Role of gestational weight gain in the association between breastfeeding duration and toddler neurodevelopment

Objective·To explore the role of gestational weight gain (GWG) in the association between breastfeeding duration and offspring neurodevelopment, and to identify appropriate GWG to sustain breastfeeding among reproductive-age women.Methods·A prospective birth cohort study was conducted in Shanghai from 2010 to 2012. Mothers were recruited during mid- to late pregnancy and followed up until 24‒36 months postpartum, and information on GWG, breastfeeding duration, and related confounders was collected. Toddler neurodevelopment was assessed by the developmental quotient (DQ) of the Gesell Developmental Schedules (GDS) and scores from the Chinese Toddler Temperament Scale (CTTS). Two-piece-wise linear regression analyses were conducted (due to non-linear relationships) on the associations between breastfeeding duration and toddler neurodevelopment under different GWG stratifications, and between GWG and breastfeeding duration.Results·A total of 225 mother-infant pairs were included in this study, and the mean breastfeeding duration was 7.4 months. After adjustment for related confounders, significant differences in the associations of breastfeeding duration with neurodevelopment were observed among mother-child pairs under different GWG stratifications. For pairs with excessive GWG, when breastfeeding duration was