Breast is Best: Estimating the Long-Term Consequences of Breastfeeding for Childhood Wellbeing Using Sister Comparisons

Cynthia G. Colen, Ohio State University
David Ramey, Ohio State University

Since the 1970s, breastfeeding has witnessed a resurgence. Besides being economical, it is thought that breast milk contributes to beneficial health outcomes during the perinatal period and for many years to come. However, empirical evidence concerning long-term effects of breastfeeding on childhood wellbeing remains unclear. This is primarily a function of the fact that, on average, breastfed children are different from their bottle-fed counterparts along several demographic dimensions. The overarching objective of this study is to estimate the extent to which breastfeeding influences the health trajectories of children in the United States. We rely on a multipronged analytic strategy that includes growth curve models, propensity score matching, and sibling comparisons. Each approach offers a more rigorous test of the hypothesis that breastfeeding contributes to enduring positive childhood outcomes by more closely approximating the counterfactual question – what would the health of this infant be like if he/she had not been breastfed.