Paediatrica Indonesiana
Vol. 66 No. 3 (2026): May 2026

The association of exclusive breastfeeding with early child development: secondary analysis of a cohort study using the deuterium oxide dose-to-mother technique

Sofa Rahmannia (1. Faculty of medicine, Universitas Pasundan, Bandung, West Java, Indonesia. And Nutrition working group, faculty of medicine, Universitas Padjajaran, Bandung, West Java, Indonesia)
R Siti Amalia (Faculty of Medicine Universitas Pasundan, Bandung, West Java, Indonesia)
Mia Miranda (Faculty of Medicine, Universitas Pasundan, Bandung, West Java, Indonesia)
Aly Diana (Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia . Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia)



Article Info

Publish Date
01 Jul 2026

Abstract

Background The World Health Organization (WHO) recommends exclusive breastfeeding during the first six months of life to support optimal growth and development. Evidence from Indonesia on how exclusive breastfeeding affects various developmental domains remains limited, particularly those using objective methods to assess breastfeeding practices. Objective To examine the association between exclusive breastfeeding during early infancy and child developmental outcomes across multiple domains in an Indonesian cohort. Methods This study used secondary data from a cohort study 221 mother–infant pairs in Bandung and Sumedang, Indonesia. Breastfeeding status at 2 and 5 months was determined in the parent cohort using the deuterium oxide dose-to-mother (DTM) method. Child development was assessed at 2, 5, 12, and 18 months using the Ages and Stages Questionnaire, Third Edition (ASQ-3), across five domains: communication, gross motor, fine motor, social, and problem-solving. Outcomes were classified as age-appropriate or not. Nutritional status and morbidity were also assessed and considered as potential covariates. Results Exclusive breastfeeding at five months was associated with improved fine motor development at 18 months (OR 3.3; 95%CI 1.5 to 7.6; P=0.003). No associations were observed for communication, gross motor, social, or problem-solving domains. Nutritional status and sociodemographic factors did not show significant confounding effects in bivariate analysis. Conclusion Exclusive breastfeeding during early infancy was associated with improved fine motor development at 18 months in this Indonesian cohort. These findings support ongoing efforts to promote exclusive breastfeeding as part of early childhood development strategies.

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Journal Info

Abbrev

paediatrica-indonesiana

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Paediatrica Indonesiana is a medical journal devoted to the health, in a broad sense, affecting fetuses, infants, children, and adolescents, belonged to the Indonesian Pediatric Society. Its publications are directed to pediatricians and other medical practitioners or researchers at all levels of ...