Professor Universidade Federal de Uberlândia Uberlandia, Minas Gerais, Brazil
Background: Maternal education is an important socioeconomic marker for child health indicators, such as development and nutrition. The COVID-19 pandemic triggered specific concerns about infection and exposure to SARS-CoV-2 but also deepened social inequalities and exposed children to adverse experiences that may affect their potential development. However, protective factors such as breastfeeding (BF) may mitigate the impact of socioeconomic inequalities on neurodevelopment, especially in low- and middle-income countries. Objective: To evaluate the moderating effect of BF on the association of maternal education and child development during the COVID-19 pandemic. Design/Methods: It is a cross-sectional study nested in a cohort carried out in five Brazilian municipalities, including 269 infants born between April and August 2021. Child development at 12 months of age was assessed using the Bayley Scales of Infant and Toddler Development - Third Edition (BSID-III), and the breastfeeding patterns and maternal education level through phone calls. As BSID-III scores had a non-normal distribution, the moderation analysis was performed using Kruskal-Wallis test to examine the effect of breastfeeding patterns on the association between cognitive, language, and motor composite scores (BSID-III) and maternal education level (significance level 5%). Results: 269 full-term infants were evaluated (45% female). Maternal education level was associated with cognitive and language scores (p < 0.01). Exclusive breastfeeding at six months moderated the effect of maternal education, increasing child cognitive scores when mothers studied for less than 10 years (p=0.04), and when mothers studied for 10-12 years (p=0.03). Infants who were breastfed up to 12 months, scored higher in language subscale when their mothers studied less than 10 years (p=0.04). No moderation effect was observed for motor scores.
Conclusion(s): BF practices appear to have a moderating effect on the association between maternal education and child development, improving the cognitive and language skills of infants born from mothers less schooled, suggesting a protective effect of the BF on neurodevelopment in the first year of life for children born during the pandemic. Table 1.jpeg
