Study Questions: Is Breast Still Best?

Breast Still Best? | @VeggieConverter

A recent study garnered a bit of attention lately in healthy living circles by saying the breast may not be as superior as we once thought. Myriad prior studies proclaim breastfeeding and breast milk to be superior to formula when it’s possible for the baby. Yet according to new research published in the journal Social Science & Medicine, breastfed babies may not have the long term health advantages that have been claimed.

So, how do this researchers discount all those prior studies? Selection bias is to blame, the researchers say. Employment, age and family income skews research results.  Dr Cynthia Colen, a sociology professor at Ohio State University, says the study is the first to look at a sample of families where one or more siblings had been breastfed while others had been bottle-fed. 

The sibling study claims not to suffer from selection bias since it compares siblings who were bottle and breastfed.

Dr. Colen says the findings do not oppose the view that breastfeeding has clear short-term health benefits for young children.

“I’m not saying breast-feeding is not beneficial, especially for boosting nutrition and immunity in newborns,” Colen said. But, Colen continues, the focus shouldn’t be so strong on the superiority of breast versus bottle. Raising a healthy child depends on other factors, too, and that should be the focus.

The researchers argue that the majority of mothers who choose breastfeeding in developed countries are white middle-class women. It’s possible that the relatively privileged societal position, rather than breastfeeding itself, accounts for the improved outcomes claimed to be associated with breastfeeding. In this single study, all of the participants who were breastfed had statistically better outcomes in 9 out of 11 areas. 

But when looking at the differences between siblings who were breastfed versus bottle-fed, researchers found no statistically significant differences.

What does this mean for moms? 

Not a lot. Remember that myriad of other studies and empirical breastfeeding wisdom? That still exists. This study’s sample of about 7300 siblings is not the new holy grail for formula manufacturers. Of those siblings, only 1773 were discordant siblings—siblings who were fed differently as babies. Meaning the primary conclusion of the study is based on the results of just one-quarter of the subjects.

Even this study says breast is still best overall. It’s just hard to separate other causes like income, education and lifestyle from breastfeeding. So the children in this study were found to fare better if breastfed. Yet, when compared with bottle-fed siblings raised by the same parents, they fared just a bit better.

Breast is still best. I think that the point of this controversial study is simply this, we don’t know what all goes into the health of a child. Breastfeeding contributes to healthy babies. But, if you must formula feed, it’s perhaps not as detrimental to your child’s health as you may have been led to believe. Breast is still best, but you can make up for the shortcomings of formula with other factors.

This study doesn’t alter the current body of research showing the benefits of breastfeeding. There were statistically significant differences in health, behavior and academic outcomes in the full cohort.

 The study also has many confounding factors that weren’t considered.

In the U.S., women are rarely offered paid maternity leave. This means those who breastfeed in the States are more likely higher income. Yet, in the UK and throughout Europe, paid maternity leave is common. This means that socioeconomics is not a likely confounding factor for breastfeeding studies outside of the United States.

Additionally, the study didn’t determine cause for changing feeding style within the discordant siblings’ families. Maternal breast disease, inability to nurse due to lip ties or cleft palates and other factors can also contribute to the child’s overall health and affecting the study’s results. For more on issues with this research study, read here.

Bottom line: If you can’t nurse your child, of course you shouldn’t beat yourself up. Everyone does their best. If you can breastfeed, you should. Much like choosing all-natural groceries, choosing all-natural breast milk versus processed formula is the best choice whenever possible.

Dr. Colen’s research analyzed 8,237 children, 7,319 siblings and 1,773 “discordant” sibling pairs, in which at least one child was breast-fed and at least one other child was bottle-fed.

The cohort study that used data from the US National Longitudinal Survey of Youth. It aimed to see if breastfeeding made a difference to outcomes for children between the ages of 4 and 14 after socioeconomic factors were taken into account. Since this is a cohort study, it cannot prove that breastfeeding is the cause of any differences found. The study only shows associations, not causes.


Breast Still Best? | @VeggieConverter

Image: Baby Dust Diaries via Compfight cc


Colen CG, Ramey DM. Is Breast Truly Best? Estimating the Effects of Breastfeeding on Long-term Child Health and Wellbeing in the United States Using Sibling Comparisons. Social Science & Medicine. Published online January 29 2014

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