(AL01-01-26) Associations of Exclusive and Predominant Breastfeeding With Social-Emotional Development at 9-11 Years of Age: A Longitudinal Analysis of Ghanaian Children

Saturday, July 25, 2026

5:30 PM - 5:45 PM ET

Location: Maryland Ballroom A/C

Robert Suskind and Leslie Lewinter-Suskind Pediatric Nutrition Student Awards

Presenting Author(s)

Katherine Y. Kwon, PhD, RDN, IBCLC (she/her/hers)

PhD Student
University of California, Davis
Davis, California, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

CA

Charles D. Arnold, MS

Statistician
University of California, Davis
Davis, California, United States
SA

Seth Adu-Afarwuah

University of Ghana, Ghana
Kathryn G. Dewey, PhD (she/her/hers)

Distinguished Professor Emerita
University of California, Davis
Davis, California, United States
PH

Paul D. Hastings

University of California, Davis, United States
AG

Amanda E. Guyer

University of California, Davis, United States
AL

Anna Lartey

University of Ghana, Ghana
AM

Adom Manu

University of Ghana, Ghana
MM

Mavis O. Mensah

University of Ghana, Ghana
BO

Brietta M. Oaks

University of Rhode Island, United States
Christine P. Stewart, MPH, PhD

Professor
University of California, Davis
Davis, California, United States

Disclosure(s):

Katherine Y. Kwon, PhD, RDN, IBCLC: No relevant financial relationship(s) with ineligible companies to disclose.

Kathryn G. Dewey, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: To investigate the associations of durations of exclusive or predominant breastfeeding (EBF or PBF) with social-emotional outcomes in 9-11 y old Ghanaian children.

Methods: This is a secondary analysis using data from the International Lipid-Based Nutrient Supplements (iLiNS)-DYAD-G trial, which evaluated the impact of small-quantity lipid-based nutrient supplements or multiple micronutrient supplements during the first 1000 days on child growth and development. Maternal report of breastfeeding was collected at birth and monthly up to 6 mo. EBF was defined as infants receiving only breastmilk, except for medicines and supplements; PBF allowed for water-based drinks. Primary outcomes measured at 9-11 y were parent, teacher and child-report Strengths and Difficulties Questionnaire (SDQ) subscale scores: total difficulties, emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Associations of EBF/PBF for 5 mo (yes/no) or EBF/PBF duration with SDQ outcomes were examined using linear regression controlling for maternal, child and household factors.

Results: In our sample (n = 979), median durations of EBF and PBF were 5.9 and 6.0 mo. From 0 to 5 mo, 576 (61%) of children were EBF, 714 (77%) were EBF or PBF, and 100% were still BF at 6 mo. Children who were EBF for 5 mo, compared to those who were not, had lower total difficulties as reported by parents (β = -0.55 points, 95% CI: -1.07, -0.04) and teachers (β = -0.95, 95% CI: -1.74, -0.16), as well as lower conduct problems as reported by parents (β = -0.22, 95% CI: -0.40, -0.04) and teachers (β = -0.34, 95% CI: -0.59, -0.09). Results were consistent with EBF duration and PBF for 5 mo predictors. PBF for 5 mo was also associated with lower emotional symptoms scores as reported by teachers (β = -0.44, 95% CI: -0.80, -0.08). There were no associations with child-reported outcomes.

Conclusions: In a population with high breastfeeding rates, longer duration of exclusive breastfeeding was associated with better social-emotional outcomes at 9-11 y of age, as reported by both parents and teachers, and controlling for maternal, child, and household factors.

Funding Sources: Bill & Melinda Gates Foundation, NICHD, Fogarty International Center, Academy of Nutrition and Dietetics Foundation