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Association of infant and young child feeding practices with cognitive development at 10–12 years: a birth cohort in rural Western China

  • Zhonghai Zhu (a1) (a2), Yue Cheng (a3), Qi Qi (a1), Yu Lu (a1), Siyuan Ma (a1), Shaoru Li (a1), Hongbo Li (a1), Mohamed Elhoumed (a1), Sintayehu Tsegaye (a1), Wafaie W. Fawzi (a2), Christopher R. Sudfeld (a2), Hong Yan (a1) (a4) (a5), Michael J. Dibley (a6) and Lingxia Zeng (a1) (a5)...


We aimed to comprehensively examine the association of breast-feeding, types and initial timing of complementary foods with adolescent cognitive development in low- and middle-income countries. We conducted a prospective cohort study of 745 adolescents aged 10–12 years who were born to women who participated in a randomised trial of prenatal micronutrient supplementation in rural Western China. An infant feeding index was constructed based on the current WHO recommendations. Full-scale intelligence quotient (FSIQ) was assessed and derived by the fourth edition of the Wechsler Intelligence Scale for Children. The duration of exclusive or any breast-feeding was not significantly associated with adolescent cognitive development. Participants who regularly consumed Fe-rich or Fe-fortified foods during 6–23 months of age had higher FSIQ than those who did not (adjusted mean differences 4·25; 95 % CI 1·99, 6·51). For cows’/goats’ milk and high protein-based food, the highest FSIQ was found in participants who initially consumed at 10–12 and 7–9 months, respectively. A strong dose–response relationship of the composite infant feeding index was also identified, with participants in the highest tertile of overall feeding quality having 3·03 (95 % CI 1·37, 4·70) points higher FSIQ than those in the lowest tertile. These findings suggest that appropriate infant feeding practices (breast-feeding plus timely introduction of appropriate complementary foods) were associated with significantly improved early adolescent cognitive development scores in rural China. In addition, improvement in Fe-rich or Fe-fortified foods complementary feeding may produce better adolescent cognitive development outcomes.


Corresponding author

*Corresponding authors: Yue Cheng, email; Lingxia Zeng, email


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Association of infant and young child feeding practices with cognitive development at 10–12 years: a birth cohort in rural Western China

  • Zhonghai Zhu (a1) (a2), Yue Cheng (a3), Qi Qi (a1), Yu Lu (a1), Siyuan Ma (a1), Shaoru Li (a1), Hongbo Li (a1), Mohamed Elhoumed (a1), Sintayehu Tsegaye (a1), Wafaie W. Fawzi (a2), Christopher R. Sudfeld (a2), Hong Yan (a1) (a4) (a5), Michael J. Dibley (a6) and Lingxia Zeng (a1) (a5)...


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