by Anne Eglash MD, IBCLC, FABM
Does breastfeeding improve the cardiovascular status of women? Cardiovascular disease is the leading cause of death among women worldwide. Many behavioral factors play a role in the risk of cardiovascular disease, such as obesity, lack of physical activity, and an unhealthy diet, but can we add breastfeeding to this list?
There are a few different ways to evaluate breastfeeding’s effect on the likelihood that a woman will have a heart attack, stroke, or clogged arteries. Researchers could simply measure the rate of these outcomes among women based on their breastfeeding histories. Researchers could also evaluate whether breastfeeding changes a woman’s risk factors for heart disease, such as reducing the risk for high blood pressure, high cholesterol, diabetes, metabolic syndrome and/or diabetes.
Researchers recently published a systematic review of 21 robust studies that measured the effect of breastfeeding on metabolic risk factors for heart disease, the presence of cardiovascular disease, and death from cardiovascular disease.
What do you think the researchers found regarding the association between breastfeeding and cardiovascular disease risks/events? Choose 1 or more:
- Breastfeeding does not have an effect on high blood pressure.
- Breastfeeding does not seem to have an effect on change in postpartum weight.
- Breastfeeding reduces the risk of metabolic syndrome (defined by abdominal obesity, high triglycerides, low high-density lipoprotein cholesterol, high blood pressure, and elevated fasting blood sugar)
- A longer duration of lifetime lactation is associated with more protection from cardiovascular risk factors and diseases.
- Breastfeeding increases metabolic expenditure by about 1000 calories on average.
See the Answer
The answers are B,C,D (not A or E)
Breastfeeding and Maternal Cardiovascular Risk Factors and Outcomes: A Systematic Review
Binh Nguyen, Kai Jin, Ding Ding
PLOS One November 29, 2017
There is growing evidence that breastfeeding has short- and long-term cardiovascular health benefits for mothers. The objectives of this systematic review were to examine the association between breastfeeding and maternal cardiovascular risk factors and outcomes that have not previously been synthesized systematically, including metabolic syndrome, hypertension and cardiovascular disease.
Methods and findings
This systematic review meets PRISMA guidelines. The MEDLINE, EMBASE and CINAHL databases were systematically searched for relevant publications of any study design from the earliest publication date to March 2016. The reference lists from selected articles were reviewed, and forward and backward referencing were conducted. The methodological quality of reviewed articles was appraised using validated checklists.
Twenty-one studies meeting the inclusion criteria examined the association between self-reported breastfeeding and one or more of the following outcomes: metabolic syndrome/metabolic risk factors (n = 10), inflammatory markers/adipokines (n = 2), hypertension (n = 7), subclinical cardiovascular disease (n = 2), prevalence/incidence of cardiovascular disease (n = 3) and cardiovascular disease mortality (n = 2). Overall, 19 studies (10 cross-sectional/retrospective, 9 prospective) reported significant protective effects of breastfeeding, nine studies (3 cross-sectional/retrospective, 5 prospective, 1 cluster randomized controlled trial) reported non-significant findings and none reported detrimental effects of breastfeeding. In most studies reporting significant associations, breastfeeding remained associated with both short- and long-term maternal cardiovascular health risk factors/outcomes, even after covariate adjustment. Findings from several studies suggested that the effects of breastfeeding may diminish with age and a dose-response association between breastfeeding and several metabolic risk factors. However, further longitudinal studies, including studies that measure exclusive breastfeeding, are needed to confirm these findings.
The evidence from this review suggests that breastfeeding is associated with cardiovascular health benefits. However, results should be interpreted with caution as the evidence gathered for each individual outcome was limited by the small number of observational studies. Additional prospective studies are needed.
Milk Mob Comment by Anne Eglash MD, IBCLC, FABM
It is exciting to see so much research on the role of breastfeeding in cardiovascular outcomes among women. Clearly the trend in the literature is that the longer lactation is associated with a lower risk of various cardiovascular risk factors and the risk of heart attacks and strokes. We don’t know how long this protection lasts. Since cardiovascular disease is the leading cause of death among women, the question is whether breastfeeding will allow women to live longer, with a better quality of life.
The authors discuss why breastfeeding might be associated with lower risk of cardiovascular disease. The average amount of calories used during lactation is 480 (not 1000). Perhaps it is as high as 1000 calories per day for a mom with twins, or a mother donating gallons of breastmilk. This extra calorie expenditure might help to lose some of the fat stored during pregnancy. Even though breastfeeding is not found to effect postpartum weight change, it still has an effect on the mother’s metabolism by decreasing abdominal fat, and reducing the insulin resistance that occurs during pregnancy. In addition, the authors share that the higher levels of prolactin and oxytocin during lactation might play a role in reducing the blood pressure.