I would be doubtful about the exclusivity of breastfeeding in the highly-touted sibling comparision studies in the recent BMJ article. In my experience, few mothers who have exclusively breastfed one child are willing to withhold the benefits and pleasures of exclusive breastfeeding from their other children or themselves In addition, exclusively breastfeeding women often do so because they regard formula as harmful and, once again, would be unlikely to feed it to their other children. It is much more likely that women who report breastfeeding one child and not that child's siblings both breast and bottle-fed the "breastfed" child, confounding the research. Chirstine Guarnera, RN MSN IBCLC



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