Address correspondence to Eirik Evenhouse, Ph.D., Department of Economics, Mills College, 5000 MacArthur Boulevard, Oakland, CA 94613. Siobhan Reilly, Ph.D., is with the Department of Economics, Mills College, Oakland, CA.
Improved Estimates of the Benefits of Breastfeeding Using Sibling Comparisons to Reduce Selection Bias
Article first published online: 15 AUG 2005
Health Services Research
Volume 40, Issue 6p1, pages 1781–1802, December 2005
How to Cite
Evenhouse, E. and Reilly, S. (2005), Improved Estimates of the Benefits of Breastfeeding Using Sibling Comparisons to Reduce Selection Bias. Health Services Research, 40: 1781–1802. doi: 10.1111/j.1475-6773.2005.00453.x
- Issue published online: 15 AUG 2005
- Article first published online: 15 AUG 2005
- Breast feeding;
- selection bias
Objective. Better measurement of the health and cognitive benefits of breastfeeding by using sibling comparisons to reduce sample selection bias.
Data. We use data on the breastfeeding history, physical and emotional health, academic performance, cognitive ability, and demographic characteristics of 16,903 adolescents from the first (1994) wave of the National Longitudinal Study of Adolescent Health. The sample includes 2,734 sibling pairs.
Study Design. We examine the relationship between breastfeeding history and 15 indicators of physical health, emotional health, and cognitive ability, using ordinary least squares and logit regression. For each indicator, we estimate, in addition to the usual between-family model, a within-family model to see whether differences in siblings' outcomes are associated with differences in the siblings' breastfeeding histories.
Principal Findings. Nearly all of the correlations found in the between-family model become statistically insignificant in the within-family model. The notable exception is a persistent positive correlation between breastfeeding and cognitive ability. These findings hold whether breastfeeding is measured in terms of duration or as a Yes/No variable.
Conclusions. This study provides persuasive evidence of a causal connection between breastfeeding and intelligence. However, it also suggests that nonexperimental studies of breastfeeding overstate some of its other long-term benefits, even if controls are included for race, ethnicity, income, and education.