Yahoo Lifestyle New research challenges 'breast is best' claims
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Though breastfeeding has been declared the gold standard by everyone from the Australian Breastfeeding Association, the American Academy of Pediatrics to the World Health Organization, a new study has suggested that its benefits might actually not be all that.
The research, out of Ohio State University, found that when siblings raised in the same family were fed differently — one breastfed, the other not — the long-term health results were virtually the same.
“I do think a lot of the effects of breastfeeding have been overstated,” lead researcher Cynthia Colen, assistant professor of sociology at Ohio State University, tells Yahoo Shine. Because it’s been well-established that the rate of breastfeeding differs substantially by demographic — with non-white, poorer women among the least likely to nurse — Dr Colen was curious about how other factors played into negative health benefits usually blamed on formula feeding. “African-American women breastfeed children much less than white women do, for example, and I thought, this has to be affecting the findings,” she explains. “But I didn’t expect the research to be this striking.”
What she found, when analysing data on 8,237 children (from a national cohort following children between 1986 and 2010), was that the 1,773 sibling pairs raised in the same family but fed differently as infants had virtually no differences, between ages 4 and 14, in outcomes including BMI, obesity, hyperactivity, parental attachment, and test scores predicting academic achievement in vocabulary, reading, math, and general intelligence.
However, Jessica Leonard, breastfeeding counsellor and spokesperson for the Australian Breastfeeding Association (ABA), told Yahoo7 that there have been many recent studies comparing siblings and using the same methodology as the Ohio study that have found opposite outcomes in the areas of obesity and cognitive development. She says, "Their findings were that breastfeeding did have a significant positive impact in these outcomes when compared between siblings."
Leonard added that, "The evidence for health outcomes associated with breastfeeding is based on high quality scientific research, including meta-analyses and Cochrane reviews, which are the ‘gold standard’ of scientific evidence."
The one difference cited by Dr Colen between the siblings in the Ohio study was with asthma, with those who were breastfed more apt to develop the disease (a link that has been found before, in children whose parents have asthma).
Leonard responded to this claim, telling Yahoo7, "Families that have a history of asthma, eczema and allergies tend to breastfeed their children longer. This can lead to the issue of reverse causation, where it appears that breastfeeding ‘causes’ asthma. However, the likelihood of asthma is higher in these children because of the family history, not necessarily because they have been breastfed."
Leonard added that this highlights the need for more research into the long term effects of exclusive breastfeeding on asthma.
Another portion of the Ohio research looked at differences between children not in the same families — with those who were breastfed, as usual, having healthier outcomes. “We included that to show there was nothing funky about the study,” Dr Colen notes, adding that the differences between families could possibly be based on a variety of factors beyond breastfeeding, from socioeconomic status and eating habits later in life to the level of pollution in their respective neighborhoods. Those factors are not usually considered in major breastfeeding studies, she says.
“We know poorer kids have higher rates of obesity because their diets are worse,” she explains. “They are more likely to eat processed food, they are more likely to eat fast food, they are more likely to live in ‘food deserts’ (neighborhoods without good grocery options) and in places where they can’t get out and exercise as much.”
Still, Dr Colen's research suggests that kids' health, in the long term, may have much less to do with nursing than previously thought.
In the meantime, Ms Leonard says the ABA's position is that breastfeeding is an important factor that contributes to both infant and maternal health. "We support giving mothers access to the latest, evidence based information on which to base their feeding choices."
According to the ABA, the following are health outcomes associated with infant feeding for which there is convincing scientific evidence. This list includes results from studies where all types of breastfeeding (including partial breastfeeding), not just exclusive breastfeeding, are included. For all of the following, there is a dose-response relationship between breastfeeding and the health outcome, meaning that the less breastfeeding that occurs, the higher the risks.
For children who are not breastfeed, or breastfed for shorter lengths of time, there is increased risk of:
SIDS
gastrointestinal infections
respiratory infections
ear infections
necrotising enterocolitis in premature babies
sepsis in premature babies
overweight and obesity
lower IQ
For the mother, not breastfeeding increases the risk of:
breast cancer
ovarian cancer
About the ongoing and often heated "breast is best" discussion, Dr Colen tells Yahoo Shine, “I wanted to address the discourse out there of what women were expected to do”. She adds, in a press release about the study, “We need to take a much more careful look at what happens past that first year of life and understand that breastfeeding might be very difficult, even untenable, for certain groups of women. Rather than placing the blame at their feet, let’s be more realistic about what breastfeeding does and doesn’t do.”
The ABA's Jessica Leonard says their organisation receives more than 80,000 calls for help each year, and that breastfeeding is a learned skill that does not come easily to all mothers. She says "It is important that mothers receive quality information and skilled support so they can breastfeed for as long as they want to, and with 90 per cent of mothers starting out breastfeeding, it is clear that Australian mums want to breastfeed their babies."
However, with numbers dropping off significantly after three and six months, Ms Leonard says there is a need to look at ways of supporting mothers to breastfeed for as a long as they want to.
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