Effect of breastfeeding and sociodemographic factors on visual outcome in childhood and adolescence

Background: It has been suggested that early life factors, including breastfeeding and birth weight, program childhood myopia. Objective: We examined the relation of reduced unaided vision (indicative of myopia) in childhood and adolescence with infant feeding, parental education, maternal age at birth, birth weight, sex, birth order, and socioeconomic status. Design: Three British cohorts recruited infants born in 1946 (n = 5362), 1958 (n = 18 558), and 1970 (n = 16 567). Adjusted odds ratios (ORs) for unaided vision of 6/12 or worse at ages 10-11 and 15-16 y from each cohort were pooled by using fixed-effects meta-analyses. Results: The prevalence of reduced vision ranged from 4.4% to 6.5% at 10-11 y and from 9.4% to 11.4% at 16 y, with marginally higher levels in later cohorts. Breastfeeding declined across successive cohorts (65%, 43%, and 22% in those breastfed for >1 mo, respectively). Pooled ORs showed no associations between infant feeding and vision after adjustment at either age. Parental education (OR: 1.48, high versus low education; 95% CI: 1.23, 1.79), maternal age (OR: 1.10, per 5-y increase; 95% CI: 1.04, 1.17), birth weight (OR: 0.85, per 1-kg rise; 95% CI: 0.76, 0.95), number of older siblings (OR: 0.89, per older sibling; 95% CI: 0.83, 0.94), and sex (OR: 1.10, girls versus boys; 95% CI: 0.98, 1.23) were related to adverse visual outcome in childhood. Stronger associations were observed in adolescence, except that the association with birth weight was null. Conclusions: Infant feeding does not appear to influence visual development. Consistent associations of reduced vision with parental education, sex, maternal age, and birth order suggest that other environmental factors are important for visual development and myopia in early life.