Difficult temperament, breastfeeding, and their mutual prospective effects: the Norwegian Mother and Child Cohort Study

J Dev Behav Pediatr. 2008 Dec;29(6):458-62. doi: 10.1097/dbp.0b013e3181877a88.


Objective: (1) To examine the extent to which difficult temperament and breastfeeding are associated at child age 6 and 18 months. (2) To examine longitudinally whether breastfeeding has an influence on temperament development or whether difficult temperament has an influence on continued breastfeeding.

Method: This prospective study is part of the Norwegian Mother and Child Cohort Study, which targets all women giving birth in Norway; the present sample comprises 30,466 children. Mothers reported on child difficult temperament at child age 6 and 18 months and on breastfeeding from 0 to 6 months and from 6 to 12-14 months. Prospective associations between breastfeeding and difficult temperament were examined using structural equation modeling, with comparison of cross-lagged pathways. All analyses were adjusted for background variables that are relevant for breastfeeding.

Results: At 6 months, children with more difficult temperament were significantly less likely to have been "fully" breastfed (exclusively and predominantly breastfed) for the recommended period of 6 months (unadjusted point-biserial correlation r pb = -.15; adjusted r pb = -.11). At 12 to 14 months, there was no longer an association between difficult temperament and (continued) breastfeeding after adjusting for background variables, temperament, and breastfeeding at 6 months. The cross-lagged analyses of the longitudinal pathways yielded negligible effects of difficult temperament on later breastfeeding and of breastfeeding on later temperament.

Conclusion: Difficult temperament and reduced breastfeeding seem to be associated only during the first half-year of the child's life. After that, we found no evidence of codevelopment between difficult temperament and breastfeeding.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding / statistics & numerical data*
  • Child, Preschool
  • Cohort Studies
  • Emotions / physiology
  • Female
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Norway
  • Pregnancy
  • Prospective Studies
  • Psychology, Child*
  • Surveys and Questionnaires
  • Temperament / physiology*
  • Time Factors
  • Whites