Mental Health and Emotional Development

Infant health research

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These studies look at the effects of breastfeeding on children’s mental health, behaviour and emotional development.

A Future for the World’s Children?

A major new report commissioned by the World Health Organization (WHO), Unicef and The Lancet details new risks and solutions related to child health and wellbeing. This commission took more than two years to develop and reflects combined knowledge from 40 child health experts from around the world. The importance of close and loving relationships between parents and babies was evidenced in the report, highlighting the effects of early nurturing on later development in children:

“Beginning with the maternal-infant dyad, the child’s biological and developmental trajectory is ideally set in the context of nurturing relationships. The rights, freedoms, and entitlements of children can only be advanced when the entitlements of their mothers and care givers are realised. Moves to promote gender equality will improve nurturing care in the early years of life.”  

The need to get babies off to a good start and how that effects on development and growth is also supported within the report:

“Evidence from longitudinal studies reports that the benefits of healthy childhood development extend to older ages: birth weight, infant growth, and peak physical and cognitive capacities in childhood are associated with or predictive of older adults’ physical and cognitive capacities, muscle strength, bone mass, lens opacity, hearing capacity, skin thickness, and life expectancy.”

Clark H et al. (2020), A future for the world’s children? A WHO-UNICEF-Lancet commission 

Impact of breastfeeding on child behaviour

This study of 10,037 mother-child pairs from the Millennium Cohort Study used a Strengths and Difficulties Questionnaire (SDQ) to examine the impact of breastfeeding on children’s behaviour at five years old. Researchers found that term children breastfed for four months or longer had lower odds of abnormal SDQ scores compared with never breastfed children. In preterm children, longer duration of breastfeeding was generally associated with lower odds of abnormal SDQ total and subscores but the effect estimates were imprecise. The associations between exclusive breast feeding and abnormal SDQ scores were similar to those of any breast feeding and abnormal SDQ scores.

Heikkilä K et al, (2011), Breastfeeding and child behaviour in the Millennium Cohort Study. Archives of Disease in Childhood, doi:10.1136/adc.2010.201970

Maternal-child interaction and emotional development

This longitudinal study investigated the relative importance of emotional availability in 56 mother–child dyads at seven months, as a predictor of child’s Theory of Mind at four years. The authors found that strong maternal ability at seven months predicted the child’s Theory of Mind, that is, a child’s ability to understand that others have beliefs, desires, intentions, and perspectives that are different from their own. Results indicate the specific importance of high emotional connectedness between mothers and infants for infants’ Theory of Mind development.

Licate, M., Kristen, S. & Sodian, B. (2015). Mother–Child Interaction as a Cradle of Theory of Mind: The Role of Maternal Emotional Availability. Social Development, DOI: 10.1111/sode.12131

Long-term effects of breastfeeding on child and adolescent mental health

This Australian study recruited 2,900 pregnant women and, for those who had live births, mental health was tested at 2, 6, 8, 10 and 14 years. The tool allowed for assessment of “internalised” issues such as being withdrawn, anxious/depressed and for “externalised” issues such as delinquent or aggressive behaviour. Maternal confounders such as age, education, smoking, family income, family structure, life stress events and depression were taken into account. The researchers found that breastfeeding for less than 6 months compared with 6 months or more was an independent predictor of mental health problems, both internalised and externalised through childhood and into adolescence.

Oddy WH, Kendall GE, Li J et al (2009) The Long-Term Effects of Breastfeeding on Child and Adolescent Mental Health: A Pregnancy Cohort Study Followed for 14 Years. Jpeds. Vol 156, Issue 4, 568-574

Breastfeeding duration and emotional attachment

This study examined whether twins who differ in the extent of their exposure to breastfeeding exhibit different attachment patterns by the time they reach toddlerhood. Researchers found that, independent of genetic and shared environmental influences, breastfeeding duration increases the security of attachment among females.

Jackson, D (2016), The Association Between Breastfeeding Duration and Attachment: A Genetically Informed Analysis, Breastfeeding Medicine,  doi:10.1089/bfm.2016.0036

Impact of breastfeeding on child behaviour

Researchers used data from the Millenium Cohort Study to examine whether breastfeeding is associated with behavioural development in children aged 5 years. Child behaviour was assessed using a parent-completed questionnaire, the Strengths and Difficulties Questionnaire (SDQ).  Abnormal SDQ scores were less common in term children than pre-term children. Term children breastfed for 4 months or longer had lower odds of an abnormal total SDQ score. In preterm children, longer duration of breastfeeding was generally associated with lower odds of abnormal SDQ total and sub-scores but the effect estimates were imprecise. The associations between exclusive breastfeeding and abnormal SDQ scores were similar to those of any breastfeeding and abnormal SDQ scores. The findings suggest that longer duration of breastfeeding is associated with fewer parent-rated behavioural problems in children aged 5 years. This association was also noted even when the researchers took into account other influences such as socio-economic or parental factors.

Katriina Heikkilä, Amanda Sacker, Yvonne Kelly, Mary Renfrew, Maria Quigley. Breast feeding and child behaviour in the Millennium Cohort Study. Arch Dis Child 2011; doi:10.1136/adc.2010.201970

Related research and further reading

Research on Brain and Cognitive Development

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The impact of breastfeeding on maternal and child health: Acta Paediatrica special issue

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The Lancet: Increasing breastfeeding worldwide could prevent over 800,000 child deaths every year

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