Abstract
OBJECTIVE: A substantial body of literature has established the positive effect of breastfeeding on child developmental outcomes. There is increasing consensus that breastfed children have higher IQs after accounting for key variables, including maternal education, IQ, and socioeconomic status. Cross-sectional investigations of the effects of breastfeeding on structural brain development suggest that breastfed infants have larger whole brain, cortical, and white matter volumes. To date, few studies have related these measures of brain structure to IQ in breastfed versus nonbreastfed children in a longitudinal sample. METHOD: Data were derived from the Preschool Depression Study (PDS), a prospective longitudinal study in which children and caregivers were assessed annually for 8 waves over 11 years. A subset completed neuroimaging between the ages of 9.5 and 14.11 years. A total of 148 individuals had breastfeeding data at baseline and complete data on all variables of interest, including IQ and structural neuroimaging. General linear models and process mediation models were used. RESULTS: Breastfed children had significantly higher IQ scores and larger whole brain, total gray matter, total cortical gray matter, and subcortical gray matter volumes compared with the nonbreastfed group in models that covaried for key variables. Subcortical gray matter volume significantly mediated the association between breastfeeding and children's IQ scores. CONCLUSION: The study findings suggest that the effects of breastfeeding on child IQ are mediated through subcortical gray volume. This effect and putative mechanism is of public health significance and further supports the importance of breastfeeding in mental health promotion.