The World Health Organization and the Department of Health and Children in Ireland have put forth recommendations for exclusive breastfeeding during the first six months following birth, and non-exclusive breastfeeding up to two years of age to promote the healthy growth and development of infants. The rates of breastfeeding in the first 48 hours postpartum in Ireland are among the lowest across all European countries and have been reported by the National Perinatal statistics between 36% and 45%. This raises significant concerns as the polyunsaturated fatty acids in addition to docosahexaenoic acid found in breast milk have been argued to be related to children’s cognitive development later in life. However, there is still large debate as to whether breastfeeding is casually related to increased cognitive development and little is known about the relationship between breastfeeding and language and non-cognitive development such as children’s behaviour problems. Causality is a challenging concept to assess without the use of experimental designs yet randomization into breastfeeding versus non-breastfeeding groups raises ethical concerns. The current project utilizes data collected from the Growing Up in Ireland study, comprised of two cohorts of children (over 19,000 participants) from 9-months to 13 years of age using of state-of-the-art statistical techniques (propensity score matching) to better asses the notion of causality. The first aim will assess potential causal pathways of breastfeeding on children's cognitive, language, and behavioural development longitudinally up to 13 years of age. Second, we will compare the effects of this relationship for low-birth weight and normal babies. Third, using generalized additive models which do not impose an assumption of linearity, we seek to examine the effect of dose-response of breastfeeding on child outcomes. The final aim is untangle the impact of income, education, and occupation on maternal breastfeeding choices.
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