. . . until you’ve asked some important questions.
Last week, I saw a tweet about a new study linking long-term breastfeeding with more aggressive cancers. (“Long-term” is defined in the article as breastfeeding for six months or more . . . we call that “normal” breastfeeding . . . I would only call breastfeeding “long-term” if it extended beyond the natural age of weaning which is somewhere around 3-5 years. . . but I digress). The study was reported in Health Day on March 26th.
Immediately my head began to spin. Didn’t a recent study show that breastfeeding for more than 3 months by women with a family history of breast cancer, reduces their risk for breast cancer by 59%? That’s a significant reduction in risk. So I turned to an expert: I asked a friend of BfB, Dr. Miriam Labbok, at the Carolina Global Breastfeeding Institute, to weigh in on the Health Day news. I expressed to her my concern that new moms might be confused by this contradictory study. Today everyone is the media, and there is an enormous amount of information swirling around on the ‘net. What are moms and health professionals serving moms supposed to believe?
Here is her response, which Dr. Labbok sent to the Editors of Health Day:
Thank you for your excellent coverage of breastfeeding.
I am writing to you with a small cautionary: folks believe what they read, so I would encourage you to be a bit more critical in your reporting of research findings. (emphasis ours)
This concern arises from the recent coverage of Salma Butt’s study “Long-Term Breast-Feeding Tied to More Aggressive Cancers” (which, by the way, I could not find on PubMed to read critically), http://www.healthday.com/Article.asp?AID=637427 there is little comment on the fact that she reports on a subgroup representing about 3.6% of the entire sample. Without reading the study, one must wonder why this small percent who fed their children so differently than their fellow Swedes, chose to do so. When dealing with a tiny subgroup such at this, it is vital to explore this question. We often see odd findings in outliers in such studies. For example, are these folks with family histories of breast cancer? Are they eating a different diet or living in a different area from the vast majority? Are they an ethnic subgrouping? And, as the researchers note, it could be that women who breastfeed long have such aggressive cancers (rather than having more and other cancers) but may do better with them.
Without the answers to these questions, such findings are only useful as an idea for further exploration, but should not be presented to the public in such a manner to be potentially misunderstood and misleading.
Thank you for all you do to help keep the public informed!!
Miriam Labbok, MD, MPH, FACPM, IBCLC, FABM; Professor of the Practice of Public Health and Director, Carolina Global Breastfeeding Institute
*Note, Dr. Labbok is an MD, people! Plus she has a masters in public health, is an international board certified lactation counselor, a fellow of the Academy of Breastfeeding Medicine (a physician only designation) and I don’t even know what the heck a FACPM is. Leave me a comment if you know.
Since Dr. Labbok’s letter, the original study has been picked up by various tweeters and bloggers, and most distressingly, by BabyCenter.com, a huge parenting website that has millions of subscribers. Yet I have not seen the article be picked up by any major media outlets, nor has it been endorsed or posted by any major medical institutions such as the Academy of Obstetrics or Gynecologists. I have not done an exhaustive review, so if I missed something, please let me know! I am not saying the study is not valid. I am pointing out that Health Day did noticeably did not link to the original study, so I am now suspicious of everything they post.
Breastfeeding is a hot topic in the news, guaranteed to drive up page views and unique visitors. Best for Babes is very concerned about any news outlets that are exploiting breastfeeding’s celebrity status and putting out information to the public before the study can be cross-examined by leading media peers and reviewed and digested by the scientific community. There are tons of moms who are passionate about breastfeeding (or not breastfeeding) that are following Google Alerts for breastfeeding and breast milk and then automatically publicizing what they find, without knowing if the information is valid. Unfortunately, once information has been put out to the public, the damage is done. No amount of letters to the editor, or even the rare retraction, will have the visibility and shock value that drove views of the original study. And getting a highly visible correction by the scientific breastfeeding community takes money for a public relations firm, which none of the breastfeeding non-profits have. Most of them operate on a shoestring budget!
So please think twice before you tweet or blog about something you read:
1) We suggest you wait and see if any of the respected news outlets like the Associated Press (AP), CNN or CBS reports on it (sorry, but I lost my faith in ABC News after their biased coverage of the latest, peer reviewed and respected-media reported study).
2) If you see a study that is gaining traction on the internet (and that has not been reported as in #1 above) you can tweet me a link (follow me at www.twitter.com/BestforBabes) or email me at email@example.com, and we will find out the scoop from our friends at the Academy of Breastfeeding Medicine (ABM). Please read the ABM’s excellent response to a similarly misleading study in January (and dig that they mentioned the “Booby Traps”!!).
3) Help us educate the public and insist on responsible reporting by the media–spreading myths and misinformation is a “Booby Trap”!– consider a donation to Best for Babes to support our work!
Update: Alison Stuebe, MD, one of the authors of the study I mentioned above showing a lower risk of breast cancer for women who breastfeed and have a family history of the disease, expounded on my post with an excellent explanation of why the Health Day report is so confusing. Please read it and consider subscribing to the Acad. of Breastfeeding Medicine Blog. We need to get more information out of the heads of scientists and into the hands of moms!