A Comprehensive Assessment of the Environmental Impact of Different Infant Feeding Types: The Observational Study GREEN MOTHER.

The study was cross-sectional at 1 month postpartum, so it describes one time point rather than following mothers and infants over time. Maternal diet, food waste and consumption habits were self-reported, which may underreport amounts or portion sizes because of social desirability. Excluding participants with language barriers may have omitted immigrant women who often breastfeed longer and have different diets. This limits generalisability. The study could not fully account for the increased dietary intake of breastfeeding mothers because pre-pregnancy diet was not measured, and maternal diet impact was not included in the total comparison. The environmental impact calculation did not include the effect of breastfeeding-related amenorrhea on menstrual product use. The study measured environmental impact, not infant or maternal health outcomes, and did not test an educational or counselling intervention. The paper reports 429 participants in its strengths, while Table 1 lists 411 participants by infant feeding type.

The authors declared no conflicts of interest. The study was funded by the Department of Health of the Generalitat de Catalunya.

Do not read the large carbon footprint difference as proof that breastfeeding improves infant health or that nurses can reduce emissions through counselling. This was an observational environmental impact study using self-reported data, not a clinical trial or behaviour-change study.