Articles about breastfeeding books and breastfeeding research appear in the various forms of media on a regular basis. Sometimes they are reporting on the results of studies and sometimes they are opinion pieces. Whether the reports come from social media, blogs (including LLLC’s Thursday’s Tips & Supporting Breastfeeding), print media, radio or television reporting it is important as a reader to have a baseline against which to measure the validity of the reporting or opinion.
The most important thing to remember when reading any opinion article or research study is this: human milk and feeding at the breast are the biologically normal way of feeding human babies and therefore this is the “control” group that all research or opinion about infant feeding must be measured against.
The question is never “is human milk and breastfeeding better than XYZ?” It is always “is XYZ better than human milk and feeding at the breast?” Research, and the discussion of the results of the research, should compare the potential for risk/harm/loss from alternate infant food sources and feeding methods against the norm (human milk and feeding at the breast).
If you want to look deeper into articles or research it is important to look at the terms and understand what the author means by them. “Exclusive breastfeeding” is one term that has been defined differently in many studies. The precise definition is: nothing other than human milk is given to the baby until the middle of the first year. However, some studies may allow a limited amount of non-human milk liquid in their “exclusive” group or they may use a different time range, which leads to confusion when comparing results and conclusions. To confound the issue further, some mothers may not be made aware that their baby was given a formula supplement in hospital or by a “helpful” family member so, when asked by a researcher, they would define themselves as exclusively breastfeeding. Research shows that once a baby has had any non-human milk feeding, even if it is only once, the gut flora changes. There is an excellent article by Marsha Walker IBCLC which summarizes what we know about supplementation of the breastfed baby.
It is also important to consider the scale of the study and make-up of the group of infants being discussed. Is the piece you are reading based on one person’s experience, a study of a small group of children over a short period of time or a very large group of children over a long period of time? Were the parents reporting on their breastfeeding experiences at the time they were breastfeeding or are they looking back and reporting on what they did many years before? All of these options are valid and serve a specific purpose but they need to be recognized and understood so you as a reader can consider the potential limitations in how their conclusions could be applied to the general population of infants or your own infant.
Realistically, we need to understand that not all research is done to the same standards. The better the quality of the research the greater the value we can draw from the conclusions. Sometimes we have the opportunity to look at individual studies and to consider their implications as stand-alone information. Other times researchers undertake something called a Meta-Analysis where they look at a large number of studies on a similar topic with a goal to finding the common conclusions that can be drawn by looking at a lot of data all together. When doing a meta-analysis, researchers may set aside some of the studies because they had a poor or limiting design. This does not necessarily mean the purpose of that specific study was not worthwhile nor that the conclusions would not be repeated in a larger or more rigorous study; it means only that right now this study is considered weak and not helpful to the general discussion. An example of a meta-analysis of current breastfeeding research can be found HERE.
When you see media reports on studies about human milk it is worth trying to look at the original study. You don’t need to be a statistician or university trained researcher to look at a study report and gain some understanding of it. Most studies and journal articles that are being reported on in the various forms of media are accessible on line. Search for the author’s name(s) and “breastfeeding” or the study topic and you can usually find it quite easily. Some studies are available to the public in abstract form only, which means without paying for access to the whole article you can only see a summary of the purpose of the study, what group of individuals or specimens were included in the study and the conclusions made by the authors. When you are given online access to an entire article or study you may feel overwhelmed by the amount and detail of the information included. You will find the information about the purpose and group to be studied at the beginning of the article and the conclusions drawn by the study’s authors at the end. It can also be interesting to look for the information about who the researchers are affiliated with and who paid for the study. This information is usually found at the very end of the report.
The fact that there is so much research happening about human milk and breastfeeding is wonderful. This tells us that the research community recognizes the value of human milk and wants to better understand what makes it the ideal food for human infants, what long term health outcomes it is giving to children and how producing human milk and breastfeeding influences the health outcomes of their mothers. The researchers (for the most part) are looking to find even better evidence to understand the most important health reasons to breastfeed rather than suggesting that the human milk has little value.
Studies are generally about large populations and general conclusions, while opinion pieces tend to be about one person’s experience. La Leche League Canada Leaders are happy to help you look at information you may see in any of the forms of media and evaluate it in the context of your own breastfeeding situation with your own baby (ies). Click HERE find the contact information for your local LLLC Leader.