Is breast truly best? Estimating the effects of breastfeeding on long-term child health and wellbeing in the United States using sibling comparisons

Cynthia G. Colen, David M. Ramey

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Breastfeeding rates in the U.S. are socially patterned. Previous research has documented startling racial and socioeconomic disparities in infant feeding practices. However, much of the empirical evidence regarding the effects of breastfeeding on long-term child health and wellbeing does not adequately address the high degree of selection into breastfeeding. To address this important shortcoming, we employ sibling comparisons in conjunction with 25 years of panel data from the National Longitudinal Survey of Youth (NLSY) to approximate a natural experiment and more accurately estimate what a particular child's outcome would be if he/she had been differently fed during infancy. Results from standard multiple regression models suggest that children aged 4 to 14 who were breast- as opposed to bottle-fed did significantly better on 10 of the 11 outcomes studied. Once we restrict analyses to siblings and incorporate within-family fixed effects, estimates of the association between breastfeeding and all but one indicator of child health and wellbeing dramatically decrease and fail to maintain statistical significance. 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.

Original languageEnglish (US)
Pages (from-to)55-65
Number of pages11
JournalSocial Science and Medicine
Volume109
DOIs
StatePublished - Jan 1 2014

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Breast Feeding
Siblings
Breast
health
infant
statistical significance
social status
Social Class
Longitudinal Studies
regression
Demography
Child Health
Well-being
Children's Health
experiment
Pressure
evidence
Research

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • History and Philosophy of Science

Cite this

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