The impact of ever breastfeeding on children ages 12 to 36 months : a secondary data analysis of the standardization study of the Dominican system for evaluating early childhood development

Abstract

Extensive research has shown that breastfeeding offers many benefits to children, including advantages in lifelong health, physical development, cognitive function, behavior, and brain development, compared to those not breastfed. In the Dominican Republic, the prevalence of exclusive breastfeeding among infants aged 0-6 months remains low, and the lack of a surveillance system has made it challenging to measure the impact of breastfeeding on early childhood development (ECD). This study aims to address the effect of ever breastfeeding on ECD. We conducted secondary data analysis from the Dominican System for Measuring Early Childhood Development (SIMEDID), a screening tool adapted and validated to the Dominican context that measures four areas of development: gross-motor, fine-motor, language, and socioemotional development. The data from SIMEDID can be cross-analyzed with other datasets generated by the National Institute for Early Childhood Comprehensive Care that include information about breastfeeding. The children were evaluated during the normalization study of SIMEDID. To determine the breastfeeding impact, we: 1) collected data on breastfeeding and established associations with their ECD; 2) conducted analyses of covariance using ECD scores as dependent variables and ever breastfed as the independent variable, with age and sex as covariates. We studied a sample of 699 Dominican children aged 12-36 months who receive services at INAIPI. The results show that ever breastfed children had higher scores in overall ECD than those who were not; higher scores in language and fine motor development primarily drove this effect. The never breastfed group had a greater risk of developmental delay in all developmental dimensions, particularly twice the risk for fine motor and almost twice for socioemotional development. These findings underscore the importance of promoting and supporting breastfeeding to improve child neurodevelopmental outcomes. This is particularly relevant in low-resource settings, where mothers may need additional support. Moreover, the study’s results provide evidence of SIMEDID’s validation, which can help inform future research and evidence-based decision-making toward optimal ECD in similar contexts.