Association of Breastfeeding and Neonatal Jaundice With Infant Neurodevelopment

Am J Prev Med. 2024 Apr;66(4):698-706. doi: 10.1016/j.amepre.2023.11.025. Epub 2023 Dec 4.

Abstract

Introduction: Exclusive breastfeeding is advantageous for infant neurodevelopment. Nevertheless, insufficient human milk supply in exclusively breastfed infants may elevate the risk of neonatal jaundice, which can potentially result in neurological harm. Whether mothers should adhere to exclusive breastfeeding in infants with neonatal jaundice remains unclear.

Methods: Data comes from the Jiangsu Birth Cohort (JBC), a prospective and longitudinal birth cohort study in China. A total of 2,577 infants born from November 2017 to March 2021 were included in the analysis. Multivariate linear regression models were used to analyze the associations between breastfeeding status, neonatal jaundice, and their interaction with infant neurodevelopment. Analysis was performed in 2022.

Results: Compared with "exclusive breastfeeding," fine motor scores of infants were lower for "mixed feeding" (βadj, -0.16; 95% CI, -0.29 to -0.03; p=0.016) and "no breastfeeding" (βadj, -0.41; 95% CI, -0.79 to -0.03; p=0.034). Compared with "no neonatal jaundice," infants with "severe neonatal jaundice" had lower scores for cognition (βadj, -0.44; 95% CI, -0.66 to -0.23; p<0.001) and fine motor (βadj, -0.19; 95% CI, -0.35 to -0.03; p=0.024). In infants with severe neonatal jaundice, the termination of exclusive breastfeeding before 6 months was associated with worse cognition (βadj, -0.28; 95% CI, -0.57 to 0.01), while this association was not observed in those without neonatal jaundice (βadj, 0.09; 95% CI, -0.26 to 0.43).

Conclusions: Exclusive breastfeeding for the first 6 months is beneficial to the neurodevelopment of infants, especially in those with severe neonatal jaundice.

MeSH terms

  • Breast Feeding*
  • Cohort Studies
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Jaundice, Neonatal* / epidemiology
  • Jaundice, Neonatal* / etiology
  • Mothers
  • Prospective Studies