Would you do a study that “analyzed” the relationship of breastfeeding and IQ based on data obtained from mothers who retrospectively reported at 18 months postpartum if they did or did not breastfeed? Would you conclude anything if the data base was a yes or no answer, with no distinction made if it was exclusive breastfeeding or partial (of any degree) and with absolutely no data provided as to duration of the breastfeeding? Believe or not that was the basis for the “conclusion” by researchers in England that was published in the open access journal PLOS/one, widely reported the lay press and trumpeted gleefully by the disparagers of breastfeeding.
No less than these glaring methodological deficiencies, is the misreading by the “public” of what the authors themselves studied. As they stated, the study was NOT on IQ per se, but rather on IQ growth trajectories. Or to put it simply, if breastfeeding increased a child’s IQ as measured by the initial IQ test and the child maintained that degree of increased IQ as compared to children who did not breastfeed, there would be no increased growth trajectory.
Thus, extrapolating from trajectory data to absolute levels of IQ and concluding that breastfeeding has no impact on IQ is just plain wrong (let alone ignoring the wealth of articles in literature that support the conclusion that breastfeeding does increase IQ : see the most recent review: Effects of Breastfeeding on Obesity and Intelligence: Causal Insights From Different Study Designs. Smithers LG, Kramer MS, Lynch JW. JAMA Pediatr. 2015 Aug)
Given this combination of the basic limitations of methodology coupled with the misinterpretation of the study results, one must conclude that in no way does this study contradict what is a given: breastfeeding is critical quantitative positive variable in the cognitive development of all children. Furthermore, as a measure of the limited value of the study, one should note that authors did not even cite the issue of the lack of data as to the quantity of breast milk that the infants ingested over time in their list of the limitations of the study, let alone, did they indicate the lack of data as to major confounders such as maternal IQ and quality of home environment.
Bottom line is that this study should be discounted in any serious discussion as to the relationship of breastfeeding and IQ!
Dr. Arthur I Eidelman is a Professor of Pediatrics at Shaare Zedek Medical Center, Jerusalem, Israel. He is the Editor-in-Chief of Breastfeeding Medicine, past president of ABM, and a Fellow of the Academy of Breastfeeding Medicine.
Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.
A guy friend once informed me that breastfeeding breasts aren’t sexy. Sure, there might be the odd dreamboat (thank you, Brad Pitt) who will publicly announce his preference for the breeding female form, but my friend explains: “Breastfeeding breasts aren’t sexy. No one thinks they are sexy! They are generally overfirm, or oblong, with a giant nipple and a BABY attached to the end!” (He also has lots of very warm and supportive opinions of breastfeeding women) Let’s repeat that: “A baby is attached to it;” and that baby probably just pooped itself.
This struck me as essentially true, so it got me thinking: what’s the deal with the worry that this cultural myth of “breasts are for sex, not feeding” undermines women’s ability to feel comfortable with breastfeeding in public? What’s up with the leagues of women telling us they feel over-sexualized while breastfeeding? Or, at least, the leagues of lactation consultants and breastfeeding advocates worrying about it? In fact, it seems important to point out that breastfeeding women aren’t walking around complaining that they feel too sexy. In fact, one of the main reasons teen moms will give for not breastfeeding is that it isn’t sexy. Not to mention the common misconception that breastfeeding causes one’s breasts to become prematurely saggy. Saggy…real sexy. So, if we, as breastfeeding advocates, are not getting this directly from moms, where does it come from? Read the rest of this entry »
Whether you celebrate World Breastfeeding Week (WBW) or National Breastfeeding Month, and whether you choose the first week in August or October, the time to be launching your efforts is NOW!
The World Alliance for Breastfeeding Action (WABA) is perhaps best known for its global sponsorship of World Breastfeeding Week (WBW), but it is much more: WABA is a global network of individuals and organizations concerned with the protection, promotion & support of breastfeeding worldwide. WABA’s actions are based on the Innocenti Declaration, the Ten Links for Nurturing the Future and the Global Strategy for Infant and Young Child Feeding. WABA is in consultative status with UNICEF and is also an NGO in Special Consultative Status with the Economic and Social Council of the United Nations (ECOSOC). Its Core Partners include ABM, IBFAN, ILCA, LLLI and Wellstart International, with a shared mission: “To protect, promote and support breastfeeding worldwide, in the framework of the Innocenti Declarations (1990 and 2005) and the Global Strategy for Infant and Young Child Feeding, through networking and facilitating collaborative efforts in social mobilisation, advocacy, information dissemination and capacity building.”
World Breastfeeding Week this year occurs on the 25th anniversary of the Innocenti Declaration, signed by more than 30 countries (including the US) that stated the countries’ intention to implement the following by 1995:
- Create a national multidisciplinary authority for government support and oversight of breastfeeding
- Ensure all hospitals practice the Ten Steps for Breastfeeding
- Implement the International Code of Marketing and subsequent WHA resolutions
- And, last but by no means least, ensure maternity protection, including the ILO guidance of at least 14 weeks paid maternity leave and workplace accommodation.
This year’s theme supports the Innocenti Declaration as well as WABA’s goal to create an enabling environment for mothers and families worldwide to decide to optimally breastfeed and to succeed in that goal Breastfeeding and Work – Let’s make it work! This theme highlights the importance of ongoing support for necessary leave and workplace support.
Now is the time to inspire, empower and educate while we support, protect and promote breastfeeding. Get ready to act now in support of the theme for World Breastfeeding Week 2015. Please visit worldbreastfeedingweek.org for information on the theme, materials you can download, a photo contest and WBW 2015 Pledge forms to tell the world about your efforts.
Miriam H Labbok, MD, MPH, IBCLC, FABM, FILCA is Professor and Director of the Carolina Global Breastfeeding Institute in the Department of Maternal and Child Health at the UNC Gillings School of Global School Public Health. She is a Founder, past president and member of the board of the Academy of Breastfeeding Medicine.
Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.
The ad starts by asking “do you ever feel judged?” and shows a woman on a bench outside of a playground, holding her baby in a sling and looking unsure of herself. She is progressively joined by different stereotyped groups of women, including the “breast police,” that start a playground “brawl” of sorts. They argue in shallow derogatory terms that one group has the better form of parenting: breast vs bottle, work vs stay at home, disposable vs cloth diapers, etc… When they finally charge each other, a baby carriage is left hurtling down a hill and all the families join together to chase it. They bond over their concern for saving the baby in the carriage, and the text reads: “Whatever your beliefs, we are all parents first.”…”Sisterhood of Motherhood,” cue to “Similac.” Read the rest of this entry »
A recent study linking longer breastfeeding with higher IQ in adulthood seems to be pushing some people’s buttons. The study followed several thousand children, recruited in the early 1980s, through adulthood, and assessed years of education, IQ, and income in their early 30s. Compared with those who were not breastfed, individuals who had been breastfed for at least a year earned about $100 more each month, completed an additional year of schooling, and had IQs that were 3.76 points higher. These estimates accounted for multiple sociodemographic founders, increasing the chance that the differences were due to breastfeeding itself, rather than to other confounding factors.
On its face, this study adds to the ample evidence that how babies are fed is an important predictor of health and wellbeing. Yet several in the media have gone the great lengths to pick apart they study and its methods. The Independent’s Matilda Battersby took on the study with a pointed commentary, entitled “So breastfeeding improves your child’s IQ? Try telling that to the women who physically can’t.”
In her commentary, Battersby writes, “What none of these studies or news reports ever seem to acknowledge is quite how difficult breastfeeding actually is.” She goes on to compare her first weeks of breastfeeding to sitting “for hours at a time with a needle sticking in their nipple.” She writes, “Around 69 per cent of mothers breastfeed their babies at birth, but this falls to 23 per cent at six weeks – and for a very good reason. It is tough.”
I suspect that Battersby wanted to assuage the very real feelings of guilt and regret experienced by women who were unable to achieve their feeding goals. But as Shannon Tierney has so eloquently written, “Things can matter, without being the only things that matter. Breastfeeding matters, and it still matters even for women who cannot do it.”
Battersby goes on to write, “while we’d all like to think we’re doing the best for our bambinos we’re stuck between the Earth-motherish pressure to be constantly attached via a teat to our sprogs, versus the “Put it away, dear” mentality – thank you, Nigel Farage – which suggests that breastfeeding is embarrassing and dirty.”
And here, for me, is where her argument falls apart. The “breastfeeding problem” is not that studies have found that breastfeeding is different from formula feeding – rather, the problem is our collective failure to convert those data into a sustained commitment to provide women with the care and support that they need to achieve their infant feeding intentions. It’s the system that did not provide Battersby with help to resolve her pain during the hours of “needles sticking in her nipples.” It is Nigel Farage, and our collective cultural neglect of – and often open hostility toward – mothers and children. Read the rest of this entry »
I #March4Nutrition because breastfeeding is a powerful predictor of health and wellbeing for mothers and infants — and yet, too many families face barriers that prevent them from achieving their own breastfeeding goals.
Families who want to breastfeed navigate a veritable minefield of “Booby Traps.” Many maternity providers have minimal training in lactation support, and providers may not ask about breastfeeding during prenatal care — or spend only seconds on the topic — missing the opportunity to address concerns and provide guidance. Parents are inundated with misleading materials from infant formula manufacturers, promising that their product is “designed to be like breast milk” or will magically convince fussy babies to sleep through the night. Indeed, in a study, mothers looking at formula advertisements voiced concerns that their milk didn’t have added vitamins, so perhaps it would be healthier to formula feed.
At birth, too few families receive evidence-based maternity care that gets infant feeding off to an optimal start. For example, putting a baby skin-to-skin for the first hour of life increases breastfeeding duration by as much as 6 weeks — yet 28% of US hospitals do not provide such care to most women. Skin-to-skin is one of the World Health Organization Ten Steps to Successful Breastfeeding. Hospitals that implement all ten can be designated as “Baby Friendly” – but currently, only 11.5% of US maternity centers meet that standard. It’s worth noting that we are making progress — just 2.9% of hospitals were Baby Friendly in 2007 — but 88% of families are still hobbled at the starting gates when they start their breastfeeding journey.
Over the past 3 decades, an increasing number of studies and reviews have examined the relationship of breastfeeding and childhood obesity. The authors of Agency for Healthcare Research and Quality’s (AHRQ) Evidence Report on Breastfeeding meta-analysis concluded that children who were breastfed for at least 3 months were less likely to be obese than those never breastfed, taking into account multiple confounding factors.1 The duration of breastfeeding was found to be inversely related to the risk of being overweight; each month of breastfeeding being associated with a 4% reduction in risk. A WHO meta-analysis from 2007 also concluded that longer breastfeeding (typically durations of 3 to 9 months), in comparison to no breastfeeding, was associated with lower rates of obesity.2 The Framingham Offspring study noted a relationship of breastfeeding and a lower BMI in adults.3 A sibling difference model study showed that the breastfed siblings weighed 13 pounds less than formula fed siblings at a mean age of 14 and were less likely to reach BMI obesity threshold.4 Based upon these studies, the promotion of breastfeeding to prevent obesity has been recommended by the CDC, the Institute of Medicine, and the Surgeon General.
However, there are, however, other important studies that failed to find a relationship. The PROBIT study, the only randomized trial of breastfeeding in term infants, randomized an intervention to promote increased duration and exclusivity of breastfeeding in Belarus and found no significant differences in BMI, percent body fat, and obesity between the experimental and control group children at 11.5 years of age.5 The “discordant sibling study” looked at data obtained from the National Longitudinal Survey of Youth study and found that breastfeeding was not associated with significant improvements in childhood obesity when siblings who were fed differently during infancy, one breastfed, the other bottle fed, were compared.6
So how are we to interpret these conflicting studies? My opinion has been that, as the etiology of obesity is multifactorial, breastfeeding can play an important role in its prevention, but is unlikely to entirely prevent it. The limitation of most of these studies is that they look at breastfeeding alone. Future studies need to focus on the role of multiple modifiable factors on these conditions.7 Read the rest of this entry »