When Ohio State sociologist Cynthia Colen embarked on the biggest study yet of the long-term effects of breastfeeding, she expected it to yield still more evidence of “breast is best.”
Her research focuses on the health gaps between rich and poor, and she anticipated findings that would underscore the high price paid by poor and working-class mothers, whose jobs often stand in the way of breastfeeding.
But the data did not go there.
Previous research had reported a variety of long-term breastfeeding benefits in children, ranging from slightly higher IQs to lower risks of Attention Deficit Disorder. But those studies had mainly compared children across different families.
And all the previously reported long-term benefits evaporated.
“I was shocked,” she said. “I thought, ‘Of course there’s going to be some confounding. We know that children who are breastfed are much more likely to come from middle-income families; to have parents with higher levels of education; they’re more likely to be white; more likely to live in middle-class or safe neighborhoods — all these things that we know are going to impact these long-term child outcomes.’ But I didn’t expect such a dramatic reduction.”
So, in this study spanning 25 years of data on more than 8,000 children ages 4 to 14, the long-term benefits of breastfeeding dwindled down to virtually nothing?
Yikes. It takes courage to question breastfeeding benefits these days. So let’s be clear: Dr. Colen is by no means against breastfeeding. On the contrary. And the evidence for the short-term benefits of breastfeeding is overwhelmingly clear, from improved immunity for the baby to healthier weight for both baby and mother. But, she says, “We need to just get a more balanced conversation going.”
“I’m not saying that women shouldn’t breastfeed and I’m not saying that breastfeeding is not beneficial,” she said. But “I think we have to be honest and try to understand more about what breastfeeding can and cannot do for women and their children, and to start to expand the conversation to these larger social and economic factors that we need to address.”
Those social and economic factors include the need for better maternity leaves and more affordable daycare — as well as higher school quality, safer neighborhoods, more family-friendly jobs. Dr. Colen argues for taking a more careful look at what happens in a child’s life beyond infancy, and for understanding that breastfeeding may be difficult to the point of impossibility for some groups of women. (Interesting paper: Is Breastfeeding Truly Cost-Free?) Continue reading