables that can intervene with results.
Article # 1 Summary(Methodology)
Design
The method used is correlational study since it studied the relationship between breastfeeding and cognition. There were 3,271 participants selected from The Child Development Supplement(CDS).
Materials
Tests
1-Woodcock Johnson Psycho-Educational Battery-Revised(WJ-R), which examines cognitive abilities in different areas, such as present progress position and proficiency in math and literacy(Reading).
2-Wechsler Intelligence Scale for Children-Revised (WISC-R) tests, which examines children’s capability to deal with information in memory( working memory).
Article # 1 Summary(Methodology)
Materials(Continue)
The Child Development Supplement(CDS)
is a part of The Panel Study of Income Dynamics (PSID). The participants and their families where selected from CDS. Also, CDS provides information concerning children and their families, such as cognitive abilities, children’s families and neighborhood conditions (Health).
1997 CDS interviews
Previous literature
CDS Data
Article # 1 (Methodology)
Data collection procedures
Variables
1-Cognition data were collected from tests mentioned.
2-Breastfeeding initiation and period are the independent variables and were collected from 1997 CDS interviews. Breastfeeding can be divided into four groups: not once breastfeed, less that 6 months, between 7 months and year and more than a year.
3- Confounding variables were collected from lit review, CDS and PSID. There are three groups of confounding variables:
Article # 1 (Methodology)
A-Children confounding variables
B-Mothers confounding variables, such as IQ scores taken from 1997 CDS, education and age.
C-Family confounding variables, such as income since the child birth.
Note: there are many confounding variables that had been investigated. However, there is no space to mention them here.
Article # 1 (Methodology)
Data analysis Procedures
Propensity Score Matching is ,According to Jiang et al. ( 2011) ,“ the conditional probability of assignment to treatment given a set of covariates” Calculating Propensity Score for breastfeeding initiation.
Calculati ...
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
3. A LTHOUGH BREASTFEEDING IS widely regarded as
beneficial for child and maternal health,1 its effect
on children’s cognitive development remains an open
METHODS
Subjects
The FF is a large birth cohort study of 3700 unmarried
question. Mothers who breastfeed have more education,
and 1200 married new parents. Couples were sampled
higher incomes, and better mental and physical health
from 75 hospitals in 20 large cities in 15 different states.
than those who do not,2–5 and failure to adequately
Mothers were interviewed in the hospital shortly after
adjust for these differences can overestimate the effects giving birth, and fathers were interviewed either in the
of breastfeeding. Maternal verbal ability seems particu- hospital or wherever they could be located. When the
larly important, because it can account for the entire child was 1 and 3 years old, parents were surveyed by
association between breastfeeding and child cognition.6,7 telephone. The FF surveyed parents on topics related to
Nevertheless, many studies have found a positive effect child and family well-being, and additional details of the
of breastfeeding on mental functioning,8–14 and a 20- study, including city and hospital selection, are pub-
study meta-analysis found that breastfeeding increased lished elsewhere.22
cognition scores by 5 points for low birth weight infants At 3 years, an in-home assessment was conducted,
and 3 points for normal birth weight infants.15 Two which included measures of both mother and child cogni-
recent literature reviews16,17 also concluded that breast- tive ability and the quality of the child’s home environ-
feeding was beneficial, particularly for low birth weight ment. Data used in this article come from the baseline
children. survey, first- and third-year surveys, and the in-home
The majority of previous studies have assumed that assessment.
breastfeeding has a direct effect on child cognition; most At baseline, information was collected from 4898
commonly, this effect is ascribed to the superior nutri- mothers, of which 4231 (86%) participated in the year-3
ents found in breast milk.2,18,19 Yet, it is possible that telephone survey. Of the 4231 families, 3336 (79%)
breastfeeding is beneficial because it occurs in the con- participated in some portion of the in-home assessment,
text of other positive parenting practices. Breastfeeding but only 2182 (52%) participated in the child observa-
mothers may respond more to the needs of their child, tion. Nonresponse on the child observation was a result
spend more time in mother-child interaction, or engage of family relocation ( 85% of nonrespondents) or re-
in more stimulating activities. These advantageous par- fusal (15% of nonrespondents). Of these 2182 observa-
enting practices, together with breastfeeding, may pro- tions, an additional 221 were missing data on either the
duce cognitive benefits. cognitive or the mother-child interaction outcomes, re-
Advantageous parenting practices, particularly cogni- sulting in 1961 completed in-home assessments. Cases
tively stimulating parenting, are strongly correlated with were also deleted if they were missing data on breast-
maternal education,20,21 in part because better-educated feeding (n 62), the child had a physical disability (n
mothers have more opportunities to provide stimulation 58), or the mother was not born in America (n 196),
for their children. In this study we stratified our sample which resulted in a final sample size of 1645.*
according to education level to analyze the association Informed consent was obtained from all participants.
between breastfeeding and children’s verbal abilities. We The survey was approved by the internal review boards
would expect that among better-educated mothers, of Princeton and Columbia Universities.
those who breastfeed, relative to those who do not, will Subjects who completed the year-3 telephone survey
have children with higher cognition scores. This associ- versus those who completed the in-home assessment
ation may not exist among less-educated mothers, be- had few differences in demographic characteristics, with
cause they may not be able to draw on the same re- the exception that they had lower household incomes
sources as mothers with more education. and younger children. Mothers who participated in both
We examined the effect of breastfeeding on a mea- the in-home assessment and the child observation, as
sure of children’s verbal ability, the Peabody Picture compared with those who participated in the in-home
Vocabulary Test-Third Edition (PPVT-III). Data come assessment without the child observation, were more
from the Fragile Families and Child Wellbeing Survey likely to be black and have older children.
(FF), a longitudinal birth cohort study drawn from 20
cities in 15 states. We first present estimates of breast- Measures and Procedure
Maternal and child cognitive ability was measured at 3
feeding that have been adjusted for maternal PPVT-III
years with the PPVT-III, a measure of receptive vocabu-
scores, hypothesizing that maternal verbal ability medi-
lary.23 The PPVT-III correlates well with standardized
ates much of the effect of breastfeeding. Next, we test
measures of intelligence such as the Wechsler Intelli-
the hypothesis that breastfeeding is moderated by ma-
ternal education by estimating separate models for 3
* Immigrant mothers were omitted because it was unclear if their educational status would be
education groups: no high school diploma, high school adequately captured by the American-based measures. Including immigrant mothers does not
diploma, and some post–secondary education. substantially change our results, nor does including children with a physical disability.
PEDIATRICS Volume 118, Number 5, November 2006 e1445
Downloaded from www.pediatrics.org by on June 2, 2009
4. gence Scale-Third Edition.23 The PPVT-III was adminis- using the Composite International Diagnostic Interview
tered in both English and Spanish by interviewers who Short Form,27,28 following the developer’s guidelines,29 to
had received appropriate training. As has been done classify mothers who had a score of 3 as having a
elsewhere,24 extreme PPVT-III scores were imputed; probable major depressive episode (according to Diagnos-
scores below 55 were imputed to 55 for 104 children and tic and Statistical Manual of Mental Disorders, Fourth Edition
12 mothers. Because the average age at assessment was criteria).
36 months, 6% of children had PPVT-III scores of 55. The correlations between the 2 HOME scales and ma-
Because the PPVT-III can only be administered to chil- ternal PPVT-III were low (r 0.31 in all cases). Correla-
dren 3 years, this left-censoring reflects a basal effect. tions between the HOME measures and income, and be-
Results do not change if scores below 55 are not im- tween HOME and maternal education, were all 0.20. The
puted. The correlation between maternal PPVT-III and correlation between income and education was 0.43.
child PPVT-III, education, and income was 0.42, 0.47, Most control variables were taken from the year-3
and 0.46, respectively. survey, because maternal PPVT-III and the HOME scores
Breastfeeding behaviors, collected at year 1, were were only measured at that time. Race and ethnicity,
based on mother’s report of how long she breastfed the parity, health behaviors during the pregnancy, and
child. On the basis of the work of Jain et al,25 and child’s birth weight status and gender were gathered
because mothers may change feeding methods within during the baseline interview. In other models not
the first few weeks of life, mothers were classified as
shown, we substituted year-3 variables for baseline vari-
having breastfed if they did so for at least the first month.
ables; using baseline measures of education, relationship
Maternal educational status was classified into 3
status, age, and income did not substantively change our
groups: those who did not complete high school, those
results.
who graduated from high school or obtained their gen-
The association between breastfeeding and PPVT-III
eral equivalency degree, and those who had some edu-
scores was modeled by using hierarchical multivariate
cation beyond high school.† Educational status was orig-
regression. The first model estimated a bivariate associ-
inally measured at baseline, but cases were coded to
ation between breastfeeding and PPVT-III scores, and in
reflect any additional education received.
Home environment was measured through 2 inter- the second and subsequent models, additional blocks of
viewer-rated scales of the Home Observation for Mea- covariates were added. Changes in the breastfeeding
surement of the Environment (HOME) scale.26 The non- coefficient across models provided an indication of how
punitive/hostility scale consisted of 5 items on which the breastfeeding was mediated by the other covariates. In
interviewer rated the mother on the absence of antago- all models, to account for clustering within city, we used
nistic or aggressive behaviors (eg, if the mother did not Huber-White standard errors that correct for potential
shout or spank the child). The emotional-responsiveness nonindependence across observations. To address the
scale consisted of 6 items that measured positive verbal problem of missing data in the control variables, we used
maternal interactions (eg, if the mother spontaneously multiple imputation.30 In multiple imputation, every
praised the child). For both scales, higher scores mean missing case is replaced by n simulated values, resulting
better home environments. in n complete data sets. These data sets can then be
Demographic variables included maternal and pater- analyzed by using standard regression methods, and the
nal race/ethnicity and age, paternal education (mea- results are combined and adjusted for the multiple im-
sured similarly to that of mothers), parity, and if the putation procedure. Rates of missing data were low,
mother had a child subsequent to the child participating because only a few variables were missing in 4% of the
in the FF. Marital status was measured through 4 dichot- cases.
omous variables: married to the birth father (the refer-
ence category), cohabiting with the birth father, no ro-
mantic relationship, and married or cohabiting with a RESULTS
new partner. Household income was the log of the Because the FF oversampled nonmarital births, the pop-
mother’s household income averaged over the 3 rounds ulation is relatively disadvantaged in terms of cognitive
of the survey. The child characteristics included if the ability, educational attainment, and income (Table 1).
child was female, the child’s age (in months), and if the PPVT-III scores are normed to be 100 on national sam-
child had a low birth weight. Maternal health variables ples, yet the FF PPVT-III scores were below national
were pregnancy behaviors (smoked during pregnancy, norms for both children (86.8) and mothers (89.9). Ap-
saw a doctor during first trimester), a self-report of proximately one quarter of mothers did not complete
health status (if mother was is in good or excellent high school, and an additional third had no post–second-
health), and depression. Depression was measured by ary education. Average yearly household income was
$30 500. Only 40% of the mothers breastfed for at least
† There were too few mothers who had a bachelor’s degree to constitute their own category. 1 month, a rate lower than that reported by the National
e1446 GIBSON-DAVIS, BROOKS-GUNN
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5. TABLE 1 Characteristics of the FF Survey (n 1645) Immunization Survey (62%).31 The sample was 60%
Characteristic Average (SD) black and 20% Hispanic.‡
Breastfed at least 1 mo, % 40.3 Rates of breastfeeding and PPVT-III scores were
PPVT-III score (child) 86.8 (15.1) higher for the mothers with more education. For breast-
Cohabitating , % 25.3 feeding, 58% of the mothers with some post–secondary
No romantic relationship, % 38.3 education breastfed for at least 1 month, as compared
Cohabit with or married to new partner, % 10.5
with 27% of the mothers without a high school diploma
Black, % 59.7
Hispanic, % 19.5 and 33% who had graduated from high school. Better-
Father different race, % 13.7 educated mothers had higher PPVT-III scores (mean:
Age, y 27.6 (5.9) 95.2) and children with higher PPVT-III scores (mean:
Age (father), y 30.0 (7.0) 90.1) than either mothers with only a high school di-
No high school, % 25.8
ploma (mean scores: 88.5 [mothers] and 84.4 [chil-
High school only, % 31.0
No high school (father), % 27.2 dren]) or those who did not complete high school (mean
High school (father), % 37.1 scores: 82.3 [mothers] and 83.1 [children]). Mothers
Child was mother’s first, % 36.7 with some post–secondary education also had HOME
Mother had subsequent child, % 28.4 scores that were one third to one half higher than moth-
Household 3-y average income, $ 30 550 (29 798)
ers with a high school diploma or less.
Smoked during pregnancy, % 21.8
Saw doctor during first trimester, % 81.3 In bivariate associations (Table 2, model 1), the average
Mother in good/excellent health, % 61.3 breastfed child had PPVT-III scores that were 6.2 points
Probable case of depression, % 23.7 higher than a child who was not breastfed. This difference
Characteristic, mean (SD) remained significant at the 5% level even after adjusting
Female child, % 48.1
Child’s age, mo 35.5 (2.3)
for demographics, health behaviors, and the HOME mea-
Child had low birth weight, % 9.4 sures (models 2 and 3). However, the coefficient decreased
HOME: emotional responsiveness score 5.50 (1.05)
HOME: nonpunitive score 5.15 (1.34)
PPVT-III score (mother) 89.9 (11.8) ‡ The Hispanic sample includes 28 mothers who classified themselves as another race or eth-
nicity (eg, Asian or Pacific Islander).
TABLE 2 Regression of Children’s PPVT-III Scores on Breastfeeding and Other Characteristics
b (P)
Model 1 Model 2 Model 3 Model 4
Breastfed at least 1 mo 6.22 (.000) 2.43 (.018) 2.56 (.009) 1.72 (.060)
Cohabiting 3.75 (.000) 3.78 (.000) 3.03 (.002)
No romantic relationship 2.89 (.013) 2.52 (.028) 2.10 (.072)
Cohabit with or married to new partner 4.50 (.000) 4.29 (.000) 3.47 (.002)
Black 7.91 (.000) 6.63 (.000) 4.13(.003)
Hispanic 6.98 (.000) 6.90 (.000) 5.00 (.001)
Father of different race 0.35 (.804) 0.31 (.815) 0.11 (.931)
Age 0.25 (.014) 0.23 (.018) 0.26 (.017)
Age (father) 0.25 (.002) 0.25 (.001) 0.24 (.003)
No high school 1.69 (.171) 0.94 (.403) 1.38 (.272)
High school only 2.19 (.011) 1.87 (.018) 0.83 (.255)
No high school (father) 2.00 (.051) 1.94 (.052) 1.56 (.112)
High school (father) 0.79 (.425) 0.89 (.353) 0.91 (.319)
Child was mother’s first 1.75 (.073) 1.59 (.122) 1.52 (.101)
Mother had subsequent child 2.63 (.012) 2.12 (.032) 2.08 (.047)
Household 3-y average income (log) 1.60 (.005) 1.26 (.017) 0.33 (.430)
Smoked during pregnancy 0.38 (.702) 0.42 (.644) 0.52 (.584)
Saw doctor during first trimester 0.96 (.230) 0.55 (.436) 0.79 (.276)
Mother in good/excellent health 0.39 (.544) 0.34 (.631) 0.18 (.777)
Probable case of depression 0.38 (.580) 0.27 (.683) 0.66 (.353)
Female child 1.77 (.006) 1.78 (.009) 1.76 (.008)
Child’s age (months) 0.39 (.040) 0.42 (.008) 0.33 (.022)
Child had low birth weight 3.32 (.008) 3.09 (.016) 2.67 (.028)
HOME: emotional responsiveness 1.94 (.001) 1.69 (.000)
HOME: nonpunitive/hostility scale 1.02 (.001) 0.95 (.002)
PPVT-III score (mother) 0.33 (.000)
Observations 1645 1645 1645 1645
R2 0.04 0.19 0.22 0.27
PEDIATRICS Volume 118, Number 5, November 2006 e1447
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6. to 1.72 once the mothers’ PPVT-III scores were added breastfed, their child’s PPVT-III score increased by 0.27
(model 4), and its P value increased to .060. points (P .05).
Using the same progression of models, mothers were
DISCUSSION
next stratified by educational level (Table 3).§ The first 2
Previous research has indicated that children who are
rows of the table indicate no significant bivariate associ-
breastfed, in unadjusted comparisons with children who
ation between breastfeeding and PPVT-III scores for
are formula fed, score higher on measures of cognitive
mothers with a high school diploma or less (model 1).
functioning.3,9,10,32 The reasons for this difference, how-
The coefficients were small (1.9 for mothers who did not
ever, are unclear. It may be because breast milk contains
complete high school, 2.1 for mothers who did), and the
nutrients that promote optimum cognitive development;
coefficients only decreased in subsequent models.
alternatively, it could be a result of the advantageous
The third row of Table 3 indicates that, among moth-
characteristics of mothers who breastfeed.
ers with some post–secondary education, children who
One of those advantages is that mothers who breast-
were breastfed scored 7.4 points higher (P .01) on the
feed have higher verbal abilities.6,7 Given the high heri-
PPVT-III than children who were not breastfed. Once
tability in cognition between parent and child,33 models
any covariates were included (model 2), the coefficient
that do not control for maternal abilities risk finding a
decreased to 3.7 points (P .01). The coefficient con-
spurious correlation between breastfeeding and cogni-
tinued to decline across models but remained significant;
tive functioning. Our findings underscore this point, be-
in the final model, breastfed children scored 2.2 points
cause adjusting for maternal PPVT-III scores decreased
higher on the PPVT-III (P .05).
the size of the breastfeeding coefficient in the full sample
In additional analyses not shown, mothers were di-
by 48% and resulted in a coefficient that was no longer
vided into education according to race and ethnicity
statistically significant at the 5% level. The large effect of
groups. Although the sample sizes were small, the pat-
maternal PPVT-III is consistent with past research6,7 and
tern of effects was similar. For non-Hispanic white, non-
leads us to conclude that measures of maternal ability
Hispanic black, and Hispanic children, it is only among
must be included in studies on breastfeeding and child
mothers with more education that breastfeeding was
cognitive development.
associated with an increase in PPVT-III scores.
Another potential advantage associated with breast-
Because of the importance of considering the dose-
feeding is that it may be correlated with other positive
response effects of breastfeeding, in other models not
parenting practices. In this study, on the basis of past
shown we classified breastfeeding according to duration:
research that has found a strong positive correlation
never breastfed (the reference category), breastfed for 1
between education and cognitively enriching parent-
month, breastfed for 2 to 5 months, and breastfed for 6
ing,21,34 we had hypothesized that these parenting prac-
months. In these models, there were no significant
tices might be occurring among the better-educated
breastfeeding effects among mothers without some post–
mothers and had stratified our sample on the basis of
secondary education. For better-educated mothers, the
education group. We found that among mothers with
coefficients for all 3 dichotomous breastfeeding mea-
some post–secondary education, children who were
sures were positive, but only the coefficient associated
breastfed for at least 1 month had higher PPVT-III scores
with breastfeeding for 6 months was significant at
than those who were not. The gain was not large; once
conventional levels (b 3.63; P .01). We also modeled
all relevant maternal and child factors were taken into
breastfeeding as a continuous variable. Breastfeeding
account, the difference was 2 points. It is notable, how-
had a significant and positive effect, but only for the
ever, that there were no differences in PPVT-III scores,
upper-education group; for every month this group
even in unadjusted mean comparisons, for mothers with
a high school diploma or less.
A 2-point difference is 0.14 of an SD, a small effect
§ In additional models, we included an interaction term between breastfeeding and education. The according to Cohen’s rules35 for effect-size magnitude.
term was not significant at conventional levels, but its positive direction was consistent with what we
would expect. Furthermore, in these models, the associated breastfeeding coefficient decreased by
However, the difference is similar to the gap in child
50%, indicating that some of its effect was moderated by the interaction term. PPVT-III between married and unmarried mothers (0.18
TABLE 3 Regression of Children’s PPVT-III on Breastfeeding According to Educational Status
Breastfed at Least 1 mo b (P)
Model 1 Model 2 Model 3 Model 4
No high school diploma (n 424) 1.94 (.061) 1.35 (.351) 1.46 (.293) .94 (.506)
High school diploma (n 510) 2.06 (.286) .94 (.650) 1.34 (.501) 1.03 (.594)
Post-secondary education (n 711) 7.39 (.000) 3.65 (.003) 3.53 (.002) 2.20 (.030)
Model 1 is the bivariate association between breastfeeding and PPVT-III scores. Model 2 is model 1 plus marital status, age, race/ethnicity, parity,
income, child characteristics, and health status. Model 3 is model 2 plus HOME scores. Model 4 is model 3 plus maternal PPVT-III.
e1448 GIBSON-DAVIS, BROOKS-GUNN
Downloaded from www.pediatrics.org by on June 2, 2009
7. of an SD). In addition, as explained by Rock and Sten- aware of any literature that documented a connection
ner,36 small differences in a vocabulary-test score may between breastfeeding recall and education, and breast-
not mean much for any one individual but can be con- feeding information was collected within 1 year of the
sequential for groups of children (such as those entering child’s birth. Although the FF shows lower rates of
into a kindergarten class). breastfeeding among high school dropouts than in other
These results are consistent with the one study that surveys,4,37 this may reflect the minority nature of the
has looked at breastfeeding by maternal educational sta- sample. White mothers, when stratified according to
tus. Oddy et al11 found higher PPVT-R (revised edition) educational level, breastfed at rates commensurate with
scores for breastfed infants, but only for mothers with a those from other large-scale surveys (results not
college degree. The authors do not explain their educa- shown).38 Another source of bias could arise if inter-
tion-breastfeeding interaction but instead attribute their viewers assigned higher PPVT-III scores to better-edu-
significant findings to the beneficial properties of breast cated mothers. However, information on education sta-
milk.11 tus was collected by telephone, whereas the PPVT-III
Some limitations to our study should be noted. First, scores were gathered in person by a different inter-
the FF cannot be generalized to the larger US popula- viewer. We also note that neither of these biases could
tion. The FF oversampled births from unmarried couples account for differences found by breastfeeding status
in cities across the United States, which resulted in a within the group of better-educated mothers.
sample that is predominantly urban and low income. In the sample, mothers who completed the in-home
Therefore, these results pertain to relatively disadvan- assessment were also more likely to be black. Because
taged mothers who live in select cities, and the findings results were replicated in models estimated separately
cannot be applied to the effect of maternal education for for white, black, and Hispanic mothers, we do not be-
mothers with a bachelor’s degree or higher. Omitted lieve this selection unduly bias our findings.
variable bias may also be a problem. Although models This work occurs in the context of other studies that
controlled for a broad set of characteristics, there may be have attributed the beneficial effects of breastfeeding to
other relevant parenting behaviors and/or environmen- the presence of long-chain polyunsaturated fatty acids
tal factors that were not included. (LCPUFAs) in breast milk.2,11,12,14,39,40 LCPUFAs are nec-
Another disadvantage of the FF is that it does not essary for retinal and neural development,3,18,41,42 and
contain measures of exclusive breastfeeding. It is unclear animal studies indicate that severe LCPUFA deprivation
if mothers used formula, when they began to do so, and negatively affects cognitive and behavioral perfor-
how much they used. This limitation has important im- mance.43 Evidence showing a causal role between
plications, because well-educated mothers are more LCPUFAs and enhanced human neural functioning,
likely to exclusively breastfeed.4 Therefore, it is possible however, is inconclusive.19,41,43,44 Although these findings
that the lack of observed effect among lower-educated do not relate directly to possible associations between
women is because some breastfeeding mothers are ac- LCPUFAs and cognition, they may indicate that LCPUFAs
tually supplementing with formula, and both groups by themselves are insufficient to create cognitive gains.
are being conflated in the comparison between mothers
who do and do not breastfeed. The effects among better- CONCLUSIONS
educated mothers could also be explained, because that The finding of a positive effect of breastfeeding but only
might represent a more accurate comparison between for better-educated mothers could be because of the
infants who are breastfed and those who are not breast- larger parental context in which breastfeeding occurs.
fed. Unfortunately, data limitations preclude identifying
Research on breastfeeding exclusivity has found that what parental factors, beyond the 2 HOME measures,
the majority of mothers of all educational levels who are important. It is unclear, therefore, if breastfeeding
initiated breastfeeding do so exclusively for at least the stimulates better parenting behaviors, if breastfeeding
first month of life.4 On the basis of this evidence, we only shows positive effects when done in conjunction
infer that most mothers who breastfeed for the first with these behaviors, or some combination of the two.
month are doing so exclusively. We are less sanguine Nevertheless, these results indicate that those perform-
about the results that use different durations of breast- ing research into breastfeeding and cognition should
feeding, because it is likely that some mothers classified consider the parental context, and training and support
as breastfeeding are supplementing with formula. Nev- in parenting skills are important regardless of whether
ertheless, these results are consistent with our earlier the mother breastfeeds or bottle feeds.
findings.
There are other sources of potential bias. Because the ACKNOWLEDGMENTS
breastfeeding data are retrospective, the results may be The Fragile Families and Child Wellbeing Study is funded
biased if better-educated mothers can report their by National Institute of Child Health and Human Develop-
breastfeeding behaviors more accurately. We are un- ment grants R01HD369I6, R01HD41141, HD40933-04,
PEDIATRICS Volume 118, Number 5, November 2006 e1449
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8. and HD40421-03, the California Healthcare Foundation, breastfeeding on cognitive development of infants born small
the Center for Research on Religion and Urban Civil Soci- for gestational age. Acta Paediatr. 2002;913:267–275
10. Quinn PJ, O’Callaghan M, Williams GM, Najman JM,
ety at the University of Pennsylvania, the Commonwealth
Andersen MJ, Bor W. The effect of breastfeeding on child
Fund, the Ford Foundation, the Foundation for Child De- development at 5 years: a cohort study. J Paediatr Child Health.
velopment, the Fund for New Jersey, the William T. Grant 2001;37:465– 469
Foundation, the Healthcare Foundation of New Jersey, the 11. Oddy WH, Kendall GE, Blair E, et al. Breast feeding and cog-
William and Flora Hewlett Foundation, the Hogg Founda- nitive development in childhood: a prospective birth cohort
study. Paediatr Perinat Epidemiol. 2003;17:81–90
tion, the Christina A. Johnson Endeavor Foundation, the
12. Angelsen NK, Vik T, Jacobsen G, Bakketeig LS. Breast feeding
Kronkosky Charitable Foundation, the Leon Lowenstein and cognitive development at age 1 and 5 years. Arch Dis Child.
Foundation, the John D. and Catherine T. MacArthur 2001;85:183–188
Foundation, the A. L. Mailman Family Foundation, the 13. Horwood LJ, Darlow BA, Mogridge N. Breast milk feeding and
Charles S. Mott Foundation, the National Science Founda- cognitive ability at 7– 8 years. Arch Dis Child Fetal Neonatal Ed.
tion, the David and Lucile Packard Foundation, the Public 2001;84:F23–F27
14. Lucas A, Morley R, Cole TJ, Lister G, Payne-Leeson C. Breast
Policy Institute of California, the Robert Wood Johnson
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Foundation, the St David’s Hospital Foundation, St Vincent preterm. Lancet. 1992;339:261–264
Hospital and Health Services, and the US Department of 15. Anderson JW, Johnstone BM, Remley DT. Breast-feeding and
Health and Human Services. Dr Gibson-Davis thanks the cognitive development: a meta-analysis. Am J Clin Nutr. 1999;
Bendheim-Thoman Center for Research on Child Wellbe- 70:525–535
16. Reynolds A. Breastfeeding and brain development. Pediatr Clin
ing at Princeton University, which is supported by National
North Am. 2001;48:159 –171
Institute of Child Health and Human Development grant 17. Drane DL, Logemann JA. A critical evaluation of the evidence
R01HD369I6, and the Office of Population Research at on the association between type of infant feeding and cognitive
Princeton University, which is supported by National Insti- development. Paediatr Perinat Epidemiol. 2000;14:349 –356
tute of Child Health and Human Development grant 18. Carlson SE. Long-chain polyunsaturated fatty acids and devel-
P30HD32030. Dr Brooks-Gunn thanks the National Insti- opment of human infants. Acta Paediatr Suppl. 1999;88(430):
72–77
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the Virginia and Leonard Marx Family Foundation. Dr
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Gibson-Davis has had full access to all data in the study and income on child achievement: the indirect role of parent ex-
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PEDIATRICS Volume 118, Number 5, November 2006 e1451
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10. Breastfeeding and Verbal Ability of 3-Year-Olds in a Multicity Sample
Christina M. Gibson-Davis and Jeanne Brooks-Gunn
Pediatrics 2006;118;e1444-e1451
DOI: 10.1542/peds.2006-0072
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