Breastfeeding not solely responsible for infant's health

Breastfeeding is majorly correlated with positive health outcomes in infants, but it might not be the causal mechanism.

Researchers from the University at Buffalo found that the benefits of breastfeeding, reported in the vast majority of prior research, could be influenced by the mother's characteristics, such as what they know about health and nutrition.

"It's important to understand that we are not trying to imply that just intending to breastfeed is what's leading to these health outcomes," said Jessica Su, co-author of the study. "What we found is that intending mothers had more information about nutrition and diet; they more frequently consulted their physicians; and had better access to information related to infant health than those moms who did not intend to breastfeed."

This access to health care is an important policy focus. By channelising so much energy into getting moms to breastfeed, we miss something very important: that access to health care and the ability to take medical advice is critically important to a mother and her infant. By exploring factors influencing better infant health outcomes, information from the study helps contextualise the tradeoffs that a lot of mothers have to make when deciding how to feed their children.

"We don't have the social support to facilitate the recommendations being put forth. The U.S. is the only developed country with no federal paid parental leave, and only about 12 per cent of mothers in the private sector have access to paid leave," explained Su. "Paid maternity leave likely increases breastfeeding success, and also seems to have additional health benefits for mothers and infants. If we have concerns about disparities in infant health we need social policies that support these recommendations and also go beyond simply encouraging breastfeeding over formula."

Breastfeeding is not always practical and may not produce the health benefits mothers hope for, yet the "breast is best" message is so strong that it can create undue stress and feelings of inadequacy for mothers who are unable to breastfeed. There is a high cost to this message, especially if the benefits of breastfeeding are overstated.

"It's important to more carefully quantify the trade-offs between breast milk and formula given the strong breastfeeding recommendations and the realistic challenges that many mothers face, particularly among working mothers," Su said.

The findings appeared in the journal Social Science & Medicine: Population Health.