Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil

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Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil

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Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil Prof Cesar G Victora, PhD, Dr Bernardo Lessa Horta, PhD, Christian Loret de Mola, PhD, Luciana Quevedo, PhD, Ricardo Tavares Pinheiro, PhD, Denise P Gigante, PhD, Helen Gonçalves, PhD, Fernando C Barros, PhD The Lancet Global Health Volume 3, Issue 4, Pages e199-e205 (April 2015) DOI: 10.1016/S2214-109X(15)70002-1 Copyright © 2015 Victora et al. Open Access article distributed under the terms of CC BY Terms and Conditions

Figure 1 Association of mean IQ with breastfeeding duration, stratified by family income at birth Estimates are adjusted for parental education, household score index, genomic ancestry, maternal smoking during pregnancy, maternal age, type of delivery, maternal body-mass index before pregnancy, gestational age, and birthweight. The Lancet Global Health 2015 3, e199-e205DOI: (10.1016/S2214-109X(15)70002-1) Copyright © 2015 Victora et al. Open Access article distributed under the terms of CC BY Terms and Conditions

Figure 2 Direct acyclic graph of the effect of breastfeeding on monthly income at 30 years NIE shows that 72% of the total effect of breastfeeding on income at 30 years (99 [95% CI 6·0–192·0]) is mediated by an individual's IQ and only 28% through NDE. We adjusted estimates for base confounders—family income at birth, parental education, household score index, genomic ancestry, maternal smoking during pregnancy, and birthweight—and educational attainment as a postconfounder. NIE=natural indirect effect. NDE=natural direct effect. The Lancet Global Health 2015 3, e199-e205DOI: (10.1016/S2214-109X(15)70002-1) Copyright © 2015 Victora et al. Open Access article distributed under the terms of CC BY Terms and Conditions