Breast is Best for the National Economy

Remember when people used to believe that it took a village to raise a child? It seems that the last vestige of that sentiment took its dying breath in recent weeks as online discussion boards launched into lactation consultants. In a time in which big corporations are a new mother’s best friend, who needs the advice of women with training and experience to tell us what it best for babies?

The problem with breastfeeding is that, despite being the most natural way to feed a baby, in the first few days of an infant’s life it is not the easiest way to feed a baby. Getting through that difficult period, when mothers are exhausted and more and more frequently post-operative, requires a great deal of encouragement.

Historically, of course, support was provided by mothers, sisters and aunts who had years of accumulated breastfeeding experience. Now, the majority of a new mother’s female relatives have never breastfed and so that responsibility for providing the necessary training and support has been passed on to health care providers – including lactation consultants. Efforts made by those men and women is seen by some as interference in a mother’s right to choose how she raises her child and, hence, the online lactation bashing that has been popping up in recent weeks.

This is what economists would call a bad equilibrium – mothers don’t breastfeed so their daughters don’t breastfeed and so on down through the generations.

Both the World Health Organization and American Academy of Pediatricians recommend that women breastfeed exclusively until the their infants are six months old and then be breastfed along with other foods up through the remainder of the first year of life and beyond.

Women have known this for decades but the overwhelming majority does not follow this recommendation – despite the fact that most women can breastfeed if they have adequate support.

Just to give you an idea of how few follow this advice, consider a recent article that uses longitudinal data on the breastfeeding experience of 19,000 children in the UK.

The study finds that 36% of the children were never exclusively breastfed, only 16% were exclusively breastfed for between four and six months, and only 1% where exclusively breastfed beyond six months.

Twenty-five percent of babies are non-exclusively breastfed beyond the six months of age, but other foods are being introduced earlier than recommended.

I started off saying that breast is best for the national economy and support for that claim is also found in this same paper.

The data includes a measure of cognitive ability for each child – the Bracken Basic Concept Scale-Revised (BBCS-R) School Readiness Assessment. This test assessed a child’s knowledge of colors, letters, numbers/counting, sizes, and shape recognition at age three.

The authors find that cognitive ability at age three is associated with how long a child is breastfed, even after controlling for the mother’s IQ and the quality of the child’s home environment.  Specifically, they find that cognitive ability increases for every additional week a child is exclusively breastfed up until the age of about 28 weeks (approximately 6.5 months of age). They also find that cognitive ability increases with non-exclusive breastfeeding as well, although at a slower rate and peaking at a lower level when the child is between 45 and 50 weeks old.

So the optimal breastfeeding time for cognitive ability appears to be roughly consistent with the WHO and AAP recommendations for infant health.

Why this should matter for the national economy is probably obvious. The cognitive ability of the workforce determines how well a country is able to compete in the modern, knowledge based, economy. This evidence suggest that, holding everything else constant, a country that is able to move to a new equilibrium in which the over-whelming majority of children are breastfed should do better than one in which mothers lack the support and encouragement needed to successfully breastfeed.

Parents may no longer want the village’s help to raise their child, but there are good reasons why the village should make itself available for those who do – because everyone benefits when infants receive the best possible start to life.

Reference:

Doyle, Orla and Lori Timmins (2008). “Breast is Best, But for How Long?
Testing Breastfeeding Guidelines for Optimal Cognitive Ability” UCD Geary Institute Discussion Paper.