Breastfeeding Controversy Heats up Again

breastfeeding

Breastfeeding controversy heats up again every few years and, right now, it is warming up quite nicely. A new report in the journal Social Science & Medicine suggests that the benefits of the practice may have been overstated by previous studies, according to a new study conducted by researchers at Ohio State University.

The Ohio State University study is unique, according to the authors, because it looked at siblings who were fed differently, one bottle fed and one breast fed, and compared the results for children in from four to 14 years old. There were 8,000 children in the study, about 25 percent of whom were in discordant pairs, with one sibling getting the bottle and the other getting the breast. Those 1,000 pairs of siblings were then measured for 11 variables such as body mass index, intelligence, hyperactivity, parental attachment, asthma and obesity.

Studies like these are prone to something called selection bias, according to lead author Cynthia Cohen, an assistant professor at Ohio State. All researchers attempt to control selection bias by attempting to select study subjects blindly, which makes it difficult to control for variations such as age, ethnicity, income and maternal employment, factors that can affect the outcomes the study sought to compare.

What Cohen found was not surprising at first. When comparing children from different families, the breast-fed children fared better than the bottle fed kids on all 11 variables, but researchers believe those differences were due to family circumstances rather than breastfeeding itself. The mothers who breastfeed tended to be from a higher socioeconomic group, with better incomes and personal support systems than the bottle feeders.

When comparing siblings who were fed differently were compared, however, the socioeconomic factors no longer applied.  Because they came from the same families, the children were presumably raised under similar circumstances. The results obtained with the sibling pairs indicated no difference in 10 of the eleven categories. The only difference was that the breastfed children were more likely to to have asthma than the bottle fed babies were.

One  evaluation factor that was not included in the study was the prevalence of allergies in the sibling pairs. The most frequently cited potential benefit from breastfeeding has always been the transmission of anti-bodies from mother to child that were thought to protect the children from allergies. There are several types of asthma, one of which is specifically considered to be allergic asthma, but there was no indication in the study about which kinds of asthma were identified in the study.

Some of the variables not considered in the study included the reasons why one child was breastfed and the other was not, and whether the breastfed child was the older or younger sibling, both of which might factor into the results. Nevertheless, the study’s author believes that breasting a baby is good, if the mother is able, but it is not the panacea that it has been cracked up to be. Critics of breastfeeding advocates point out that many women feel inadequate because they cannot breastfeed in the face of the tremendous social pressure to do so.

There are, however, other opinions on the subject. One such opinion comes from actress Mayim Bialik, who plays Dr. Amy Fowler on the long-running Big Bang Theory comedy series which airs on CBS. Bailik, who is a real Ph.D with a degree in neuroscience, has defended her practice of breastfeeding her children into their toddler years. She points to a recent report documenting a significant drop in obesity rates for preschoolers, the only age group for which obesity rates improved in the most recent study.

The study found that that the percentage of breastfed children increased from 35 percent in the 2003-2004 sample to 49 percent in 20011-2012 sample for children who were breastfeeding for the first six months, an increase of 14 percent. The percentage for children who were still being breastfed at 12 months increased from 16 percent to 27 percent, an increase of 11 percent over the same time period.

The average improvement in obesity rates for the children in the toddler group, ages two to five, was an astonishing 43 percent over an eight year period. Researchers speculated that feeding by breast during a child’s early years helps children to regulate their food intake, but no one know exactly why it works that way.

This is one of those subjects that people love to disagree about. The sight of a doting mother giving her breast to her six year-old seems perfectly normal to some people, and totally insane to others.  Some people, like Dr. Bialik, believe that doing it in public is perfectly acceptable.  She was once photographed breastfeeding her 3-year-old on a New York subway. Other people believe that it is simply not in good taste.

However, pitting a study with 2,000 subjects against a statistical review of an eight year long study of 10,000 subjects might give the breastfeeders an edge. The breastfeeding controversy heats up again and again, every few years, and it never quite goes away completely, but the conversation may often be as much about propriety as it is about nutrition.

By Alan M. Milner

Sources:

Arizona Daily Star
Christian Science Monitor
JAMA
New York Times

3 Responses to "Breastfeeding Controversy Heats up Again"

  1. Alan Miner   March 3, 2014 at 6:49 am

    I agree with your critique, but we only have a 1000 words to work with in this format. Both studies are seriously flawed, but it is pretty clear that the Ohio State study was formulated for the specific purpose of debunking breastfeeding, so it was biased from the outset. I tried to indicate that the sibling comparison is invalid unless the siblings were twins, raised at the same time under the same circumstances. The second study is far more objective. I was especially amused by the study’s assertion that breastfeeding was associated with greater affluence which is a cultural bias and hundreds of millions of women around the world would attest. Breastfeeding is the cheaper alternative, in addition to possible health benefits.

    Reply
  2. NikkiLeeHealth   March 3, 2014 at 5:18 am

    The findings, despite all the fancy statistical analysis, are meaningless. There is no definition of breastfeed. Exclusivity and duration were not even considered during the late 70s, when some of the cohort was born. The benefits of breastfeeding are dose related. The best study would compare 10,000 exclusively breastfed babies with 10,000 exclusively formula fed babies, for 3 or 6 months.

    Reply
    • NikkiLeeHealth   March 3, 2014 at 5:19 am

      Error: should read, “There is no definition of breastfeeding.” A baby could have been breastfed once or twice a day for several weeks, and be considered breastfed in this study.

      Reply

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