Breastfeeding Benefits: Fact Versus Fiction

Breastfeeding is not a pancea. Parents deserve a nuanced look at the science.

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Breast pumps. Ignorance is bliss. If you’ve been there, you know what I mean.

Studying breastfeeding benefits

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We need solid study designs, solid statistics, and appropriate framing of results. Photo by Glenn Carstens-Peters on Unsplash

What happens when we raise the scientific bar?

Short Term Impact

  • Breastfed infants are less likely to experience gastrointestinal GI infections (e.g. diarrhea), eczema and other rashes.
  • Breastmilk may offer some protection against a serious condition called Necrotizing Enterocolitis (NEC) to preterm low birthweight infants.
  • Breastfeeding may help protect against ear infections, but effects are moderate at best. Protection was not significant according to the PROBIT study but a large, well-designed cohort study supported a small benefit.
  • It’s unclear whether or not breastfeeding helps reduce rates of Sudden Infant Death Syndrome (SIDS). The PROBIT trial did not find statistically significant differences in SIDS rates between the two study groups, despite numbers that favoured breastfeeding. Case-control studies provide some support for lower rates of SIDS with breastfeeding, but the link is murky. This 2017 review of eight international case-control studies didn’t show protective effect in the first 2 months, either in individual studies or the pooled analysis. From 2–6 months, some studies showed a protective effect of breastfeeding, while others didn’t. The pooled analysis landed in support of breastfeeding protection, though there was no difference between exclusive breastfeeding and some breastfeeding. There is no clear mechanism for how breastfeeding helps.
  • Many other short term benefits (e.g coughs and colds) lack rigorous evidence.

Long Term Impact

Most claims of long term benefits to breastfeeding, such as childhood obesity, asthma, and intelligence, are not supported by well-controlled trials.

Our results suggest that much of the beneficial long-term effects typically attributed to breastfeeding, per se, may primarily be due to selection pressures into infant feeding practices along key demographic characteristics such as race and socioeconomic status.

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A cheeky graph showing that correlation does not equal causation. Source GLP. Credit to David Warmflash, astrobiologist and science communicator. @CosmicEvolution

What about moms?

Moms may also benefit health-wise from breastfeeding, but the story here is also more complex than meets the eye (see 2015 maternal health review). As with infant benefits, most of the evidence comes from uncontrolled studies that make it difficult to draw firm causal conclusions.

More Nuance

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Antibodies help offer short-term protection against infections.

The cost of exaggeration

Some breastfeeding advocates seem to feel that a little exaggeration can only help, by nudging moms towards the “right” track. I disagree.

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Does it really have to be breast or bust?

The path forward

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Breastfeeding rates in the US (Source)

My Bottom Line

Breastfeeding does offers real short term health advantages, both for babies and moms. Yet, the differences between breastfed and bottle fed babies aren’t nearly as dramatic as they are made out to be.

Credit

Thank you, SciMoms and Prof. Emily Oster whose work on this topic inspired and informed this article and my own deep dive.

About Me

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Thanks for reading! See more of my work at: https://fueledbyscience.com.Photo credit: Ingemorsen

Written by

Scientist (PhD Genetics @Stanford) * Mother * Passionate about science-based healthy choices * Lifelong learner * Founder: Fueled by Science

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