Breastfed babies are better behaved says study

[crikeybadger]

Link here if you are interested.

It's based on assessments made of children by their mothers, according to a rigidly structured questionnaire.

It is just about possible that it simply proves that bf mothers are massively more tolerant of their DCs' poor behaviour (or that poorer and less educated mothers are much less tolerant of poor behaviour, since most of the huge difference is explained by social factors).

mumtobandd - the study does not claim to be 'medical' in the sense of bio-medical. But it's perfectly scientific. As Rita says, a read of the thread will show you that when posters on here have raised similar issues, it's been explained how the study was carried out. Parents' observations were collected via a validated tool.

Why the sneering tone about NCT 'peddling' information 'ad nauseam'? The research showing that infant feeding makes a difference to child health is very robust - but you seem to think that because your own two children are fine and happy they negate the research. Infant feeding does not predict or guarantee anything in any individual child - it's a factor, that's all.

Infant feeding methods do not 'cause' certain behaviours and the study does not claim this.

I absolutely agree with you about attachment - in fact attachment is one of the variable controlled for in this study. Other factors than feeding - including attachment - are more important than breast/formula and this study reflects this.

Why do you have a bee in your bonnet about this? Surely as a student at the Tavi you are encouraged to think carefully and scientifically about issues, and not to judge a study by a news report of it?

rollit the researchers only make a decision to include or exclude a variable from the model. then the model treats all variables equally to try and find a set of coefficients (estimates of the odds ratio) related to each variable which best describe the observed data. some variables will be more closely related to the outcome, but none are given more importance than others.

tiktok the accuracy of these estimates is expected to increase as sample size increases. but if two variables are related to each other ("correlated", like being poor and having depression) then the accuracy will tend to be lower than for two unrelated variables for a fixed sample size. however, in a large study such as this, this will be unlikely to be a problem. the issue of interaction - being poor affecting how her depression affects her baby - are more serious. they can be modelled if the researchers choose to include additional variables (eg an extra indicator for women who are poor and depressed), but it's not always clear how best to do this in the case of numeric variables, and I haven't read this paper so don't know if they did it here.

in terms of the estimate of the association between bf and sdq, we should care whether there might be interactions with bf - ie is the effect of bf likely to differ between a child of a poor mother and a rich one? one problem is that while you can test for this, the sample sizes needed to test for significant interactions tend to be much larger than those needed to test for simple effects. note though that missing an interaction would not, I think, create a spurious association between bf and sdq, but it could mean the estimated odds ratio is biased.

technically, we cannot, in an observational study, exclude the possibility that the entire association observed may be due to reverse causality (issues measured by sdq affecting ability to bf) which was Diva's point.

hence my question to tiktok earlier: are there genetically determined physiological conditions which result in an inability to produce milk? if so, causality studies could be designed.

wow thats pretty offensive! although luckily i realise most (MOST) people dont think quite that narrow minded.

I am a 21 year old student. Mum to my now 1 year old son and have been with partner for 4 years.
I tried to breastfeed for a week but my son had a cleft palate when born and he just wouldnt latch on, he had no suck what so ever, so then i tried expressing but a week later my milk had dried up.
Everyone made me feel terrible about it and like i had failed when i knew i had done the best i could. But whenever people ask, "did you breadtfeed?" and i say no or just for 2 weeks. You can tell their thoughts are just like these...that im not educated, or intelligent enough or just not mature enough. wrong wrong wrong.
I also run my own business and in the midst of studying full time take my son to 3 various play sessions a week, swimming classes and baby gym.
Granted some young mums dont understand the seriousness of not even trying but the rest of us really should get more credit.

What is offensive Frankie?

mumto what are you studying? this is an observational study which shows, robustly, that bf babies tend to have fewer issues as measured by sdq that bottlefed at 5 years. it makes no claims of causality in the abstract (I haven't read the full paper). one possibility is that it's completely reverse causality. another is that there is some magic ingredients in breastmilk. another is that nothing in breastmilk affects sdq, but bf generally encourages certain behaviours when feeding babies to a greater degree than ff. these are all hypotheses (there are probably others) which would need further study. but if you believe in the behaviour hypothesis, note that it doesn't mean that such behaviours are universal with bf or impossible with ff, and perhaps studies like this suggest they should be encouraged in both cases?

I think Rita raises a valid point.The NHS site says a weakness is mothers may well not be honest,could have forgotten and could well answer what they think they should according to their demographics. This is a pretty damn big weakness and does make one question the "science" in it.

What I also find interesting is the same site says if you bf for less than 4 months there is no difference what so ever. I find that odd.

They also said they didn't look into why mothers gave up bf ie didn't look at the highly plausible fact that easy babies will be easier to bf,said babies will probably be easier 5 year olds.

Personally I think the most important point is that behaviour 9 times out of 10 comes down to how parents parent. Obviously there are hoards of other important factors such as genes,life circumstances etc. Not a parenting "style" but how they deal with things on a daily basis eg overbearing parents are far more likely to get lying kids. To find out how parents parent or indeed a lot of life circumstances (many parents might not even feel it's necessary to record)would take hours and hours. 2 questionnaires in the course of what was it 5 years is laughable.

Dilys point is an extremely good one too.

I don't think asking perfectly valid questions isn't having a bee in ones bonnet. it is ok to question studies,clearly this is one that deserves such questioning more than most.

Hmm could it just be that babies who naturally took to breast feeding ... making it the easiest option for the mums are just different temperamentally with all these studies nobody ever tells you that both mum and baby have to learn how to feed and thats not always easy, saying that I breastfed my DD for the first 6months and that was because it was easiest for me no bottles or sterilising to think about ( I melted a microwave trying to sterilise stuff.) but it may have been different if either me or my DD had not cottoned on to the breast feeding thing - good luck to all those who bottle feed!

Maybe there is a small point, do 'breastfeeders' simply have slightly more will power? TBH I think not, I think it is the whole of the childs upbringing that is important and the parents general attitude. I am increasingly peed off with parents who don't give 2 hoots about there kids. I see so much as long as there not bothering me i dont really care what they are doing. We live on a military base kids as young as 3 are allowed to roam about as they please, how is that right?? I know for a fact that some of these kids were breast fed but can assure u all that they NOT well behaved! I think peopleshould take their heads out of their arses and look after/play with/educate and support their children! Isn't this why we all decided to have babies in the first place??? Would more time actually listening to and playing with our kids not stop poor behaviour in it's tracks?

Mmm lies & statistics eh? This study is not statistically convincing as far as I can see. The only fact here that everyone seems to overlook is the importance of every baby mammal receiving colostrum (the 'first milk' so denigrated by Mother & Baby books but which farmers move heaven and earth to get to baby lambs and calves knowing that their future health and well-being depends on it). And why does everyone connive with the industry in using the euphemism 'Formula' instead of 'artificial/synthetic or modified cow'? We shall never know...

I don't have a bee in my bonnet, I am very open-minded and I wasn't "sneering" about the NCT - but thanks for the positive welcome to the board!!

I was part of an NCT group when I was having my first child and it was great in many ways, I made some good friends, but I didn't feel that their rigid "breast is best" standpoint was based on any real evidence of it being a significant advantage to Mum or baby as opposed to ff, and some of the "facts" that were presented by them and, at the time, the DoH - such as breast fed babies tend not to develop allergies - was simply untrue. I was trying to say that I ff my kids, they're doing really well thankfully, maybe they won't do as well in future, who knows, but it won't be anything to do with whether they were bf or not, and peddling nonsense about allergies and intelligence isn't helpful to parents or their babies.

My personal viewpoint is that "research" such as this, based on parent's personal opinions of their own childs' behaviour, not on long-term independent observation or another reliable research method, is misleading at best. Every Mum should choose how she feeds her baby for herself and not get bogged down with focusing on "bf or not bf", (easier said than done). I would have thought given the far greater emphasis now placed on attachment theory, (which has nothing to do with bf) arguments over whether a Mum breast feeds or not are largely redundant.

I personally feel it would be more helpful to spend money on improving the post natal support for all Mums regardless of whether they choose to bf or not; the emphasis should be on support and understanding Mum (and Dad!) and the new baby and what's going on between them in those first few months / years, because that's what's going to make a difference to the long-term outcome for that child, not whether the baby sucked on Mum or a bottle!

But hey, it's just my opinion!!

mamachoc, ta for stats lesson :) :)

You ask about physiological conditions leading to no milk. Apart from very rare acquired (rather than genetic/congenital) conditions, like radical surgery on the breasts, I can only think of the very rare hypoplasia of the breasts which means the mother seems to be very short of milk making tissue but some women who have this bf perfectly well. PCOS, severe anaemia, thyroid conditions may have some impact, too. I don't know of any cases in the medical literature which describe a woman with a genetic total absence of milk.

I found this very interesting, coming on the day that I stopped breastfeeding my DD (11 weeks) as she was so fractious while feeding - now on bottles and content, harmony is restored in our household. It seems to me that it is impossible to look at a person and guess whether they were breast or formula fed, which suggests to me (quite unscientifically I know) that there is very little difference in the long term. This theory is bourne out by the fact that the scientific community seems entirely unable to agree whether breast really is best, which suggests that there is very little in it. We all have to make the decision we think is right for us and it would be nice if we could do so without the media constantly sensationalising the issue.

mumtob - to talk about an organisation 'peddling claims ad nauseam' is pretty sneering, I would have thought! The research on allergies is not as strong as the research on infections, in that studies give varying effects, but there as there is a clear connection between the immune system and infant nutrition, and sufficient studies that show a link in practice it's not a concept without foundation.

'Long term observation' of children is no more reliable than parents' questionnaires when it comes to children's everyday behaviours - clearly the questionnaires have to be good ones, and the SDQ is a validated tool, well-known and well-used. Anyone studying kids' behaviours has to ask parents questions - what else are they going to do? Move in 10,000 researchers with notebooks and cameras with families for 10 years - invisible ones who don't affect the behaviour of the family in any way? Specific behaviours - like the ones that demonstrate attachment - can be observed objectively in specific situations. But this is not what this study was looking at.

Please do check with your tutors about breastfeeding and attachment, by the way....perhaps you are a new student at the Tavi and have not yet read the very extensive literature on this.

You are right in saying that breastfeeding is not necessary for attachment to 'happen', and that normal attachment is far more dependent on responsiveness and emotional containment than whether the baby is bottle or breastfed - but that's very far from saying breastfeeding and attachment have 'nothing' to do with one another.

I suspect your tutors will ask you to remain open-minded about this.

LadyLex - you can't tell by looking at someone if they have diabetes, or are a smoker, or are French, Italian, or Spanish, or if they are good at ballroom dancing, or have a happy marriage, or if they like sugar in the tea.....this does not mean these differences do not exist!

You say, "This theory is bourne out by the fact that the scientific community seems entirely unable to agree whether breast really is best" - but they do agree! Where's the idea that they don't agree come from?

"We all have to make the decision we think is right for us and it would be nice if we could do so without the media constantly sensationalising the issue." Agree with you there on both counts :)

Mila - I said the poster had a bee in her bonnet not because she asked questions but because she raised points that had been dealt with before, and because she presented her own personal study of her children (n= 2) as counter evidence.

I know, it's such a woolly study! And unscientific. And breast is probably not even good for you and who's to know anyway? It's not even like it's been checked...

Far more likely that dried cows' milk is better for babies. Why wouldn't it be? I certainly can't think of any reasons that would make milk from a dirty person's skin better for a human. Especially if they've not showered for days. And their house is filthy.

Hahahaha too much

I'd like to hear what Joan Wolf thinks of the study. Want to know more about Joan Wolf? Read this.

I was very pro breastfeeding until I had my daughter. She couldn't latch on at first and when that was sorted she couldn't suckle. I had to ff because she lost so much weight and couldn't gain enough even when we supplemented her.

If the UK is to continue being so in favour of breastfeeding new mums need far more support and I'd love there to be more research on how to help new mums and babies with feeding problems.

Being sent home within hours of the birth despite telling midwives the baby wasn't latching on didn't help. Various midwives and the nursery nurse teaching me incorrect methods - for example, hold the baby's back of the head and shove the nipple in while the baby's crying - also didn't help.

Having to hire a private lactation consultant for help - in a country that has legislation in favour of breastfeeding (no discounts allowed in Boots for early formula) - is a disgrace.

I needed help with every feed for the first week or so - not help with just one feed every other day over three weeks.

Everybody that's in favour of breastfeeding and managed to do it successfully should campaign for more feeding support and research in the UK rather than harp on about the benefits of breastfeeding and criticise mums that have struggled.

Lotta, I appreciate your problems (having been there myself), but surely "harping on about benefits" is necessary if we're going to get support - nobody's ever going to fund support or train midwives properly in the absence of loads of evidence that it has tangible benefits (nor should they - if it's just the mother's choice that has no long term impact on her baby's health and development then why on earth should it be funded any more than baby yoga).

DilysPrice - but just harping on about the benefits doesn't improve the situation. Everybody needs to campaign for more support.

Great so now I've breast fed I can take my foot off the gas on all other irks then can I? Education, clubs, holidays, interactions, toys etc etc just because I made it a few months bfing?! I'm sure there are benefits but can't tell if they are quantifiable in a study because there's so many variables. I'm also wondering who started /funded it.

Wonderful to hear that in 5yrs time I'll see a result.....

Lotta - there is very little criticism of mothers who have struggled...have you seen any on this thread, for instance?

Many bf supporters do work hard for more support for mothers and there is a ton of research into what helps mothers bf - NICE have guidelines on it, the Dept of Health has policies on it, every maternity unit in the country has a bf policy and so on and on. We know what supports bf, and you are absolutely right that it is a disgrace this is not easily available everywhere.

Breastfeeding should not be a struggle.

I hope you have written to the maternity unit where you had your baby and also to the breastfeeding lead at your PCT to complain about the lack of help and then the unhelpful and counter-productive interventions by community HCPs. What did they say?

LaCiccolina - the study comes from data collected for the Millennium Cohort which is a publicly funded project collecting data from something like 15000 babies born in 2000. This is a major public health study which will track these babies for many years, certainly into adulthood.

The study makes it quite clear that infant feeding is only one factor among many associated with later outcomes and it uses respected techniques to quantify its effect - your satirical suggestion that education and so on do not matter is just misplaced, given the study is very careful not to overstate the effect.

Am a bit nervous of jumping into the discussion. Here goes!

Infant feeding is only one of the many things that is being looked at in this study. And to counter all the critcisms being levelled at this study - well as observational studies go, it seems a pretty good one to me.

This is just one study among hundreds (thousands?) of public health studies going on. It's the one that's been picked up by the media though - clearly because they know the findings will cause discussion. As tiktok says, we do need research about possible benefits to inform campaigns about better support for mothers.

The full paper does discuss possible explanations for the observed association, and is very careful to consider the results in terms of the limitations of the study (this is good research practice BTW). The authors acknowledge that there may be other unmeasured factors which may explain the findings. At no point do the authors say there is a causal relationship.

Personally I do agree that often the claims about the benefits of breastfeeding are exaggerated. Sometimes this is down to iffy research studies - but I don't think this is one of them. I think we're all in agreement that infant feeding is just one factor among many. I don't think there is any disagreement in the scientific community that breastfeeding is in general a good thing for most mothers and babies. However, the difference it makes in the overall picture is probably very minimal in light of everything else - certainly for us, here in the UK. But we research all the other factors that may be associated with long term social and health outcomes, so why not breastfeeding?

disclaimer: I work as a medical researcher, and have some indirect knowledge of the study being discussed - though not personal involvement. Have read full paper.

thought this was interesting, and obviously a lot of information missing in a short news report, so I thought I'd find the paper itself.

Abstract: adc.bmj.com/content/early/2011/03/24/adc.2010.201970.abstract

Conclusion notes "Conclusions The findings suggest that, at least in term children, longer duration of breast feeding is associated with fewer parent-rated behavioural problems in children aged 5 years."

Full paper PDF: press.psprings.co.uk/adc/april/adc201970.pdf

enjoy :)