Breastfeeding, Maternal Education and Cognitive Function: A Prospective Study in Twins
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The effect of breastfeeding on cognitive abilities is examined in the offspring of highly educated women and compared to the effects in women with low or middle educational attainment. All offspring consisted of 12-year old mono- or dizygotic twins and this made it possible to study the effect of breastfeeding on mean cognition scores as well as the moderating effects of breastfeeding on the heritability of variation in cognition. Information on breastfeeding and cognitive ability was available for 6,569 children. Breastfeeding status was prospectively assessed in the first years after birth of the children. Maternal education is positively associated with performance on a standardized test for cognitive ability in offspring. A significant effect of breastfeeding on cognition was also observed. The effect was similar for offspring with mothers with a high, middle, and low educational level. Breast-fed children of highly educated mothers score on average 7.6 point higher on a standardized test of cognitive abilities (CITO test; range 500–550; effects size = .936) than formula-fed children of mothers with a low education. Individual differences in cognition scores are largely accounted for by additive genetic factors (80%) and breastfeeding does not modify the effect of genetic factors in any of the three strata of maternal education. Heritability was slightly lower in children with a mother with a middle-level education.
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Other studies have failed to replicate the G × SES finding, including the largest sample to date.
“Other studies, however, have failed to replicate the finding (Bartels, van Beijsterveldt, & Boomsma, 2009; Kremen et al., 2005; Soden-Hensler, 2012; van der Sluis, Willemsen, de Geus, Boomsma, & Posthuma, 2008), including the largest sample to date (Hanscombe et al., 2012).”
From Large Cross-National Differences in Gene × Socioeconomic Status Interaction on Intelligence (2016) · cites this paper as Bartels, van Beijsterveldt, & Boomsma, 2009
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Holland, C. M., Alleyne, K., Pierre-Louis, A., Bansal, R., Pollatou, A., Barbato, K., Cheng, B., Hao, X., Rosen, T. S., Peterson, B. S., et al. (2023) · Child Neuropsychology · doi:10.1080/09297049.2023.2233155 · Cited by 2 · see citing works
“Previous literature demonstrated that intelligence is heritable based on extensive twin studies (Bacharach & Baumeister, 1998; Bartels et al., 2009; Bradley et al., 1993; Burchinal et al., 1997; Luster & Dubow, 1992; Tong et al., 2007; Voss et al., 2012) and that maternal intelligence or estimates…”
BackgroundBreastfeeding: Importance in Early Development of the Immune System and Long-term Health
Rani, U. (2022) · JOURNAL OF COMMUNICABLE DISEASES · doi:10.24321/0019.5138.202280 · Cited by 2 · see citing works
Intergenerational Transmission of BMI and Educational Outcomes in Children and Adolescents
Alrouh, H., van Bergen, E., Dolan, C. V., & Boomsma, D. I. (2023) · Twin Research and Human Genetics · doi:10.1017/thg.2023.18 · Cited by 1 · see citing works
“In addition to the possible role of nutrition, higher income is associated with many other factors; for example, it is associated with breastfeeding (Bartels et al., 2009) and may facilitate physical activity in children, insofar as such activity involves cost (e.g., club memberships, sportswear…”
BackgroundSelf-citationHeritability and public policy – a reappraisal
Rietveld, C. A. (2025) · Journal of Economic Inequality · doi:10.1007/s10888-025-09690-9 · Cited by 1 · see citing works
“That is, Bartels et al. (2009) find that 78–84% of the variance in CITO scores is explained by additive genetic effects while the remaining variance is accounted for by non-shared environmental effects.”
Long-term breastfeeding mothers’ perspectives on the warm chain’s support
Uijtewaal, R., & EDMONDS, C. (2026) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-026-08800-3 · Cited by 1 · see citing works
An investigation of the effects of lead on children’s cognitive abilities.
Earl, R. (2011) · Adelaide Research & Scholarship (AR&S) (University of Adelaide) · Cited by 1 · see citing works
Cremers, L. M. C. J., Lambermont, F. W. M., van Ommen, M., & Vlot, A. (2012) · Utrecht University Repository (Utrecht University)
La lactancia materna y su relación con el neurodesarrollo
Manrique, F. P., Correa, M. G., Moreno, D. M., & Rocha, V. V. (2014) · Pediatría · doi:10.1016/s0120-4912(15)30128-2
“…el nivel educativo de la madre, también se asoció con la posibilidad de que la mujer lacte a su hijo, viéndose una ventaja de los niños de madres con un nivel educativo alto en sus habilidades cognitivas frente a los que fueron lactados con fórmula o cuya madre tenía un bajo nivel educativo 21 .”
BackgroundModes d’allaitement et développement psychomoteur chez des enfants ivoiriens de 6 à 24 mois
Tieffi, H. G. R., & Meite, A. (2012) · Presses universitaires de Provence eBooks · doi:10.4000/books.pup.37065
von Stumm, S., & Nancarrow, A. F. (2023) · doi:10.31235/osf.io/y28h6
Müller, A. B., Vieira, H. C. V. S., Panceri, C., Nobre, G. C., & Valentini, N. C. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22071158
“Such inadequate teacher-child ratios likely limit the necessary individual attention and interactions crucial for optimal development.”
Bernard, J. Y. (2013) · doi:10.70675/a3e0b8a6z4855z4a77za6ebz68e599d268ea
“…d’allaitement maternel Mesures du neurodéveloppement Âge Sens de l’association Kramer et al. (2008) Biélorussie 13889 Essai randomisée par grappes Prospectif Maternités avec/sans promotion WASI 6.5 ans + Bartels et al. (2009) Pays-Bas 6569 Cohorte Rétrospectif (2 ans) NBF / 0-2 sem / 2-6 / 6…”
BackgroundInfluentialExposure to Breast Milk in Infancy and Risk of Adult Breast Cancer: A Summary of the Evidence
Wise, L. A., & Titus, L. J. (2012) · Humana Press eBooks · doi:10.1007/978-1-62703-224-7_21
- Authors
- Bartels, M., van Beijsterveldt, C. E. M., & Boomsma, D. I.
- Affiliations
- Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Bartels, M.
- Venue
- Behavior Genetics
- Published
- 2009-08-04
- Volume
- 39
- Issue
- 6
- Pages
- 616-622
- ISSN
- 0001-8244 (ISSN-L)
- 1573-3297
- PMC
- PMC2780679
- OpenAlex
- W2116383443
- Cited by
- 48
- References
- 34
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 2 · 2016: 3 · 2015: 5 · 2014: 2 · 2013: 5 · 2012: 6
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Behavior Genetics (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (NWO/ SPI 56-464-14192, 400‐05‐717, NWO 480-04-004, 56‐464‐14192, Spi-56-464-14192, 14192, 480-04-004)
- National Institute of Mental Health (RO1 MH58799-03, R01MH58799‐03, R01MH058799)
- Topics
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- breastfeeding, maternal education, cognitive ability, heritability of intelligence, monozygotic twins, dizygotic twins, bottle feeding, genetic factors, moderating effect, educational attainment
- MeSH terms
- Achievement, Adolescent, Breast Feeding, Child, Educational Status, Female, Genotype, Humans, Individuality, Infant, Intelligence, Male, Models, Genetic, Netherlands, Phenotype, Prospective Studies, Social Environment, Twins, Dizygotic, Twins, Monozygotic
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