ORIGINAL RESEARCH article
Front. Public Health
Sec. Children and Health
This article is part of the Research TopicChildren in Global Health: Promoting Health Equity from the Perspective of Media, Culture and CommunicationView all 10 articles
The mediating role of sleep disorders in the relationship between breastfeeding and behavioural problems among 6-to 8-year-old children in Shanghai, China
Provisionally accepted
- 1Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
- 2Huzhou University, Huzhou, Zhejiang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Improving breastfeeding rates is a crucial goal in the WHO Global Nutrition Targets 2025. However, the connection between breastfeeding duration/exclusivity and childhood behavioral problems (BPs) remains contentious due to conflicting evidence. This study investigated sleep disorders' mediating role in the relationship between breastfeeding and BPs in children to offer a scientific foundation for early intervention. A cross-sectional study was carried out in 34 elementary schools in Shanghai's Xuhui District from September to December 2019, involving 11,319 students aged 6 - 8. Guardians completed an online survey for demographic data and scored the CSHQ and CPRS. After controlling for relevant factors, breastfeeding was associated with higher overall sleep problem scores and specific issues (P < 0.05). It also had direct and significant effects on multiple behavioral domains. Sleep disorders mediated the relationship between lack of breastfeeding and several BPs. Yet, the cross-sectional design limits causal inference, and parent-reported sleep disorder severity may introduce bias. Future research should use longitudinal cohorts to further explore this relationship.
Keywords: breastfeeding, Childhood behavioral problems, a cross-sectional study, CPRs, Children
Received: 13 Apr 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Hu, Shen, Wang, Xinyi, Guan, Jiang and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qunfeng Lu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.