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Associations of maternal fish intake during pregnancy and breastfeeding duration with attainment of developmental milestones in early childhood: a study from the Danish National Birth Cohort^1,2,3

¹ From the Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA (EO and MWG); the Maternal Nutrition Group, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MLO, VKK, TIH, MS, and SFO); the Department of Nutrition, Harvard School of Public Health, Boston, MA (MWG and SFO); the Department of Neurology, Children's Hospital Boston and Harvard Medical School, Boston, MA (DCB); the Department of Neurology, University Medical Center Groningen, Groningen, Netherlands (MH-A); and the Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Fredriksberg, Denmark (KFM)

Background: Few studies have examined the overall effect of maternal fish intake during pregnancy on child development or examined whether the developmental benefits of maternal fish intake are greater in infants breastfed for a shorter duration.

Objective: We aimed to study associations of maternal prenatal fish intake and breastfeeding duration with child developmental milestones.

Design: We studied 25 446 children born to mothers participating in the Danish National Birth Cohort, a prospective population-based cohort study including pregnant women enrolled between 1997 and 2002. Mothers reported child development by a standardized interview, which we used to generate developmental scores at ages 6 and 18 mo. We used multivariate cumulative ordinal logistic regression to evaluate the odds of higher developmental scores associated with maternal fish intake and breastfeeding, after adjustment for child age, sex, and growth; maternal size and pregnancy characteristics; and parental education and social status.

Results: Higher maternal fish intake and greater duration of breastfeeding were associated with higher child developmental scores at 18 mo [odds ratio: 1.29 (95% CI: 1.20, 1.38) for the highest versus the lowest quintile of fish intake, and 1.28 (1.18, 1.38) for breastfeeding for 10 mo compared with breastfeeding for 1 mo]. Associations were similar for development at 6 mo. Associations of fish intake with child development did not differ by breastfeeding duration.

Conclusions: Maternal fish intake during pregnancy and the duration of breastfeeding are independently associated with better early child development. Future research and consumption guidelines, incorporating nutritional benefits as well as contaminant risks, should consider the overall effect of prenatal fish consumption on child development.