Funded by the Government of Canada through Grand Challenges Canada, researchers working in South Africa and Pakistan under the Saving Brains program, reported their findings in papers launched this July, indicating that babies exclusively breastfed to six months old are half as likely to have later conduct disorders, and that enriched play/stimulation to age 2 creates brighter 4-year-olds.

In the first study, an international team led by Dr Ruth M. Bland at the Africa Centre for Population Health assessed over 1,500 children in South Africa, 900 of whom had been involved in an early infant feeding study.  They found longer durations of exclusive breastfeeding strongly associated with fewer conduct disorders at ages 7 to 11 years. Children exclusively breastfed for the recommended six months, compared with those exclusively breastfed for less than one month, were approximately half (56 percent) as likely to have conduct disorders at primary school age.

Other highlighted findings, published in PLOS Medicine, included:

• Important determinants of a child’s cognitive development: attending crèche (preschool) and mother’s IQ
• Children who attended crèche for at least one year were 74 percent more likely to have higher executive function (which enables us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. The brain needs this skill set to filter distractions, prioritize tasks, set and achieve goals, and control impulses. Executive function, therefore, influences educational and social success.)
• Children stimulated at home, such as through play, were one third (36 percent) more likely to have higher executive function scores
• There was weaker evidence that, for boys, exclusive breastfeeding for more than one month improved cognitive development.

The study also examined a number of current life factors that might influence children’s development, finding that children were two-and-a-half times more likely to exhibit emotional-behavioural problems if their mothers had a current mental health problem or severe parenting stress.

The study was also one of the first to assess the impact of HIV exposure on the development of primary school-age children in Africa. Previous studies suggested that children, although themselves HIV-negative, were disadvantaged if they were born to HIV-positive mothers, particularly in the areas of emotional and behavioural development. This study found that HIV- negative children born to HIV-positive mothers performed as well as those born to HIV-negative mothers.

The second paper, published by The Lancet Global Health and led by Dr Aisha K. Yousafzai of Aga Khan University, Karachi, followed up a cohort of impoverished children in rural Pakistan whose parents had been guided on strengthening nutritional care and “responsive stimulation” used to the end of age 2.

In the responsive stimulation intervention, caregivers were coached to observe and respond to their child’s cues during play and communication activities, improving the quality of interactions.

The intervention, adapted from the UNICEF and the World Health Organization’s ‘Care for Child Development’ approach (which is readily available online), included using everyday household items or homemade toys to stimulate children’s cognitive, language, motor and affective (emotional/feeling) skills.

At age 4, children who received the responsive stimulation intervention were, to varying degrees, more likely to have:

• Higher IQ
• Better pre-academic skills (in sizes and comparisons, and shapes)
• Better executive functioning
• More pro-social behaviour.

The follow-up study also found that parents were better caregivers.   The follow-up research involved 1,302 four-year-olds and their mothers from the original study, which had likewise shown that responsive stimulation “significantly benefitted children’s cognitive, language and motor development at two years.” The investigators intend to follow this cohort throughout their schooling.