Does Breastfeeding Result in Smarter Kids?

A recent study conducted in the United Kingdom claims that breastfeeding makes for smarter kids when they reach the ripe old age of 16. If I had to guess, I'd guess that you were thinking, so what? Don't we already know that kids are smarter if they're breastfed? That is definitely the dominant narrative, but do the data support it? That's the topic of this week's healthcare treatment. To the research! The study, published in June of 2023, examines performance on standardized tests at age 16 and compares scores between kids who breastfed for different amounts of time as babies, including those who were never breastfed. After some adjusting for socioeconomic factors and maternal cognitive ability, better educational outcomes were found in children who were breastfed. You might not be surprised to hear that I am unimpressed by this report. I was unimpressed before I even read it, because the persistent belief that breastfeeding makes smarter babies has never really been supported by the science. But then I read the report, and I got more unimpressed. The first thing that jumped out at me was listed right there in the beginning, in the abstract. Compared to children who were never breastfed, kids who were breastfed for longer were less likely to fail the English, but not the math, standardized tests. So I guess breastfeeding will produce more writers, but the engineering field's out of luck? Come on! A deeper dive reveals that the statistics in this paper are way less than convincing, and I'm not the only one who thinks so. As one analysis posted on Twitter points out, the results are borderline, or not significant, and the stats tests weren't even done appropriately. I don't know if you've listened to our podcast series on reproducibility in science, and you should, but using statistics incorrectly like this just gives us a bunch of unreliable results. The major problem with studies like these is that kids who are breastfed usually have a bunch of other advantages, because in developed countries, it's usually parents who have more resources and education that end up breastfeeding. This is likely due to many factors, like having the resources, support, and time to do it. If you've never breastfed an infant full-time, trust me when I say that those things are necessary for it to be successful. It's actually pretty difficult for many people in the beginning, and it's all-consuming, particularly in the first few months. So the kids who have access to more resources through their parents usually end up having better outcomes. It isn't the breastfeeding that helped them get better marks in school, it's the resources that enabled the breastfeeding in the first place. But wait, you scream. I've read slash heard a lot about this, and breastfeeding has definite advantages over formula. I hear you. I've read it and heard it too. But the data just don't support most of it. The biggest problem is the poor quality of evidence. However, we do actually have data from a randomized controlled trial of a program that encouraged breastfeeding and then analyzed differences between breastfed and non-breastfed babies. There were some positive outcomes of breastfeeding, mainly less diarrhea and fewer rashes in breastfed babies. And that's great, but it's important to keep in mind that these things still weren't happening to a ton of babies in the non-breastfed group, they just happened even less in the breastfed group. Data also support the benefit of breast milk for babies born very prematurely. It doesn't make them smarter, but it can help them to avoid a very serious intestinal problem that can affect babies with very low birth weights and that can also be fatal. Outside of these things, there is evidence that ear infections might be reduced in breastfed infants, and that's basically all we've got. The rest of the evidence is shaky at best, and it's baffling that such weak science underlies the pervasive belief that breastfeeding is basically magic. If you have the time, resources, and inclination to breastfeed your children, that's great. We did it, and you could too. But if you don't, that's okay too. Your children will not be worse off than anyone else as they suffer through standardized testing 16 years down the road. Hey, if you enjoyed this episode, you might enjoy this previous episode, Debunking Common Childbirth Advice. We'd appreciate it if you'd like and subscribe to the channel down below, and consider going to patreon.com slash healthcare triage, where you can help support the show, make it bigger and better. We'd like to especially thank our research associates, Joe Sivitz and Edward Lilleholm, and of course, our surgeon admiral, Sam.