Review Article

The Impact of Breastfeeding on Auditory, Speech, and Language Development: A Narrative Review

Abstract

Introduction: The type of feeding has different effects, and the effects of breastfeeding on the auditory system, speech and language has also been confirmed. The aim of this study is to provide a comprehensive review of various studies conducted on the effects of different feeding types on the auditory system, speech and language.
Materials and Methods:  A narrative review was conducted using PubMed, Scopus, Medline, Web of Science, Google Scholar, ScienceDirect, and the Cochrane Library to identify English-language studies on the effects of feeding type on auditory, speech, and language development. A total of 57 studies published between 1981 and 2025 were identified and selected based on predefined inclusion criteria, and the findings were synthesized to evaluate developmental outcomes.
Results: Breastfeeding has different effects on various aspects of hearing, speech, language, and cognition in children compared to formula feeding. Breastfeeding, as a protective factor against middle ear. Breastfeeding is associated with better speech and language development, including verbal intelligence, better receptive and expressive language, improved language skills, and the natural development of oral-motor skills necessary for speech production.
Conclusion: As the optimal source of nutrition for infants, breast milk not only meets physical and motor needs but also contributes to optimal functioning of the peripheral and central auditory systems. It plays a significant role in enhancing communication skills, speech and language development, and related abilities.This review is limited by its narrative design and the heterogeneity of existing studies; future research should employ standardized, longitudinal methodologies to clarify causal mechanisms.

1. Martin CR, Ling P-R, Blackburn GL. Review of infant feeding: key features of breast milk and infant formula. Nutrients. 2016;8(5):279.
2. Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatric Clinics. 2013;60(1):49-74.
3. Castellote C, Casillas R, Ramírez-Santana C, Pérez-Cano FJ, Castell M, Moretones MG, et al. Premature delivery influences the immunological composition of colostrum and transitional and mature human milk. The Journal of nutrition. 2011;141(6):1181-7.
4. Lönnerdal B. Human milk proteins: key components for the biological activity of human milk. Protecting infants through human milk: Advancing the scientific evidence. 2004:11-25.
5. Jensen RG, Blanc B, Patton S. Particulate constituents in human and bovine milks: Academic Press: San Diego, CA, USA; 1995.
6. Guo M. Human milk biochemistry and infant formula manufacturing technology. 2020.
7. Goldman AS. Modulation of the gastrointestinal tract of infants by human milk. Interfaces and interactions. An evolutionary perspective. The Journal of nutrition. 2000;130(2):426S-31S.
8. Wang B. Molecular determinants of milk lactoferrin as a bioactive compound in early neurodevelopment and cognition. The Journal of pediatrics. 2016;173:S29-S36.
9. Schirmbeck GH, Sizonenko S, Sanches EF. Neuroprotective role of lactoferrin during early brain development and injury through lifespan. Nutrients. 2022;14(14):2923.
10. Thongseiratch T, Kittisakmontri K, Chandeying N. Bovine milk fat globule membrane supplementation and neurocognitive development: a systematic review and meta-analysis. Nutrients. 2024;16(14):2374.
11. Colombo J, Harris CL, Wampler JL, Zhuang W, Shaddy DJ, Liu BY, et al. Improved neurodevelopmental outcomes at 5.5 years of age in children who received bovine milk fat globule membrane and lactoferrin in infant formula through 12 months: a randomized controlled trial. The Journal of Pediatrics. 2023;261:113483.
12. Gould JF, Gibson RA, Yelland LN, Colombo J, McPhee AJ, Gallier S, et al. Infant formula supplemented with milk fat globule membrane compared with standard infant formula for the cognitive development of healthy term-born formula-fed infants: protocol for a randomised controlled trial. BMJ open. 2024;14(6):e083399.
13. Auestad N, Stockard-Sullivan J, Innis SM, Korsak R, Edmond J. Auditory brainstem evoked response in juvenile rats fed rat milk formulas with high docosahexaenoic acid. Nutritional Neuroscience. 2003;6(6):335-41.
14. Wan G, Gómez-Casati ME, Gigliello AR, Liberman MC, Corfas G. Neurotrophin-3 regulates ribbon synapse density in the cochlea and induces synapse regeneration after acoustic trauma. elife. 2014;3:e03564.
15. Chumak T, Rüttiger L, Lee SC, Campanelli D, Zuccotti A, Singer W, et al. BDNF in lower brain parts modifies auditory fiber activity to gain fidelity but increases the risk for generation of central noise after injury. Molecular Neurobiology. 2016;53(8):5607-27.
16. Savino F, Benetti S, Liguori SA, Sorrenti M. Advances on human milk hormones and protection against obesity. Cellular and Molecular Biology. 2013;59(1):89-98.
17. Belfort MB. The science of breastfeeding and brain development. Breastfeeding Medicine. 2017;12(8):459-61.
18. Smith JP, Ellwood M. Feeding patterns and emotional care in breastfed infants. Social Indicators Research. 2011;101(2):227-31.
19. Bhatia J, Greer F. Use of soy protein-based formulas in infant feeding. Pediatrics. 2008;121(5):1062-8.
20. Miraglia Del Giudice M, D’Auria E, Peroni D, Palazzo S, Radaelli G, Comberiati P, et al. Flavor, relative palatability and components of cow’s milk hydrolysed formulas and amino acid-based formula. Italian journal of pediatrics. 2015;41(1):42.
21. Verduci E, Di Profio E, Cerrato L, Nuzzi G, Riva L, Vizzari G, et al. Use of soy-based formulas and cow's milk allergy: lights and shadows. Frontiers in pediatrics. 2020;8:591988.
22. Elnaz Rashed C, Ali G, Soudabeh A, Reyhane M, Mahboobeh R. Pragmatic Skills in Children with Cochlear Implants. Journal of Modern Rehabilitation. 2023;17(1).
23. Mehrkian S, Moossavi A, Gohari N, Nazari MA, Bakhshi E, Alain C. Long latency auditory evoked potentials and object-related negativity based on harmonicity in hearing-impaired children. Neuroscience Research. 2022;178:52-9.
24. Gohari N, Firuzbakht M, Esmailzade M, Mashhadihossein F, Rashedi V. Evaluation of universal newborn hearing screening with TEOAE-TEOAE and TEOAE-AABR. Journal of Research in Rehabilitation Sciences. 2014;10(1):46-55.
25. Gohari N, Farahani F, Gharebaghy S, Alaei S, Ahmadi S, Mozafari Z. The prevalence of hearing loss in infants hospitalized in the neonatal intensive care units. Auditory and Vestibular Research. 2020.
26. Ciampo LAD, Almeida CAN, Ricco RG. Tabagismo passivo em lactentes. Pediatria (Säo Paulo). 1999:15-20.
27. Garcia MV, de Azevedo MF, Testa JRG, Luiz CBL. The influence of the type of breastfeeding on middle ear conditions in infants. Brazilian Journal of otorhinolaryngology. 2012;78(1):8-14.
28. Sequi-Canet JM, Sequi-Sabater JM, Collar-Castillo JI, Orta-Sibu N. Breastfeeding results in better hearing in newborns compared to bottle-feeding. Journal of Clinical and Translational Research. 2020;6(3):81.
29. Bowatte G, Tham R, Allen K, Tan D, Lau M, Dai X, et al. Breastfeeding and childhood acute otitis media: a systematic review and meta‐analysis. Acta Paediatrica. 2015;104:85-95.
30. Wang Y, Hu Y, Lin H, Pan Y, Zhou Z, Zhu C, et al. Different Feeding and Delivery Modes on Otitis Media with Effusion in Children: A Correlational Study. 2024.
31. Sayed EM, Abdel Hamid TM, Ibrahim AA, Mohammed EI. Assessment of auditory brainstem response in infants in relation to type of feeding. Journal of Recent Advances in Medicine. 2021;2(1):80-6.
32. Alatorre-Cruz GC, Andres A, Gu Y, Downs H, Hagood D, Sorensen ST, et al. Impact of feeding habits on the development of language-specific processing of phonemes in brain: An event-related potentials study. Frontiers in Nutrition. 2023;10:1032413.
33. Guzzardi MA, Granziera F, Sanguinetti E, Ditaranto F, Muratori F, Iozzo P. Exclusive breastfeeding predicts higher hearing-language development in girls of preschool age. Nutrients. 2020;12(8):2320.
34. Pivik R, Andres A, Badger TM. Diet and gender influences on processing and discrimination of speech sounds in 3‐and 6‐month‐old infants: a developmental ERP study. Developmental science. 2011;14(4):700-12.
35. Algarín C, Murguia-Peniche T, Reyes S, Wu SS, Wampler JL, Peirano P. Effects of infant feeding type on auditory event-related potentials at 24 months of age. Pediatric Research. 2024:1-9.
36. Garon-Carrier G, Tiraboschi GA, Bernard JY, Matte-Gagné C, Laurent A, Lemieux A, et al. Unraveling the effects of maternal breastfeeding duration and exclusive breast milk on children’s cognitive abilities in early childhood. Frontiers in Public Health. 2023;11:1225719.
37. Der G, Batty GD, Deary IJ. Effect of breast feeding on intelligence in children: prospective study, sibling pairs analysis, and meta-analysis. Bmj. 2006;333(7575):945.
38. Mohammed S, Oakley LL, Marston M, Glynn JR, Calvert C. The association of breastfeeding with cognitive development and educational achievement in sub-Saharan Africa: A systematic review. Journal of Global Health. 2022;12:04071.
39. Hayiou-Thomas ME. Genetic and environmental influences on early speech, language and literacy development. Journal of communication disorders. 2008;41(5):397-408.
40. Mahurin-Smith J, Ambrose NG. Breastfeeding may protect against persistent stuttering. Journal of communication disorders. 2013;46(4):351-60.
41. Goel M, Jayachandran S, Kadam SJ, Sharma R. Relationship Between Breastfeeding Duration and Exclusivity on Various Language Milestones in United States Children Aged 3–5 Years. Children. 2025;12(6):719.
42. Smith JM. Breastfeeding and language outcomes: A review of the literature. Journal of communication disorders. 2015;57:29-40.
43. Dee DL, Li R, Lee L-C, Grummer-Strawn LM. Associations between breastfeeding practices and young children's language and motor skill development. Pediatrics. 2007;119(Supplement_1):S92-S8.
44. Brauer J, Anwander A, Friederici AD. Neuroanatomical prerequisites for language functions in the maturing brain. Cerebral cortex. 2011;21(2):459-66.
45. Nieto-Ruiz A, Diéguez E, Sepúlveda-Valbuena N, Catena E, Jiménez J, Rodríguez-Palmero M, et al. Influence of a functional nutrients-enriched infant formula on language development in healthy children at four years old. Nutrients. 2020;12(2):535.
46. Choi HJ, Kang SK, Chung MR. The relationship between exclusive breastfeeding and infant development: A 6-and 12-month follow-up study. Early human development. 2018;127:42-7.
47. Horta BL, de Sousa BA, de Mola CL. Breastfeeding and neurodevelopmental outcomes. Current Opinion in Clinical Nutrition & Metabolic Care. 2018;21(3):174-8.
48. Belfort MB, Anderson PJ, Nowak VA, Lee KJ, Molesworth C, Thompson DK, et al. Breast milk feeding, brain development, and neurocognitive outcomes: a 7-year longitudinal study in infants born at less than 30 weeks' gestation. The Journal of pediatrics. 2016;177:133-9. e1.
49. Luby JL, Belden AC, Whalen D, Harms MP, Barch DM. Breastfeeding and childhood IQ: the mediating role of gray matter volume. Journal of the American Academy of Child & Adolescent Psychiatry. 2016;55(5):367-75.
50. Belfort MB, Rifas-Shiman SL, Kleinman KP, Guthrie LB, Bellinger DC, Taveras EM, et al. Infant feeding and childhood cognition at ages 3 and 7 years: effects of breastfeeding duration and exclusivity. JAMA pediatrics. 2013;167(9):836-44.
51. Barbosa C, Vasquez S, Parada MA, Gonzalez JCV, Jackson C, Yanez ND, et al. The relationship of bottle feeding and other sucking behaviors with speech disorder in Patagonian preschoolers. BMC pediatrics. 2009;9(1):66.
52. Kamino D, Studholme C, Liu M, Chau V, Miller SP, Synnes A, et al. Postnatal polyunsaturated fatty acids associated with larger preterm brain tissue volumes and better outcomes. Pediatric research. 2018;83(1):93-101.
53. Mariën P, Borgatti R. Language and the cerebellum. Handbook of clinical neurology. 2018;154:181-202.
54. Agostoni C, Zuccotti GV, Radaelli G, Besana R, Podesta A, Sterpa A, et al. Docosahexaenoic acid supplementation and time at achievement of gross motor milestones in healthy infants: a randomized, prospective, double-blind, placebo-controlled trial. The American journal of clinical nutrition. 2009;89(1):64-70.
55. Meldrum SJ, D'Vaz N, Simmer K, Dunstan JA, Hird K, Prescott SL. Effects of high-dose fish oil supplementation during early infancy on neurodevelopment and language: a randomised controlled trial. British journal of nutrition. 2012;108(8):1443-54.
56. Makrides M, Gibson RA, McPhee AJ, Collins CT, Davis PG, Doyle LW, et al. Neurodevelopmental outcomes of preterm infants fed high-dose docosahexaenoic acid: a randomized controlled trial. Jama. 2009;301(2):175-82.
57. Ramili Da, Hagr A, Ashraf Mo, Al-Arfaj A. Effect of Breastfeeding on Hearing Outcome in Childhood. Saudi Journal of Otorhinolaryngology Head and Neck Surgery. 2011;13(1):38-42.
IssueArticles in Press QRcode
SectionReview Article(s)
Keywords
Auditory system; Breastfeeding; Bottle feeding; Formula feeding; Speech, Language

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1.
Gohari N, Ghorbani Aghdam B, Khoshfetrat M. The Impact of Breastfeeding on Auditory, Speech, and Language Development: A Narrative Review. jmr. 2026;(-).