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Erik Lykke Mortensen, PhD; Kim Fleischer Michaelsen, MD,ScD; Stephanie A. Sanders, PhD; June Machover Reinisch, PhD

JAMA. 2002;287:2365-2371.

Context  A number of studies suggest a positive association between breastfeeding and cognitive development in early and middle childhood. However, the only previous study that investigated the relationship between breastfeeding and intelligence in adults had several methodological shortcomings.

Objective  To determine the association between duration of infant breastfeeding and intelligence in young adulthood.

Design, Setting, and Participants  Prospective longitudinal birth cohort study conducted in a sample of 973 men and women and a sample of 2280 men, all of whom were born in Copenhagen, Denmark, between October 1959 and December 1961. The samples were divided into 5 categories based on duration of breastfeeding, as assessed by physician interview with mothers at a 1-year examination.

Main Outcome Measures  Intelligence, assessed using the Wechsler Adult Intelligence Scale (WAIS) at a mean age of 27.2 years in the mixed-sex sample and the Børge Priens Prøve (BPP) test at a mean age of 18.7 years in the all-male sample. Thirteen potential confounders were included as covariates: parental social status and education; single mother status; mother's height, age, and weight gain during pregnancy and cigarette consumption during the third trimester; number of pregnancies; estimated gestational age; birth weight; birth length; and indexes of pregnancy and delivery complications.

Results  Duration of breastfeeding was associated with significantly higher scores on the Verbal, Performance, and Full Scale WAIS IQs. With regression adjustment for potential confounding factors, the mean Full Scale WAIS IQs were 99.4, 101.7, 102.3, 106.0, and 104.0 for breastfeeding durations of less than 1 month, 2 to 3 months, 4 to 6 months, 7 to 9 months, and more than 9 months, respectively (P = .003 for overall F test). The corresponding mean scores on the BPP were 38.0, 39.2, 39.9, 40.1, and 40.1 (P = .01 for overall F test).

Conclusion  Independent of a wide range of possible confounding factors, a significant positive association between duration of breastfeeding and intelligence was observed in 2 independent samples of young adults, assessed with 2 different intelligence tests.

Author Affiliations: Danish Epidemiology Science Center, Institute of Preventive Medicine, Copenhagen University Hospital, Denmark (Drs Mortensen and Reinisch); Department of Health Psychology, Institute of Public Health, University of Copenhagen, Denmark (Dr Mortensen); Research Department of Human Nutrition, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark (Dr Michaelsen); The Kinsey Institute for Research in Sex, Gender and Reproduction (Drs Sanders and Reinisch) and Gender Studies (Dr Sanders), Indiana University, Bloomington.

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