Evidence map›Paper›PMID 25794674›Full record

ArticleThe Lancet. Global health2015

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

Cesar G Victora, Bernardo Lessa Horta, Christian Loret de Mola, Luciana Quevedo, Ricardo Tavares Pinheiro, Denise P Gigante, Helen Gonçalves, Fernando C Barros

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Global health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03529630 (Breastfeeding Success With the Use of the WHO Syringe Technique for Management of Inverted Nipples in Lactating Women), which is not on this map. Cited by 275 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
275citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03529630 nacompletednot on this mapstarted 2018, after this paper: background citation

Breastfeeding Success With the Use of the WHO Syringe Technique for Management of Inverted Nipples in Lactating Women: a Study Protocol for a Randomized Controlled Trial

TypeinterventionalSponsorAmerican University of Beirut Medical CenterRan2018 to 2020Enrolled54ConditionsBreastfeeding, Inverted NippleArmsInverted syringe
3 · Its place in the literature

Who cites it

275 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  8. Breastfeeding in the Community-How Can Partners/Fathers Help? A Systematic Review.International journal of environmental research and public health · 2020
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  18. Stop Auditing Mothers and Start Auditing Systems.Maternal & child nutrition · 2026
    Article
  19. Valuing five centuries of unpaid breastfeeding in England.Proceedings of the National Academy of Sciences of the United States of America · 2026
    Article
  20. Article

215 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Cesar G VictoraPostgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, Brazil.
Bernardo Lessa HortaPostgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, Brazil. Electronic address: blhorta@gmail.com.
Christian Loret de MolaPostgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, Brazil.
Luciana QuevedoPostgraduate Programme in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brazil.
Ricardo Tavares PinheiroPostgraduate Programme in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brazil.
Denise P GigantePostgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, Brazil.
Helen GonçalvesPostgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil, Pelotas, Rio Grande do Sul, Brazil.
Fernando C BarrosPostgraduate Programme in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brazil.

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundBreastfeeding has clear short-term benefits, but its long-term consequences on human capital are yet to be established. We aimed to assess whether breastfeeding duration was associated with intelligence quotient (IQ), years of schooling, and income at the age of 30 years, in a setting where no strong social patterning of breastfeeding exists.

methodsA prospective, population-based birth cohort study of neonates was launched in 1982 in Pelotas, Brazil. Information about breastfeeding was recorded in early childhood. At 30 years of age, we studied the IQ (Wechsler Adult Intelligence Scale, 3rd version), educational attainment, and income of the participants. For the analyses, we used multiple linear regression with adjustment for ten confounding variables and the G-formula.

findingsFrom June 4, 2012, to Feb 28, 2013, of the 5914 neonates enrolled, information about IQ and breastfeeding duration was available for 3493 participants. In the crude and adjusted analyses, the durations of total breastfeeding and predominant breastfeeding (breastfeeding as the main form of nutrition with some other foods) were positively associated with IQ, educational attainment, and income. We identified dose-response associations with breastfeeding duration for IQ and educational attainment. In the confounder-adjusted analysis, participants who were breastfed for 12 months or more had higher IQ scores (difference of 3·76 points, 95% CI 2·20-5·33), more years of education (0·91 years, 0·42-1·40), and higher monthly incomes (341·0 Brazilian reals, 93·8-588·3) than did those who were breastfed for less than 1 month. The results of our mediation analysis suggested that IQ was responsible for 72% of the effect on income.

interpretationBreastfeeding is associated with improved performance in intelligence tests 30 years later, and might have an important effect in real life, by increasing educational attainment and income in adulthood.

fundingWellcome Trust, International Development Research Center (Canada), CNPq, FAPERGS, and the Brazilian Ministry of Health.

Indexed as

Breast FeedingIncomeIntelligenceAdultAnalysis of VarianceBrazilChild DevelopmentEducational StatusFemaleHumansInfantInfant, NewbornMaleProspective StudiesRegression Analysis

Identifiers

PMID25794674
PMCPMC4365917

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.