Children who are exclusively breastfed or fed a mix of formula and breastmilk for the first six to eight weeks of life are at lower risk of having special educational need and learning disabilities, according to a new study.

The research, led by the University of Glasgow and published in PLOS Medicine, studied data from more than 190,000 children to understand the impact of early life feeding on later development. The findings suggest that having breastmilk in the first few weeks of life may help to reduce the risk of having special educational need, or the learning disabilities and difficulties that often cause this.

The World Health Organisation recommend that babies are breastfed for the first six months, however many women struggle to exclusively breastfeed for this long. This study provides evidence that a shorter duration of non-exclusive breastfeeding may still be beneficial for a child’s later learning development.

Researchers looked at the health and educational data for 191,745 children born in Scotland from 2004 onwards, and who also attended a state or special needs school between 2009 until 2013. Of those included in the study, 66.2% of children were formula fed, 25.3% were breastfed, and only 8.5% were mixed fed for the first six to eight weeks.

Overall, 12.1% of children in this study had special education need. However, when compared with formula feeding, a history of early-life mixed feeding and exclusive breastfeeding were both associated with a decrease in the risk of having special educational need – around10% and 20% less likely, respectively. Moreover, exclusively breastfed children were also less likely to have emotional or behavioural difficulties (around 20% less likely) and physical health conditions (around 25% less likely).

The number of children in Scotland with a record of special educational need increased almost four-fold between 2010 and 2018, and by 2020 almost a third of pupils in Scotland had a record of having special educational need. This represents a significant burden on the education, health, and social sectors, as well as having substantial impact on the children, their families and wider society.

Children with special educational need experience lower educational attainment, higher rates of school absenteeism and exclusion, and higher rates of bullying and maltreatment, which can all further impact on their physical and mental health and well-being.

Dr Michael Fleming, who led the study at the University of Glasgow’s School of Health and Wellbeing, said: “We know that many women struggle to exclusively breastfeed for the full six-months recommended by the WHO, however our study provides evidence that a shorter duration of non-exclusive breastfeeding could nonetheless be beneficial with regards to a child’s learning development.

“The results of this study suggest that feeding method in infancy could be a modifiable risk factor for the causes of special educational need, which in turn has the potential to help reduce the burden for affected children, their families and wider society.”

Children who were born in private hospitals, privately educated, or home-schooled were not included in the study.

The paper ‘Infant feeding method and special educational need in 191,745 Scottish schoolchildren: a national, retrospective cohort study’ is published in PLOS Medicine. The study was funded by Health Data Research UK.


Enquiries: ali.howard@glasgow.ac.uk or elizabeth.mcmeekin@glasgow.ac.uk / 0141 330 6557 or 0141 330 4831

First published: 6 April 2023

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