Hi, my name is Joe and I am a nursing student at the University of North Dakota.  When learning about the benefits of breast feeding, I came across some information which suggested that breast milk may enhance cognitive function over formula feeding.  I believed that breast milk was better for digestion, enhanced immunity, helped the infant gain the proper amount of weight, and was an excellent bonding experience for mother and infant, but I questioned the idea that breast milk enhanced cognitive function.  Many studies positively associate duration of breast feeding with mother's age, social status, education, birth weight, birth length and other factors.  I believed that these variables also played a large role in determining cognitive function.
      Wigg, Tong, McMichael and Baghurst, et al (1998) observed cognitive development at ages 2, 4, 7, 11, and 13.  The results showed the greatest positive effect, although not significant, of breast feeding at 2 years with a declining positive effect continuing through age 13.  This suggests that breast feeding may give children a head start through the first several years of life.  One big problem with this study is that infants who were breast fed for 5 months and 3 weeks were classified as formula fed, and infants who were breast fed for 6 months and 1 week were classified as breast fed.This may diminish the results comparing these two categories.  In a more recent study, infants breast fed for less than 3 months were compared to infants breast fed for more than 6 months, and the correlation with cognitive development at 1 and 5 years was tested.  Once again it showed the greatest significant effect of breast feeding at the age of 1 year with a nonsignificant positive e!
ffect at
 5 years (Angelsen 2001).  In a third study comparing duration of breast feeding with intelligence at the age of approximately 27, the findings showed a positive correlation between the duration of breast feeding up to 9 months and a higher intelligence level at age 27 (Mortensen 2002).  The last three studies which I have discussed also adjusted for the covariates mentioned earlier, eliminating biased results.
      The possible explanation for these results is the presence of docosahexanoic acid (DHA), which is found in breast milk and not in formula. DHA is a main ingredient in cell membranes of the CNS and may also play a role in nerve transmission.  Formulas do however offer the DHA precursor alfalinolenic acid (ALA) (Mortensen 2002).  Another possible explanation may be that women who take the extra time to breast feed for longer durations spend more time interacting with the child throughout childhood.  I think that other factors that are associated with breast feeding, as stated earlier, play a much larger role than breast feeding.  What do you think?  Is the correlation of breast feeding and intelligence included in patient teaching in the clinical setting?

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