If you want to breastfeed get a midwife?

I’m still scanning through my pile of “read this as soon as I get a chance” materials and found a study that looked for associations between breastfeeding intent and provider type.  This is an example of a study that makes me say “yeah, but…”

What’s my concern?

The study looked for associations between provider type and intention to breastfeed.  Associations let us see relationships that exist, but don’t explain those relationships.  So the fact that the study found women who were receiving care from midwives were more likely to intend to breastfeed may mean midwives do a good job of encouraging women to breastfeed.  Or it may mean women who intend to breastfeed are more likely to seek care from a midwife. Or it may mean women in communities with easier access to midwives are more likely to have community support for breastfeeding which increases the likelihood they will intend to breastfeed.

It gets complicated.

So my advice, remember to proceed with caution when you interpret the results of a study.  Studies like this, that use one time point to find associations, give you no temporal information to determine which factor influenced the other. Just remind yourself that correlation (or association) is not causation.