I've had a read of this paper.
Colen, C.G., Ramey, D.M., Is Breast Truly Best? Estimating the
Effects of Breastfeeding on Long-term Child Health and Wellbeing in
the United States Using Sibling Comparisons, Social Science &
Medicine (2014), doi: 10.1016/j.socscimed.2014.01.027.
It's a worthwhile topic - take siblings who differ in how they were
fed as infants, and see how the long term outcomes compare.
But I do think it's badly executed.
The statistical presentation is mystifying. The authors need to read
Ben Goldacre's book Bad Science which has a useful chapter on making
findings intelligible.
Having said that, the exercise is a constrained by 2 major facts:
* the bf info is restricted to ever breastfed, and how long with any
breastfeeding in weeks ie no information on whether the bf was
exclusive, predominant, minimal...
* the outcomes are selected from a longitudinal cohort study of
children aged between 4 and 14 and are body mass index, obesity,
asthma, hyperactivity, parental attachment, behavioral compliance,
reading comprehension, vocabulary recognition, math ability, memory
based intelligence, and scholastic competence
That list is a strange one. Who of us on this list would expect to
see a difference in BMI/obesity because of any breastfeeding lasting
into the early teens - family influence (obviously strong, for
siblings) and other environmental influences would overwhelm any
'breastfeeding factor'. Has anyone even hypothesised that
hyperactivty (defined how? As ADHD?) is affected by any
breastfeeding? Behavioural compliance? What's that on the list for?
The sample is reduced to 1,773 children by the time the cohort is
reduced to 'discordant siblings' - I would be unsure if the survey
is powered enough to reveal significant findings, anyway.
Not impressed.
Heather Welford Neil
NCT bfc, tutor, UK
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