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

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  • Colen, Cynthia G.
  • Ramey, David M.

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.

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  • Colen, Cynthia G. & Ramey, David M., 2014. "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, Elsevier, vol. 109(C), pages 55-65.
    • Handle: RePEc:eee:socmed:v:109:y:2014:i:c:p:55-65
    DOI: 10.1016/j.socscimed.2014.01.027
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    7. Cebolla-Boado, Héctor & Jiménez-Buedo, María & Salazar, Leire, 2017. "Avoiding selection bias without random assignment? The effect of breastfeeding on cognitive outcomes in China," Social Science & Medicine, Elsevier, vol. 194(C), pages 151-159.
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    12. Kieron J. Barclay & Martin Kolk, 2017. "The Long-Term Cognitive and Socioeconomic Consequences of Birth Intervals: A Within-Family Sibling Comparison Using Swedish Register Data," Demography, Springer;Population Association of America (PAA), vol. 54(2), pages 459-484, April.
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    16. Barclay, Kieron & Keenan, Katherine & Grundy, Emily & Kolk, Martin & Myrskylä, Mikko, 2016. "Reproductive history and post-reproductive mortality: A sibling comparison analysis using Swedish register data," Social Science & Medicine, Elsevier, vol. 155(C), pages 82-92.
    17. Leiter, Valerie & Agiliga, Alexis & Kennedy, Evangeline & Mecham, Emma, 2022. "Pay at the pump?: Problems with electric breast pumps," Social Science & Medicine, Elsevier, vol. 292(C).
    18. Barclay, Kieron & Keenan, Katherine & Grundy, Emily & Kolk, Martin & Myrskylä, Mikko, 2016. "Reproductive history and post-reproductive mortality: a sibling comparison analysis using Swedish register data," LSE Research Online Documents on Economics 65602, London School of Economics and Political Science, LSE Library.

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