(P18-014-23) Association Between Breastfeeding, Diet Quality Markers and Early Childhood Development: Brazilian National Survey on Child Nutrition (ENANI-2019)

Objectives: To evaluate the association between breastfeeding (BF), minimal dietary diversity (MDD), ultra-processed food (UPF) intake, and early childhood development (ECD).

Methods: Data from 6,071 children aged 1–23 months studied by the Brazilian National Survey on Child Nutrition (ENANI-2019) were used. Food consumption on the previous day was estimated using a structured questionnaire. BF was considered when the child received breast milk the day before the interview. MDD was classified when ≥ 5 food groups out of 8 were consumed (children aged 6–23 months). UPF was classified into none and 1 ≥ UPF groups consumed from a list of 10 groups. ECD was evaluated using the Survey of Well-being of Young Children's milestones questionnaire. The graded response model was used to estimate the developmental age according to developmental milestones reached by each child. The developmental quotient (DQ) was calculated as the developmental age divided by chronological age. DQ=1 represents the attainment of expected age milestones, and DQ < 1 and >1 suggest attaining age milestones below and above expectations, respectively. Mean, and 95% confidence intervals were used to describe the sample. Multiple linear regression models were estimated (adjusted for daycare or school, family income/per capita, maternal occupation, education, and cash transfer program).

Results: The prevalence of BF was 59% (95%CI: 56.2-62.3); 63.3% (59.8-66.9) achieved MDD, and 64.9% (62.1-67.7) consumed at least one UPF. The overall DQ mean was 1.28 (1.24-1.33); it was higher when BF was present (yes: 1.38, 1.32-1.44; no: 1.15, 1-11-1.18); it did not differ according to MDD (yes: 1.17, 1.12-1.21; no: 1.09, 1.04-1.13) and was lower among children who consumed at least one UPF (yes: 1.16, 1.12-1.19; no: 1.53, 1.42-1.63). BF (β=0.215; p < 0.001) and MDD (β=0.023; p=0.016) were directly associated, and UPF consumption was inversely associated with DQ (β=-0.089; p< 0.001).

Conclusions: Eating practices in the first two years of life are associated with ECD. Breast milk consumption, dietary diversity, and no consumption of UPF were associated with a better ECD.

Funding Sources: Brazilian Ministry of Health and the Brazilian National Research Council (CPNq) and Coordination of Improvement of Higher Education Personnel (CAPES, Phd’s fellowship)