Lactation Cookies

A yummy way to help boost your milk supply...

Ingredients

1 C butter
1 C sugar
1 C brown sugar
4 T water
2 T flaxseed meal (no subs)
2 Lg eggs
1 t vanilla
2 C flour
1 t baking soda
1 t salt
3 C Thick cut oats
1 C Chocolate chips
2 T to 4T Brewers Yeast (no substitutions)

Preparation

Preheat oven at 375.

Mix 2 T of flaxseed meal and water, set aside 3-5 minutes.
Cream butter and sugar.
Add eggs or vegan substitutes.
Stir flaxseed mix into butter mix and add vanilla.
Beat until well blended.
Sift: dry ingredients, except oats and choc chips.
Add butter mix to dry ingredients.
Stir in the oats and then the choc chips.
Drop on parchment paper on baking sheet.
Bake 8-12 minutes

Antidepressants May Complicate Breast-Feeding

Antidepressant May Complicate Breast-Feeding

Babies who are Breastfed as Infants Make Better Teens

After conducting an extensive study, which has managed to reveal that there is a link between breastfeeding and a child's mental health, researchers are now urging mothers to breastfeed their new-born, at least till the age of 6 months.

The large-scale study followed about 3,000 women for a long period of 14 years, across Western Australia. The researchers tracked the development of children of these women from the time they were infants to when they hit early adolescence.

Out of all women participating in the study, some had breastfed for varying lengths of time, and some had not done so at all. Analysis of the data thus collected helped researchers reach the hypothesis of the study.

"What we found was that for each additional month that a child was breastfed [the] behavior in teenagers improved. We can say clearly that breastfeeding for six months or longer is positively associated with mental health and wellbeing in children and adolescents", said Sven Silburn from the Menzies School of Health Research, one of the researchers.

Details of the study have been study published in the Journal of Paediatrics.

Birth Drugs Impair Breastfeeding

Sunday, January 24, 2010 by: David Gutierrez

(NaturalNews) Drugs commonly given during hospital labor may impair a woman's ability to breastfeed, according to a study conducted by researchers from Swansea University and published in the journal BJOG.

"A lot of women are not given enough information about the medications that might be given to them during childbirth, and women at low risk of bleeding may not need to take these drugs," said Rosemary Dodds of the National (British) Childbirth Trust, who was not involved in the study. "It is important that women understand the risks and can give their informed consent before they go into labor."

Researchers examined data from 45,000 births in South Wales, finding that women who were given either oxytocin (also marketed as pitocin and syntocinon) or ergometrine (also known as ergonovine) were significantly less likely to begin breastfeeding within 48 hours of birth than women who were not given the drugs.

Oxytocin and ergometrine are regularly given to women in order to reduce their risk of postpartum hemorrhaging, even when the risk is already low. Oxytocin is also used in labor in order to stimulate contractions, but this use was not examined in the current study.

Among women who had not been given either drug following the delivery of their child, 65.5 percent began breastfeeding within 48 hours. Among women who had received oxytocin, only 59.1 percent did so, while only 54.6 percent of women who received both drugs began breastfeeding within 2 days.

The researchers suggested that the anti-bleeding drugs could interfere with milk production, thus making breastfeeding more difficult and causing new mothers to give up in frustration.

The study also found that high doses of painkillers known as epidurals also reduce a woman's chance of breastfeeding. Prior studies have also found this connection.

Breastfeeding has been linked to a number of significant lifelong health benefits for both mothers and infants.

Sources for this story include: news.bbc.co.uk.

Breastfeeding is Budget Friendly

Breastfeeding is Budget Friendly

Seems like a no brainer Ü

Breastfeeding lowers diabetes risk in new moms

A new study finds breastfeeding can lower the mother's risk of developing metabolic syndrome in the long run.

According to the study published in Diabetes, breastfeeding reduces the risk of metabolic syndrome — a cluster of risk factors such as elevated blood pressure, insulin resistance, and abdominal obesity linked to diabetes and heart disease — in the new mother.

Women who breastfeed tend to adopt a healthier lifestyle than new mothers who do not breastfeed and therefore lose the weight gained during pregnancy faster.

Breastfeeding for longer than nine months lowers the risk of developing metabolic syndrome by 56 percent. Each year of breastfeeding is associated with a 15 percent reduction in diabetes risk within the next 15 years.

As for women who have developed gestational diabetes during one or more pregnancies, lactation is believed to lower the risk of metabolic syndrome by 86 percent.

Scientists concluded that nursing for as little as a month or two is effective, adding that the longer a woman breastfeeds the higher the protection level will become.

Lengthy pacifier use can lead to speech problems

Another great reason to breastfeed!
___________________________________________________________

Questions on whether a baby should be given a pacifier or allowed to thumb-suck have existed for generations. The concerns center on whether sucking habits will impact tooth alignment and speech development. The latest evidence, published today, suggests that long-term pacifier use, thumb-sucking and even early bottle use increases the risk of speech disorders in children.

The study looked at the association between sucking behaviors and speech disorders in 128 children, ages three to five, in Chile. Delaying bottle use until at least 9 months old reduced the risk of developing a speech disorder, researchers found. But children who sucked their thumb, fingers or used a pacifier for more than three years were three times as likely to develop speech impediments. Breastfeeding did not have a detrimental effect on speech development.

The authors of the study noted that other research suggests that use of a pacifier or thumb-sucking for less than three years also increases the risk of a speech problem. The sucking motion may change the normal shape of the dental arch and bite. Breastfeeding, however, seems to promote positive oral development.

"The development of coordinated breathing, chewing, swallowing and speech articulation has been shown to be associated with breastfeeding. It is believed that breastfeeding promotes mobility, strength and posture of the speech organs," the authors wrote.

The study is published in the open access journal BMC Pediatrics.

- Shari Roan

Reducing Infant Mortality

This is an awesome video on reducing infant mortality here in the states. Take the time and watch it - it is under 17 minutes long.

Reducing Infant Mortality from Debby Takikawa on Vimeo.

Breastfeeding Protects Tiny Intestines

(Ivanhoe Newswire) – An ingredient found in breast milk produced in the first few days after birth helps protect tiny intestines and get them ready for a lifetime of eating and drinking.

British researchers discovered the effect of pancreatic secretory trypsin inhibitor – or PSTI – by first testing breast milk samples for the ingredient and then assessing its ability to affect intestinal cells in the lab.

While PSTI continued to be found in breast milk throughout breastfeeding, it was seven times more concentrated in the early milk, known as colostrum. When intestinal cells were damaged in the lab, PSTI helped to form a protective layer over the damaged area and, what’s more, prevented further damage from occurring.

PSTI has been known for its role in the pancreas for years, where it helps protect the organ from digestive enzymes.

“This study is important because it shows that a component of breast milk protects and repairs the babies’ delicate intestines in readiness for the onslaught of all the food and drink that are to come,” study author Ray Playford, from the University of London, was quoted as saying. “It reinforces the benefits of breastfeeding, especially in the first few days after birth.”

SOURCE: American Journal of Physiology. Gastrointestinal and Liver Physiology, published online June 29, 2009

Vitamin K at Birth: To Inject or Not

By Linda Folden Palmer, DC

Newborn infants routinely receive a vitamin K shot after birth in order to prevent (or slow) a rare problem of bleeding into the brain weeks after birth. Vitamin K promotes blood clotting. The fetus has low levels of vitamin K as well as other factors needed in clotting. The body maintains these levels very precisely.1 Supplementation of vitamin K to the pregnant mother does not change the K status of the fetus, confirming the importance of its specific levels.

Toward the end of gestation, the fetus begins developing some of the other clotting factors, developing two key factors just before term birth.2 It has recently been shown that this tight regulation of vitamin K levels helps control the rate of rapid cell division during fetal development. Apparently, high levels of vitamin K can allow cell division to get out of hand, leading to cancer.

What's the Concern?

The problem of bleeding into the brain occurs mainly from three to seven weeks after birth in just over five out of 100,000 births (without vitamin K injections); 90 percent of those cases are breastfed infants3 because formulas are supplemented with unnaturally high levels of vitamin K. Forty percent of these infants suffer permanent brain damage or death.

The cause of this bleeding trauma is generally liver disease that has not been detected until the bleeding occurs. Several liver problems can reduce the liver's ability to make blood-clotting factors out of vitamin K; therefore extra K helps this situation. Infants exposed to drugs or alcohol through any means are especially at risk, and those from mothers on anti-epileptic medications are at very high risk and need special attention.

Such complications reduce the effectiveness of vitamin K, and in these cases, a higher level of available K could prevent the tragic intracranial bleeding. This rare bleeding disorder has been found to be highly preventable by a large-dose injection of vitamin K at birth.

The downside of this practice however is a possibly 80 percent increased risk of developing childhood leukemia. While a few studies have refuted this suggestion, several tightly controlled studies have shown this correlation to be most likely.4,5 The most current analysis of six different studies suggests it is a 10 percent or 20 percent increased risk. This is still a significant number of avoidable cancers.6

Apparently the cell division that continues to be quite rapid after birth continues to depend on precise amounts of vitamin K to proceed at the proper rate. Introduction of levels that are 20,000 times the newborn level, the amount usually injected, can have devastating consequences.

The Newborn's Diet

Nursing raises the infant's vitamin K levels very gradually after birth so that no disregulation occurs that would encourage leukemia development. Additionally, the clotting system of the healthy newborn is well planned, and healthy breastfed infants do not suffer bleeding complications, even without any supplementation.7

While breastfed infants demonstrate lower blood levels of vitamin K than the "recommended" amount, they show no signs of vitamin K deficiency (leading one to wonder where the "recommended" level for infants came from). But with vitamin K injections at birth, harmful consequences of some rare disorders can be averted.

Infant formulas are supplemented with high levels of vitamin K, generally sufficient to prevent intracranial bleeding in the case of a liver disorder and in some other rare bleeding disorders. Although formula feeding is seen to increase overall childhood cancer rates by 80 percent, this is likely not related to the added vitamin K.

The Numbers

Extracting data from available literature reveals that there are 1.5 extra cases of leukemia per 100,000 children due to vitamin K injections, and 1.8 more permanent injuries or deaths per 100,000 due to brain bleeding without injections. Adding the risk of infection or damage from the injections, including a local skin disease called "scleroderma" that is seen rarely with K injections,8 and even adding the possibility of healthy survival from leukemia, the scales remain tipped toward breastfed infants receiving a prophylactic vitamin K supplementation. However, there are better options than the .5- or 1-milligram injections typically given to newborns.

A Better Solution

The breastfed infant can be supplemented with several low oral doses of liquid vitamin K1 (possibly 200 micrograms per week for five weeks, totaling 1 milligram, even more gradual introduction may be better). Alternatively, the nursing mother can take vitamin K supplements daily or twice weekly for 10 weeks. (Supplementation of the pregnant mother does not alter fetal levels but supplementation of the nursing mother does increase breastmilk and infant levels.)

Either of these provides a much safer rate of vitamin K supplementation. Maternal supplementation of 2.5 mg per day, recommended by one author, provides a higher level of vitamin K through breastmilk than does formula,10 and may be much more than necessary.

Formula provides 10 times the U.S. recommended daily allowance, and this RDA is about two times the level in unsupplemented human milk. One milligram per day for 10 weeks for mother provides a cumulative extra 1 milligram to her infant over the important period and seems reasonable. Neither mother nor infant require supplementation if the infant is injected at birth.11

The Bottom Line

There is no overwhelming reason to discontinue this routine prophylactic injection for breastfed infants. Providing information about alternatives to allow informed parents to refuse would be reasonable. These parents may then decide to provide some gradual supplementation, or, for an entirely healthy term infant, they may simply provide diligent watchfulness for any signs of jaundice (yellowing of eyes or skin) or easy bleeding.

There appears to be no harm in supplementing this vitamin in a gradual manner however. Currently, injections are provided to infants intended for formula feeding as well, although there appears to be no need as formula provides good gradual supplementation. Discontinuing routine injections for this group alone could reduce cases of leukemia.

One more curious look at childhood leukemia is the finding that when any nation lowers its rate of infant deaths, their rate of childhood leukemia increases.12 Vitamin K injections may be responsible for some part of this number, but other factors are surely involved, about which we can only speculate.

Dr. Linda Folden Palmer consults and lectures on natural infant health, optimal child nutrition and attachment parenting. After running a successful chiropractic practice focused on nutrition and women's health for more than a decade, Linda's life became transformed eight years ago by the birth of her son. Her research into his particular health challenges led her to write Baby Matters: What Your Doctor May Not Tell You About Caring for Your Baby. Extensively documented, this healthy parenting book presents the scientific evidence behind attachment parenting practices, supporting baby's immune system, preventing colic and sparing drug usage. You can visit Linda's Web site at www.babyreference.com.

Breastfeeding linked to reduced risk of SIDS

Reuters

NEW YORK (Reuters Health) - Women who breastfeed evidently lower the chances that their baby might die of sudden infant death syndrome or SIDS, according to a German study.

Dr. M. M. Vennemann, from the University of Munster, and colleagues therefore recommend that public health messages aimed at SIDS risk-reduction should encourage women to breastfeed their infant through 6 months of age.

At present, some countries include breastfeeding recommendations in their SIDS prevention campaigns, while others do not, the investigator point out in their report in the medical journal Pediatrics. The goal of the current study was to confirm that breastfeeding is, in fact, tied to a reduced risk of SIDS.

The study included 333 infants who died of SIDS and 998 age-matched "control" infants.

At 2 weeks of age, 83 percent of controls were being breastfed compared to only 50 percent of SIDS infants. At 1 month of age, corresponding rates were 72 percent versus 40 percent

Exclusive breastfeeding at 1 month cut the risk of SIDS in half. Partial breastfeeding at this point was also tied to a reduced risk, although that could have been a chance finding.

These results add "to the body of evidence showing that breastfeeding reduces the risk of SIDS, and that this protection continues as long as the infant is breastfed," the investigators conclude.

SOURCE: Pediatrics, March 2009.

Pain Medications Used in Childbirth: Effects on Mother, Baby, Breastfeeding and Bonding

June 11, 2009 by

Denise Hibben

The medications most commonly used in hospital labor and delivery wards in the US are: Demerol (meperidine), Morphine, Stadol (butorphanol), Fentanyl, Nubain(nalbuphine). It should be noted that Demerol and Morphine are not commonly used as much as Stadol, Fentanyl, and Nubain. The anesthetics that are more common in epidurals are Lidocaine (xylocaine), and Bupivicaine (marcaine, marcain).

The benefits are obvious to the relief of pain in childbirth... relief of pain. If a mother has been in labor for a very long time and is exhausted, an epidural can make the difference between a vaginal birth and a cesarean section, by allowing her some relief so she can sleep and gain new strength. Pain relief can relax a laboring mother enough that her contractions become more effective and allow her labor to progress more efficiently. In the rare case of soft tissue dystocia that is purely physiological, pain medications may resolve it, as long as there are no emotional factors to consider.

Let us go over some of the general adverse effects of using pain relief and epidurals during labor and birth. Keep in mind that these are the adverse effects that are general among all of the more commonly used medications. Both mother and baby can experience these: sleepiness, sedation, dizziness, constipation, sleep problems, insomnia, nausea, vomiting, stomach pain, diarrhea, loss of appetite, memory problems, sweaty, clammy skin, headache, breastfeeding difficulties, bonding difficulties, and withdrawal symptoms.

These are the less serious side effects of the pain medications commonly used.

Some of the more serious adverse effects include: increased need to resuscitate newborns at birth, breathing difficulties in mother and newborn, very rapid heartbeat, very slow heartbeat, confusion, seizures, hallucinations, severe allergic reactions, numbing of face and extremities. These adverse effects are seen in both the mother and the baby.

It is known that these pain medications cross the placenta and affect the baby before birth. Most women who birth in the hospital will be offered these medications sometime during their labor, unless you have specifically requested that these not be offered. Some studies show that 90% of
healthy, low-risk women who birth in hospitals will have narcotic pain medications and/or an epidural during labor. This means that 90% of healthy infants born in hospitals are born drugged! Clearly information has not been shared with these mothers of the side effects of these medications.

Babies who are exposed to narcotics have stress put on their kidneys and livers as they try to metabolize the drugs. This can cause problems as well, considering that their livers and kidneys are still immature.


Physiological effects of Epidurals in labor

Epidurals are used to numb the nerves from the waist down during childbirth. An anesthetic/narcotic combination is injected into the dural space of the spinal column via catheter, which is in place throughout labor and delivery. Granted it can be an extreme relief during the pain of labor, but it is known to increase the length of labor and the second (pushing) stage, the need for forceps or vacuum assisted birth, episiotomy, and c-section. Those have an entire range of risks in and of themselves. It is also known to cause maternal fever and low blood pressure.
Because a woman is numbed by the epidural, she is not able to get up and move around during labor. This can cause labor to last longer and she may not be able to push as effectively because she cannot feel where to push.

Pain Medications and Breastfeeding

It is known that all of the narcotic medications used in labor and birth are exuded in Breastmilk. This means not only is the newborn baby getting an adult dose during labor, but also with the first feeding. Hence the sleepy baby that is more commonly seen in hospitals. Babies born without narcotics have a better latch during breastfeeding, are more alert and responsive during the first hours after birth, have less feeding problems and crying spells in the first 8 weeks of life, and are in general healthier, happier, and more content. American Academy of Pediatrics has taken the position that it is safe to breastfeed after receiving narcotics during labor, although they have stated that if a mother is prescribed these medications after birth, while still breastfeeding, it is recommended that the risks to the baby and the benefits to the mother should be weighed before taking these medications.

Some medications are known to actually hinder successful breastfeeding; in fact the drug Fentanyl is one of these.

Pain Medications and Bonding

To put it simply, it is hard to bond with someone who is so drugged that they can't respond in a normal fashion to us. This is not to say that women who use pain medications in labor love their babies less, it is just harder to get to know them.

Babies who are exposed to pain medications during labor and birth actually spend more time away from their mothers in the first hours of life than their non-drugged counterparts. This is due to the aforementioned adverse effects caused by narcotics.

This article is not meant to be a scare tactic. It is simply meant to educate, and hopefully encourage research by pregnant women as to the medications used to relieve pain during labor and birth.

Sources
Drugs in Pregnancy and Lactation, 5th Ed
Maternal-Newborn Nursing, 7th Ed.
Medications and Mothers Milk, 12th Ed.
Varney's Midwifery, 4th Ed
www.rxlist.com
www.drugs.com
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T8N-4G0M55R-3S&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=45b0c0e06fd406bfc694e8d4aa80a0db
http://www.redorbit.com/news/health/182842/fentanyl_during_labor_may_impede_breastfeeding/
http://www.medicalnewstoday.com/articles/58772.php

Study Suggests Breastfeeding Lowers Chance of MS Relapse

According to a new report issued by U.S. researchers, breastfeeding may help women with multiple sclerosis avoid relapses.

The researchers discovered that MS patients who nursed babies for two months, and did not use bottled formula, were less likely to relapse within a year of their child’s birth, than women who were not breastfeeding their children.

"It is well-known that women with MS have fewer relapses during pregnancy and a high risk of relapse in the postpartum period," said the researchers.

The report appears in the Archives of Neurology.

The women were also advised to not take their MS medication during pregnancy or while breastfeeding. The women could choose between nursing or using formula if they wished to restart their treatment immediately after giving birth.

It is recommended by the American Academy of Pediatrics that women breastfeed exclusively for the first six months of a baby's life and for nursing to continue for at least a year.

Dr. Annette Langer-Gould, of Kaiser Permanente Southern California in Pasadena, and her team studied 32 pregnant women with MS and 29 pregnant women without MS.

Almost 96 percent of the healthy women nursed their children, while 69 percent of the MS patients nursed.

The researchers found that 87 percent of the women with MS who did not nurse, or used formula within the first two months, had a relapse, while only 36 percent of those who breastfed for at least two months relapsed.

The women who nursed exclusively delayed normal menstruation, and did not see MS symptoms return.

"Studies of immunity and breastfeeding, while plentiful, are predominantly focused on breast milk content and health benefits to the infant. Little is known about maternal immunity during breastfeeding," the researchers noted.

Multiple sclerosis occurs when the immune system attacks the sheath protecting nerve cells.

The disease affects 2.5 million people worldwide, causing mild illness in some, and permanent disabilities in others.

Study Links Breastfeeding to Better Academic Performance

Newswise — Breastfeeding leads to better academic achievement in high school and an increased likelihood of attending college, according to a new study by American University professor Joseph Sabia and University of Colorado Denver professor Daniel Rees.

The study, published June 11 in the Journal of Human Capital, looked at the academic achievement of siblings—one of whom was breastfed as an infant and one of whom was not—and discovered that an additional month of breastfeeding was associated with an increase in high school GPA of 0.019 points and an increase in the probability of college attendance of 0.014.

According to the study, which used data from the National Longitudinal Study of Adolescent Health, more than one half of the estimated effect of being breastfed on high school grades and approximately one-fifth of the estimated effect on college attendance can be linked to improvements in cognitive ability and health.

“The results of our study suggest that the cognitive and health benefits of breastfeeding may lead to important long-run educational benefits for children,” said Sabia, a professor of public policy in AU’s School of Public Affairs whose research focuses on health economics. “But this is just a start. Much work remains to be done to establish a definitive causal link.”

Professors Sabia and Rees examined the breastfeeding histories and high school grades of 126 siblings from 59 families. Information on high school completion and college attendance data was obtained from 191 siblings belonging to 90 families.

By comparing the academic achievement of siblings, this study was able to account for the influence of a variety of difficult-to-measure factors such as maternal intelligence and the quality of the home environment. This is the first study to use sibling data in order to examine the effect of breastfeeding on high school completion and college attendance.

“By focusing on differences between siblings, we can rule out the possibility that family-level factors such as socioeconomic status are driving the relationship between having been breastfed and educational attainment,” said Rees, an economics professor.

Hand Expression of Breastmilk

Check out this link for an awesome tutorial on hand expression of breastmilk. Hand expression is such a useful tool for breastfeeding mothers.

Breastfeeding Halves SIDS Risk

(NaturalNews) Babies who are breastfed for at least six months are significantly less likely to die from sudden infant death syndrome (SIDS) than those who are formula fed, according to a study conducted by researchers from the German Study of Sudden Infant Death Study Group and the University of Munster, Germany, and published in the journal Pediatrics.

The study adds "to the body of evidence showing that breastfeeding reduces the risk of SIDS, and that this protection continues as long as the infant is breastfed," the researchers wrote.

The researchers compared breastfeeding rates among 333 infants who died of SIDS and 998 children of similar age who did not die. They found that while 83 percent of surviving infants were being breastfed at two weeks of age, only 50 percent of those who died of SIDS were. The rate of breastfeeding at one month was 72 percent among surviving children and only 40 percent among those who died of SIDS. This corresponded to a 50 percent lower risk of SIDS among children who were exclusively breastfed at the age of one month.

"In the last 20 years, the prevention campaigns to reduce the risk of sudden infant death syndrome were very successful," the researchers wrote. "In some countries the advice to breastfeed is included in the campaigns' messages, but in other countries it is not."

Women should be encouraged to breastfeed exclusively until their children are at least six months old, the researchers said.

"In our study, 73 percent of the infants died before six months of age," they wrote. "The implication of our findings is that breastfeeding should be continued until the infant is six months of age and the risk of SIDS is low. Because breastfeeding rates are low in the socially deprived sections of our population, there should be special programs to encourage mothers of low socioeconomic status to breastfeed their infants not only for the established benefits of breastfeeding for the mother and infant but also to reduce the risk of SIDS in their infants."

Sources for this story include: www.reuters.com; www.medscape.com.

Breast Is Best: New WHI Data Extend CV Benefits of Breast-Feeding to Mom

April 24, 2009 — Women who breast-fed for a year or more were less likely to develop hypertension, diabetes, hyperlipidemia, and cardiovascular disease when postmenopausal than women who were pregnant but never breast-fed, a new analysis of the Women's Health Initiative (WHI) has found [1]. Dr Eleanor Bimla Schwarz (University of Pittsburgh Center for Research on Healthcare, PA) and colleagues report their findings in the May 2009 issue of Obstetrics & Gynecology.

"We were able to show that benefits were visible in anyone with six or more months' lifetime duration of breast-feeding," Schwarz told heartwire , with those who reported a lifetime history of more than 12 months' lactation being 10% to 15% less likely to have hypertension, diabetes, hyperlipidemia, and cardiovascular death (CVD) than those who never breast-fed.

She says the findings--from a large data set and one of the first studies to report an effect on vascular events--build on a growing body of literature that demonstrates lactation has beneficial cardiovascular effects, as well as reducing the risk of breast and ovarian cancer. "We've known for years that breast-feeding is important for babies' health; we now know that it is important for mothers' health as well," she notes.

It is imperative that healthcare providers and our society support and educate women concerning the maternal benefits of prolonged breastfeeding.

In an accompanying editorial [2], ob-gyn Dr Edward R Newton (East Carolina University, Greenville, NC) says: "The findings are dramatic and persuasive." Although he notes some possible limitations of this study, he says, "A strong benefit of prolonged breast-feeding is still observed. It is imperative that healthcare providers and our society support and educate women concerning the maternal benefits of prolonged breast-feeding as well as the well-documented benefits of breast-feeding for the child."

Cardiologist Dr C Noel Bairey Merz (Cedars Sinai Healthcare Center, Los Angeles, CA) told heartwire this is "very nice work, controlled for a number of confounders such as education."

The Risks of Not Breast-Feeding

The study examined 139,681 women enrolled in both observational and clinical-trial cohorts of WHI who had had at least one live birth. The dose-response relationship between the cumulative months women lactated and postmenopausal risk factors for CVD were examined; the average age of the women was 63 years. Lifetime duration of breast-feeding was based on patient recollection, and Schwarz admitted this could have been subject to recall bias, a point that Newton also makes in his editorial.

In fully adjusted models, those who reported a lifetime history of more than 12 months of lactation were less likely to have hypertension (odds ratio 0.88; p<0.001), p="0.008)">

And women who breast-fed for seven to 12 months were also significantly less likely to develop CVD (hazard ratio 0.72) than those who never breast-fed.

Schwarz said: "We saw significant trends; the longer someone had breast-fed, the better." In his editorial, Newton says that prior analyses from the Nurses' Health Study show that women who breast-fed for a lifetime total of two years or more significantly reduced a major predictor for CVD--insulin-resistant diabetes--by 14% to 15% and had a 23% lower risk of incident MI [myocardial infarction].

We can talk about the benefits of breast-feeding but perhaps it is better framed as the risks of not breast-feeding.

Schwarz stressed an important point to heartwire . "It's not that you are better off if you have a baby and breast-feed than someone who's never been pregnant, it's that you are better off than someone who becomes pregnant and does not breast-feed. A woman who becomes pregnant and does not breast-feed is actually putting herself at risk. So we can talk about the benefits of breast-feeding but perhaps it is better framed as the risks of not breast-feeding."

Bairey Merz agrees. "We assume the pathway is that breast-feeding protects, but the association could go in the opposite direction--eg, inability to breast-feed may be a marker of early vascular dysfunction," she suggests.

"Women put themselves at risk by becoming pregnant and not fulfilling the cycle that nature has intended," Schwarz says. "In my mind, the cycle really ends with breast-feeding. During pregnancy, the body stores up a bunch of nutrients with the plan that it's going to release much of this in the form of breast milk, a very calorific food. If this doesn't happen, what we see is that the woman's body pays the price. Breast-feeding really helps bring you back to your baseline, and it helps women recover from the stress test that pregnancy entails."

Study of Physiology During Lactation May Help Tackle CVD in Women

In their discussion, Schwarz et al say their finding that women who breast-fed had lower rates of CVD even after adjustment for body mass index (BMI) "indicates that lactation does more than simply reduce a woman's fat stores. Hormonal effects, such as those of oxytocin, may have significant effects on cardiovascular profiles," they note.

Newton says: "The physiologic reasons for these important observations are largely speculative," but "the antistress, probonding effects of oxytocin and intense skin-to-skin contact found with prolonged breast-feeding certainly contribute to the protective effects," he notes.

Although Bairey Merz acknowledges the findings were adjusted for BMI, she says it is well known from many studies "that women who breast-feed lose the pregnancy weight gain better than those that do not--and this likely contributes to their lower CVD risk. What we do not know is whether breast-feeding preferentially impacts the visceral fat deposits, which would be of specific benefit and should be the focus of research."

"A more intense and focused study of maternal physiology during lactation may give us critical information to limit the scourge of CVD in women," Newton concludes.

References

1. Schwarz EB, Ray RM, Stuebe AM, et al. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol 2009; 113: 974-982. Abstract
2. Newton ER. Whatsoever a [woman] soweth, that shall [she] also reap. Obstet Gynecol 2009; 113:972-973. Abstract

Clinical Context

CVD is the leading cause of death for women in developed counties. Recent studies have suggested that lactation increases a mother's metabolic expenditure and improves glucose tolerance and lipid metabolism and may be of long-term benefit in reducing CVD risk. However, whether these benefits persist beyond menopause is uncertain.

This is a study within the WHI cohort to examine the association between lactation, duration of lactation, and the risk for postmenopausal CVD and its components.

Study Highlights

• The WHI involved 161,808 healthy postmenopausal women aged 50 to 79 years and data collection included lactation history, parity, any hospitalizations, and CVD.
• Confirmation of outcomes was by medical records review, death certificates, and description of events.
• Lactation history was assessed at baseline when women with at least 1 live birth were asked about lactation including total months (none, 1 - 6, 7 - 12, 13 - 23, and ≥ 24) and age at last lactation.
• 5 CVD factors were considered at baseline: obesity, hypertension, diabetes, hyperlipidemia, and a history of CVD before enrolment in the WHI.
• Dietary information was assessed with use of a 120-item food frequency questionnaire.
• Excluded were nulliparous women and those with incomplete data.
• This study included 139,681 women with at least 1 live birth.
• 58% reported some history of lactation, and only 6% had a cumulative history of lactation greater than 24 months, with few reporting more than 12 months of lactation per live birth.
• On average, 35 years had passed since last lactation.
• 30% of women were obese, and parous women were more likely than nulliparous women to be obese or hypertensive, but parous women who lactated were less likely than those who had not lactated to be obese or to have hypertension.
• Increasing duration of lactation was associated with lower prevalence of obesity and with a reduced risk for CVD risk factors including hypertension, diabetes, and hyperlipidemia even after adjustment for many variables.
• Women with a lifetime history of more than 12 months of lactation were less likely to have hypertension (OR, 0.88; P < .001), diabetes (OR, 0.80; P < .001), hyperlipidemia (OR, 0.81; P < .001), and CVD (OR, 0.91; P = .008).
• Women with a lifetime cumulative duration of lactation of 13 months or more were less likely to go on to have CVD before enrolling in the WHI (OR, 0.91; P = .008).
• Among parous women who did not breast-feed vs those who breast-fed for more than 12 months, 42.1% vs 38.6% would have hypertension, 5.3% vs 4.3% would have diabetes, 14.8% vs 12.3% would have hyperlipidemia, and 9.9% vs 9.1% would have CVD.
• When incident CVD during 7.9 years of follow-up was examined, the duration of lactation was associated with a decrease in incident CVD in univariable, but not adjusted, models.
• Women with at least 1 live birth who breast-fed for 7 to 12 months were significantly less likely to go on to have CVD (hazard ratio, 0.72) vs women who had never breast-fed.
• The number needed to treat to prevent 1 case of hypertension was 29; for hyperlipidemia, 40; for diabetes, 100; and for CVD, 125.
• In parous women with more than 1 live birth, duration of lactation of 24 months or more was associated with a reduced risk for CVD (hazard ratio, 0.58 for ≥ 24 months for 2 live births and hazard ratio, 0.78 for 3 live births).
• The authors concluded that women who breast-fed their children were less likely to have CVD risk factors when postmenopausal.
• They noted that cumulative lifetime lactation of greater than 12 months was associated with a 10% lower likelihood of CVD vs parous women who had never breast-fed.
• They recommended that breast-feeding in the first year of life be endorsed for both infant and maternal benefits.

Clinical Implications

• Lactation is associated with a reduced risk for postmenopausal hypertension, diabetes, hyperlipidemia, and CVD.
• Lifetime lactation duration of 13 or more months vs no lactation in parous women is associated with a 10% reduced risk for CVD.

Women who breastfeed ‘less likely to suffer heart attacks’

Women who breastfeed their babies could protect themselves against heart attacks and stroke, research out today suggests.

Data carried out on 139,681 women found those who breastfed were less likely to suffer heart attacks, stroke or heart disease in later life.

Women who had breastfed their babies for more than a year were 10% less likely to develop the conditions than women who had never breastfed.

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But even breastfeeding for at least a month could help cut the chances of women developing diabetes, high blood pressure and high cholesterol, which are all linked to heart disease.

The study, from experts at the University of Pittsburgh in the US, was carried out on women who had passed through the menopause. They were all asked about their earlier breastfeeding history.

On average, 35 years had passed since the women had last breastfed, suggesting the benefits of breastfeeding last many years.

One of the authors of the study, Dr Eleanor Bimla Schwarz, said: "Heart disease is the leading cause of death for women, so it's vitally important for us to know what we can do to protect ourselves.

"We have known for years that breastfeeding is important for babies' health; we now know that it is important for mothers' health as well.

"The longer a mother nurses her baby, the better for both of them.

"Our study provides another good reason for workplace policies to encourage women to breastfeed their infants."

The research was published in the journal Obstetrics and Gynaecology.

The research showed that women who had breastfed for more than a year in total were 12% less likely to have high blood pressure, around 20% less likely to have diabetes and high cholesterol, and 10% less likely to have heart disease than women who never breastfed.

The authors said: "These findings build on a growing body of literature that demonstrates that lactation has beneficial effects on blood pressure, risk of developing diabetes, and lipid metabolism."

Other studies have shown breastfeeding helps protect mothers against ovarian and breast cancer, and osteoporosis in later life. NHS experts say breastfeeding gives babies all the nutrients they need for the first six months of life.

It has also been shown to help protect infants against infections of the ear, stomach and chest. Breastfeeding also helps prevent urine infections, diabetes, eczema, obesity and asthma.

The Department of Health recommends exclusive breastfeeding for the first six months of life with additional breastfeeding while the baby moves on to solids if the mother wants to.

June Davison, cardiac nurse at the British Heart Foundation, said: "This study found that women who breastfed their children for more than a year were less likely to have high blood pressure, diabetes, hyperlipidemia and develop cardiovascular disease.

"Breastfeeding has long been thought to be beneficial to baby and mother. This research suggests that it might have also have heart health benefits for mum, too.

"However, it only showed an association between breastfeeding and these health benefits. We will need further research to understand why this is the case."

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Breastfeeding noted to reduce risk of SIDS

Breastfeeding reduced the risk of sudden infant death syndrome (SIDS) by about 50% at all ages throughout infancy in a study just published in the March issue of the Pediatrics, the official journal of the American Academy of Pediatrics.

Infant survival curves showed that both partial breastfeeding and exclusive breastfeeding were associated with a reduced risk of SIDS.

This finding is consistent with several previous studies in the past decade that have noted a relation between lack of breastfeeding and SIDS.

The authors state: “This large study … adds to the body of evidence showing that breastfeeding reduces the risk of SIDS, and that this protection continues as long as the infant is breastfed.”

This study, done in Germany, was controlled for such factors as maternal smoking in pregnancy, maternal family status, maternal age at delivery, socioeconomic status, previous live births, infant birth weight, bed sharing in last night, pillow in infant’s bed, additional heating in last sleep, sleep position, and pacifier use.

The authors continue: “The implication of our findings is that these infants would especially benefit from being breastfed at this early age and that breastfeeding should be continued until the infant is 6 months of age and the risk of SIDS is low. Breastfeeding is recommended by the World Health Organization on other grounds. The morbidity and mortality of infants is reduced when they are exclusively breastfed for the first 6 months of life. Being breastfed also reduces the risk of acute otitis media, atopic eczema, gastrointestinal infections, and lower respiratory infections it seems somewhat surprising that breastfeeding has not been included in the American Academy of Pediatrics and United Kingdom Department of Health SIDS prevention recommendations.”

“In the last 20 years, the prevention campaigns to reduce the risk of sudden infant death syndrome were very successful,” conclude M. M. Vennemann, MD, MPH, PD, fromUniversity of Münster in Münster, Germany, and colleagues from the German Study of Sudden Infant Death Study Group. “In some countries the advice to breastfeed is included in the campaigns’ messages, but in other countries it is not….We recommend including the advice to breastfeed through 6 months of age in sudden infant death syndrome risk-reduction messages.”

Photo: babykingdom.co.uk

http://blogs.babycenter.com/momformation/2009/03/22/breastfeeding-noted-to-reduce-risk-of-sids/