Association between breastfeeding during infancy and white matter microstructure in early childhood

Introduction Associations between breastfeeding and brain development, in the context of child, perinatal, and sociodemographic variables, remain unclear. This study investigates whether exclusive breastfeeding for the first 6 months and total duration of any breastfeeding are associated with brain white matter microstructure in young children. Methods This study included a sample of 83 mothers and 85 typically developing children (42 males). Children underwent their first diffusion tensor imaging scan between ages 2.34-6.97 years; some children returned multiple times, providing a total of 331 datasets. Feeding information was collected from the mothers at 3, 6, and 12 months postpartum and at their child’s scan to calculate breastfeeding status at 6 months (exclusive or not) as well as total duration of any breastfeeding. Linear regression was used to investigate associations between breastfeeding exclusivity/duration and fractional anisotropy (FA, a measure sensitive to myelination/axonal packing/fibre coherence) for the whole brain and 10 individual white matter tracts. Results Breastfeeding exclusivity and duration were associated with global and regional white matter microstructure, even after controlling for perinatal and sociodemographic factors. Greater exclusivity was associated with higher FA in females and lower FA in males. Conclusions These findings suggest white matter differences associated with breastfeeding that differ by sex. These may stem from different trajectories in white matter development between males and females in early childhood and suggest possible long-term white matter differences associated with breastfeeding.