Why you shouldn’t freak out about the new breastfeeding studies from Pediatrics{0}

A bunch of studies published in the journal Pediatrics have been getting a lot of attention this past week.  So they should:  they are well-designed and conducted pieces of research into the effect of early nutrition (so, what babies eat before they are one) on children at aged six.

Unfortunately, as so often happens when breastfeeding is in the subject matter, how these studies have been reported leaves a lot to be desired.

For those who haven’t seen them, here are the headlines from the studies, as nicely summed up by Dr Claire McCarthy, a medical writer and Assistant Professor of Pediatrics at Harvard Medical School no less:

1. Children who were breastfed for several months are less likely to have ear, throat and sinus infections. They have the same amount of colds, other respiratory infections, and urinary tract infections as formula-fed babies–and they are just as likely to have food allergies.
2. Breastfeeding didn’t lead to any significant difference in the “psychosocial” development of children. Children who were breastfed did have fewer emotional and behavioral problems, but when they looked at it closely, this wasn’t because of breastfeeding–it had to do with parenting and family factors (underlining, yet again, that there is way more to parenting than breastfeeding).
3. Despite what everyone tells you, breastfeeding doesn’t help get the pregnancy weight off–unless you were obese before the pregnancy, in which case it does help.
4. Children who were breastfed end up eating more fruits and vegetables and drinking more water instead of sweetened beverages–but they are just as likely to eat sweets and savory snacks.
5. Children who were given sweetened beverages during the first year of life are twice as likely to be obese, and twice as likely to still be drinking them at age 6, which means they at higher risk of staying obese (or getting more so).
6. Children who don’t eat many fruits or vegetables in the first year of life still aren’t eating many of them when they turn 6, although it’s not clear whether they don’t like them or whether their family just still isn’t serving them.
7. This one is interesting: when mothers feed babies with bottles (of either formula or pumped breast milk), they are more likely to push their children to eat generally, such as wanting them to finish all the food on their plate. This puts a child at higher risk of being overweight.

So, overall, I would say this research contains good news for both formula-feeding and breastfeeding families.  On the breastfeeding side, it reiterates its known anti-infective benefits showing that breastfed babies have fewer ear, throat and sinus infections at aged six.  They are also more likely to eat more fruit and veggies by the time they’re in primary school.  Win and win.

On the formula-feeding side, the good news is that your baby isn’t more likely to have a cold, respiratory infection or UTI at aged six than a breastfed baby.  If you have a family history of allergies, don’t worry about breastfeeding as a preventative measure – your formula-fed baby is just likely to have them as her breastfed sister.

That old chestnut about breastfeeding helping get the pregnancy weight off is also dismissed for those of us who weren’t obese to start with.  And, duh, how you feed your baby makes no difference to their social and psychological development.

Not that this is what you would have understood to come from these studies if you read the majority of press reports.

Suzanne Bartson, the Fearless Formula Feeder, has already written eloquently and in detail about this on her blog, so I won’t go over the same territory.  Suffice to say, that as a journalist I was tearing my hair out at the lazy tendency of my colleagues to look for the headlines that reiterate the accepted norm (breastfeeding=good, bottlefeeding=bad) rather than report the facts, and the nuances of the studies.

(By the way, if you want to read the studies for yourself, Pediatrics has generously made them all freely available.  Whoop!)

What I did want to talk about is putting the risk of these increased chances of ear, throat and sinus infections into perspective.

This study compared children breastfed for nine or more months with children breastfed (not exclusively) up to three months.  In relative terms they found the 9+ month group had 69% less risk of developing an ear infection, a 68% less chance of developing a throat infection and a 47% less chance of developing a sinus infection than the -3 month group.

It sure sounds like a lot, and in a statistical sense it is.  It should provide comfort and confidence to mothers who were able to breastfeed for nine months of more.

This, however, is not the majority of us, so for the huddled masses out there, yet again feeling bad because they weren’t able to keep the milk up, here is what the raw data showed.

The six year olds breastfed for 3 months or less had nearly a 3 in 10 chance of having had an ear infection in the past year, whereas the group breastfed for 9+ months had a 2 in 10 chance.  For throat infections the -3 month group had a 1 in four chance, the 9+ month had a 1 in 5 chance.  And for sinus infections, 1 out of 5 in the -3 month group developed one, whereas 1 in 10 in the 9+ month group developed one.

Of course, any time your kid is sick is one time too many, but the absolute numbers here show me that while the benefits of breastfeeding are certainly statistically significant (and taken from a public health perspective, fiscally significant also) in real world terms we shouldn’t be too worried.

Much more common than these infections is the common cold, or upper respiratory tract infection.  Around two thirds of children develop these, regardless of how they are fed.

For me, the biggest message from this slew of studies doesn’t come from the findings into breast or bottle-feeding, it comes from the research into what babies are fed after the exclusive milk period of the first six months.

As the New York Times reports, they strongly suggest that what babies eat in the first year of life affects what they will be eating a five years later.  More sugary drinks under aged one means more sugary drinks (and more obesity) at aged six.

The message is, once they’ve started complementary foods, lay off the sugary drinks, including juice (and super-sweetened formula).  Start fruit and veggies early, including fruits that are sour, and veggies that are bitter.

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