Association Between Breastfeeding and Neurodevelopment at 6 Years of Age in the French PELAGIE Birth Cohort

Marion Monperrus; Cécile Chevrier; Nathalie Costet; Maela Le Lous; Jonathan Y Bernard; Gaïd Le Maner-Idrissi; Agnès Lacroix; Pauline Blanc-Petitjean; Sylvaine Cordier; Florence Rouget; Christine Monfort; Ronan Garlantézec; Rémi Béranger

doi:10.1111/jmwh.13766

Association Between Breastfeeding and Neurodevelopment at 6 Years of Age in the French PELAGIE Birth Cohort

J Midwifery Womens Health. 2025 Jun 3. doi: 10.1111/jmwh.13766. Online ahead of print.

Authors

Marion Monperrus^{1

2}, Cécile Chevrier³, Nathalie Costet³, Maela Le Lous^{1

4}, Jonathan Y Bernard⁵, Gaïd Le Maner-Idrissi⁶, Agnès Lacroix⁶, Pauline Blanc-Petitjean³, Sylvaine Cordier³, Florence Rouget³, Christine Monfort³, Ronan Garlantézec^{2

3}, Rémi Béranger^{1

2

3}

Affiliations

¹ Department of Obstetrics and Gynecology, University Hospital Rennes, Rennes, France.
² Centre d'investigation clinique de Rennes (CIC 1414), INSERM, University Hospital Rennes, Rennes, France.
³ Univ Rennes, CHU, INSERM, EHESP, IRSET (Institut de recherche en santé, environnement et travail), Rennes, France.
⁴ Department LTSI - INSERM UMR 1099, University of Rennes, Rennes, France.
⁵ Université Paris Cité and Université Sorbonne Paris Nord , INSERM, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France.
⁶ Université Rennes 2 , Laboratoire de psychologie: comportement, cognition et communication (LP3C), Rennes, France.

PMID: 40457895
DOI: 10.1111/jmwh.13766

Abstract

Introduction: Breastfeeding has been shown to be associated with improved child cognitive performance, but the causality of this association is still debated because it tends to disappear when accounting for maternal cognitive performance and socioeconomic status. We aimed to explore the relationship between breastfeeding and the cognitive performance of children in the French general population.

Methods: From the PELAGIE woman-child cohort, which included pregnant women between 2002 and 2006 in Brittany (France), 286 children were evaluated using the Wechsler Intelligence Scale for Children (WISC-IV) and the Developmental Neuropsychological Assessment (NEPSY) scales at age 6. Associations between breastfeeding and cognitive performance were assessed using multivariable linear regression models adjusted for maternal verbal cognitive performance and education level, familial stimulation and environment (Home Observation for Measurement of the Environment scale), and Rey's Social Deprivation Index (contextual indicator). In addition, we performed structural equation modeling (SEM) to investigate the complex interrelation between these variables.

Results: Children who were breastfed for at least 4 months had significantly higher scores on the WISC Verbal Comprehension Index (WISC-VCI) than those who were never breastfed or who were breastfed less than 15 days (β_adjusted, 4.95 points; 95% CI, 0.54-9.37). Among the 193 children who were breastfed, the duration of breastfeeding, in particular during the first 4 months, was increasingly associated with the WISC-VCI score. We also observed statistically significant associations between breastfeeding itself or the duration of breastfeeding and better performance on several NEPSY subtests, including visual attention, design copying, arrows, and narrative memory. SEM analysis confirmed these associations. No statistical association was observed between breastfeeding and the WISC Working Memory Index or other NEPSY subtests.

Discussion: These data support current national and World Health Organization global 2025 targets of promoting breastfeeding for at least 4 to 6 months.

Keywords: breastfeeding; child development; cognition; cohort; neuropsychology.