scores, birth weight and premature birth, gender, birth order, parental education, number of siblings, poverty, family history with developmental delays 9 . Clear criteria and definitions of breastfeeding and exclusive breastfeeding and category of the duration of breastfeeding are absent and are different in each study.
In addition, important nutritional factors
such as iodine supplements during pregnancy and infant years play an important role in child development. Severe iodine deficiency influences fetal brain development and in the worst case induces cretinism. Also a mild iodine deficiency during pregnancy and infant first year of life has an adverse effect on a child’s brain development 24 . However, a prolonged and exclusive breastfeeding does
25
significant association of it, some presented
improve a child’s cognitive development
. It
inconclusively.
DISCUSSION
This review systematically summarized the
14 original studies using a critical appraisal approach. This present review draws on those studies in order to demonstrate the association of feeding practices and cognitive development. It implies that the benefits of breastfeeding on cognitive development in children are controversial. Some literatures even suggest that breastfeeding significantly increases a child’s development outcomes beneficially. However, this review only confirms a clear benefit of breastfeeding on language development. That is, the longer the duration of breastfeeding, the lower the risk of language impairment. Such evidence is conclusive for speech problems as it shows no association. However, the roles of breastfeeding are inconclusive in cognitive development.
Even though several studies show linkage between having been fed breast milk and higher scores in cognitive development, they were observational studies, which may not infer causality based on their findings. In addition, there is a wide range in the quality of
evidence influencing outcomes across different
cognitive development measures. In addition, the results may be confounded by numerous confounding factors associated with maternal, infant and environmental factors in a complex relationship 9,10 . There are several factors including maternal and infant factors which should be accounted for such as marital status, maternal age, antenatal care (ANC), Apgar
needs further investigation on cognitive
development. In addition, further research is needed to determine their exact roles.