If you had the power to make your child more intelligent, would you?

Doctors and scientists agree: Breastmilk is the best nourishment for babies. Human milk provides nutrients essential to building strong human bodies that cow's milk or formula simply can't supply. But does it also enhance brain function? Recent studies indicate that yes, babies who are breastfed have higher intelligence quotient (IQ) levels and enhanced cognitive development.

What We Know
Although there have been numerous studies conducted within the past decade that indicate the overall health benefits of breastfeeding, it is only within the last couple of years that researchers have looked at breastfeeding as it relates to cognitive development and IQ. One such study, conducted in 1998 in New Zealand, collected breastfeeding information on more than 1,000 children from birth to age one. These same children were assessed on a variety of measures of cognitive and academic outcomes from ages 8 to 18 years. The results, published in the January 1998 issue of Pediatrics, indicated a direct correlation between the duration of breastfeeding and higher mean scores on tests of cognitive ability.

Another study, which led to similar conclusions, was conducted by nutritionist James Anderson of the University of Kentucky. His results were published in The American Journal of Clinical Nutrition in October 1999. Anderson's results confirm that breastfeeding is accompanied by about a five point higher IQ than in bottle-fed infants. Babies breastfed at least up to 6 months of age reaped the greatest benefits, while those nursed for 2 weeks or less were not affected.

What is most interesting about these findings is that, in both studies, researchers concluded that the benefits of nursing come not primarily from the maternal bonding that accompanies breastfeeding, but from the actual nutritional value of the milk. According to Anderson, that ratio is 40 to 60, respectively.

Got Milk?
The results of a 17-week-long study conducted at the Retina Foundation of the Southwest in Texas just this year were published in Developmental Medicine and Child Neurology. These results reinforce what the aforementioned studies found. In the Retina study, two fatty acids found in human milk -- DHA and AA -- that promote long-term brain function are in all likelihood responsible for enhanced IQ levels in breastfed children. The group of newborns fed a formula containing both DHA and AA performed better than the group fed formula with just DHA and the group fed formula containing neither fatty acid in terms of memory, problem solving and language development. How much better? Two-and-a-half points and seven points, respectively.

Recent studies also indicate that 60 countries offer formula containing supplements of DHA and AA, while in the United States, there is no commercial formula like this available. The Food and Drug Administration does not require this supplementation, and formula manufacturers have not taken the lead to include the fatty acids in their products.

Nature or Nurture?
"I had heard about a study from my husband, but my choice to breastfeed had more to do with the health issues for the baby and the basic acknowledgement that breastmilk is obviously the food meant for infants, since it comes along with the pregnancy and birth," explained Kristin Galatowitsch of Princeton, Wis., mother of 5-month-old Alex. Her line of reasoning seems to be a common thread among breastfeeding mothers.

"I had heard information relating breastfeeding to higher IQ, but didn't use this as the sole basis for making the choice to breastfeed," explains Karen Broeckert of Appleton, Wis. "My doctor said any length of time I nursed would be better than not trying at all." While this is true when considering nursing from the standpoint of physical benefits -- like building healthy immune systems and getting a balance of vital nutrients -- some professionals believe the "any time is better than no time" attitude isn't accurate when it comes to the link between breastfeeding and IQ levels.

Katherine Dettwyler, Ph.D., member of the anthropology department at Texas A & M University, has researched the role of breastfeeding rituals and their results in primitive cultures as well as in today's society. "I have carefully read most of these studies, and find them to be carefully constructed and carried out," she says. "The ones that include duration of breastfeeding show that the longer the child is breastfed, up to study limits of 24 months, the greater their IQ scores and school performance. The human child's brain is growing most rapidly during the first two years of life. Since we know that some of the ingredients in breastmilk are critical to brain growth and development, the results are not surprising."

It Isn't Unanimous
Not all pediatric professionals or researchers agree with the findings of the three studies mentioned. An Australian study, concluding in early 1998, followed 375 children, assessing their cognitive development at ages 6 months and at 2, 4, 7 and 11 to 13 years. The results of this study, published in The Australian and New Zealand Journal of Public Health, indicated that breastfed children scored slightly higher than their formula-fed counterparts, but only at the younger ages. They began with a 5.5 point difference and declined to a 3.8 point difference in IQ points. Researchers concluded that the small benefit due to breastfeeding at an early age virtually disappears at later ages. The study states one explanation could be that a small cognitive benefit of breastfeeding may be overwhelmed at later ages by the effects of other social and environmental factors.

While agreeing that IQ is partly genetic and partly the result of environmental influences, Dr. Dettwyler stresses an important fact: Although a small point variation may not make much difference on the high end, it could mean all the difference on the low end. "If you have an IQ of 66, with 75 points being technically considered mentally retarded, you may be able to read, but not do math," explains Dr. Dettwyler. "Perhaps those five IQ points [gained by the breastfed child] make the difference between being able to do math or no math, between independent and assisted living, between having a real job and working in a sheltered workshop. Since none of us know ahead of time how our kids' lives will play out, it behooves us to do what we can to give them the best possible chance."

Whatever You Decide, Consider This
Judy Aikens of Manchester, N.H. chose to bottle-feed her children. "I didn't have the desire [to breastfeed] and I also worked full time," she says. "But they have been healthy and I feel that bottle-feeding has not impaired their intelligence." Dr. Dettwyler points out that it isn't necessarily a matter of "impairing" a child's intelligence as it is assisting maximum development. This comes about not only from the ingredients found in human milk, but in the relationship between mother and child.

As mentioned above, recent research places more value on the chemical makeup of milk rather than the bonding process. Dr. Dettwyler believes that, while human milk does provide the nutrients babies need, the bonding experience should not be overlooked. "Breastfeeding releases hormones in the mother which make her feel more affection toward her baby," she says. "Prior to modern times, the only time a woman would give birth and not breastfeed would be if the baby died. [Without breastfeeding], a mother's body assumes the baby has died and gears up for another attempt at reproduction. Yet she has a young baby, and the mother doesn't have the appropriate hormones."

Deciding whether or not to breastfeed is an intensely personal choice, and it is important that you feel you have made the "best" decision for your situation. When considering the information and statistics available today, it is interesting to keep in mind a point made by Dr. Dettwyler: The IQ deficit for prenatal cocaine use is only three points, which is less than the deficit for formula use.

It is natural for every mother to want to give her baby the best start. With years of research under her belt, Dr. Dettwyler sums it up simply: "If we breastfeed them, we can be really sure we've given them the best possible nutritional start in life. They may end up needing those five to eight IQ points."