Breastfeeding and handedness: a systematic review and meta-analysis of individual participant data

This study aims to determine whether breastfeeding duration affects the prevalence of nonrighthandedness in later life. A systematic search for studies on this topic was completed in 2018, and risk of bias was assessed by means of the Newcastle-Ottawa scale. Seven national surveys in five countries with Individual Participant Data (IPD) were identified (n = 62,129 mother-child dyads). These surveys had low risk of bias. An IPD meta-analysis showed that breastfeeding for < 1 month, 1 to 6 months, and > 6 months, when compared to bottle feeding, was associated with a 9%, 15% and 22% decreased prevalence of nonrighthandedness, respectively (Prevalence Ratio (PR) = 0.91, 95% confidence interval (ci): 0.83, 1.00; p-value = 0.05, PR = 0.85, 95% CI: 0.79, 0.92; p-value < 0.0001 and PR = 0.78; 95% CI: 0.71, 0.85; p-value < 0.0001). This dose-response relationship was significant (p < 0.001). No significant heterogeneity across surveys was detected (p-value > 0.54). Breastfeeding for longer than 9 months was not associated with further reductions in the prevalence for nonrighthandedness (p > 0.58). It is concluded that the critical age window for establishing hemispheric dominance in handedness includes the first 9 months of infancy and is in part determined by nurture.