Study Questions Some of the Long-Term Benefits of Breastfeeding

Abstract

Research Article| July 01 2014 Study Questions Some of the Long-Term Benefits of Breastfeeding AAP Grand Rounds (2014) 32 (1): 3. https://doi.org/10.1542/gr.32-1-3 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Study Questions Some of the Long-Term Benefits of Breastfeeding. AAP Grand Rounds July 2014; 32 (1): 3. https://doi.org/10.1542/gr.32-1-3 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: breast feeding, relationship - sibling, obesity Source: 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. Soc Sci Med. 2014; 109: 55– 65; doi: https://doi.org/10.1016/j.socscimed.2014.01.027Google Scholar Investigators from Ohio State University studied the effect of infant feeding on 11 outcome measures in children ages 4 to 14 years. Because there are tremendous racial and social disparities in breastfeeding rates, the investigators hypothesized that previous research documenting the benefits of breastfeeding on long-term child health may not have adequately accounted for unobserved heterogeneity between breast- and bottle-fed children (ie, selection bias) that may be driving observed differences in outcomes. To better account for this bias, the investigators conducted a natural experiment using data obtained from the 1979 Cohort of the National Longitudinal Survey of Youth (NLSY), a nationally representative, prospective cohort study containing information on 12,686 men and women who were 14 to 22 years old in 1979. In 1986, a second NLSY survey of all children born to the female respondents of the 1979 survey began and continued through to 2010. Investigators utilized data collected from children 4 to 14 years old as part of this second NLSY survey for the current study. Investigators separated child participants into 3 subgroups: (1) full sample; (2) sibling sample: only NLSY children in which a sibling was also assessed; (3) discordant sibling sample: only NLSY siblings who were fed differently during infancy (one breastfed, the other bottle-fed). For this discordant sibling sample, the mother served as her own “control,” therefore accounting for unobserved potential confounders that differ across families. The 2 predictor variables were breastfeeding status, defined as mother-report of her infant receiving any breast milk (yes/no), and breastfeeding duration, defined as mother-report of how old the child was (in weeks) when the mother stopped breastfeeding. Eleven outcomes were measured: BMI, obesity, asthma, hyperactivity, parental attachment, behavioral compliance, reading comprehension, vocabulary recognition, math ability, memory-based intelligence, and scholastic competence. Investigators used multivariate regression models using the 3 separate samples controlling for a wide range of observed potential confounders, including maternal age, race, marital status, income, and education. There were 8,237, 7,319, and 1,773 children in the full, sibling, and discordant sibling samples, respectively. With the full sample, there was a statistically significant association between breastfeeding and all outcomes except for asthma. In addition, each additional week of breastfeeding was associated with significant decreases in childhood BMI, obesity, and hyperactivity, as well as significant increases in parental attachment, math ability, reading comprehension, vocabulary recognition, memory-based intelligence, and scholastic competence. For the sibling sample, these results largely persisted. However, when restricting analysis to the discordant sibling sample, all associations between each outcome and both breastfeeding status and duration lost statistical significance. The investigators conclude that much of the beneficial long-term effects typically attributed to breastfeeding may be due to social selection pressures inherent in infant feeding practices that have been unaccounted for in previous studies. Dr... You do not currently have access to this content.