Infant feeding: the effects of scheduled vs. on-demand feeding on mothers' wellbeing and children's cognitive development

Background: Many popular childcare books recommend feeding babies to a schedule, but no large-scale study has ever examined the effects of schedule-feeding. Here, we examine the relationship between feeding infants to a schedule and two sets of outcomes: mothers’ wellbeing, and children’s longer-term cognitive and academic development. Methods: We used a sample of 10 419 children from the Avon Longitudinal Study of Parents and Children, a cohort study of children born in the 1990s in Bristol, UK. Outcomes were compared by whether babies were fed to a schedule at 4 weeks. Maternal wellbeing indicators include measures of sleep sufficiency, maternal confidence and depression, collected when babies were between 8 weeks and 33 months. Children’s outcomes were measured by standardized tests at ages 5, 7, 11 and 14, and by IQ tests at age 8. Results: Mothers who fed to a schedule scored more favourably on all wellbeing measures except depression. However, schedule-fed babies went on to do less well academically than their demand-fed counterparts. After controlling for a wide range of confounders, schedule-fed babies performed around 17% of a standard deviation below demand-fed babies in standardized tests at all ages, and 4 points lower in IQ tests at age 8 years. Conclusions: Feeding infants to a schedule is associated with higher levels of maternal wellbeing, but with poorer cognitive and academic outcomes for children.