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Long-term effects of breastfeeding – A systematic review

Breastfeeding has well-established short-term benefits, particularly the reduction of morbidity and mortality due to infectious diseases in childhood. A pooled analysis of studies carried out in middle/ low income countries showed that breastfeeding substantially lowers the risk of death from infectious diseases in the first two years of life.

Based on data from the United Kingdom Millennium Cohort, Quigley et al estimated that optimal breastfeeding practices could prevent a substantial proportion of hospital admissions due to diarrhea and lower respiratory tract infection. A systematic review by Kramer et al confirmed that exclusive breastfeeding in the first 6 months decreases morbidity from gastrointestinal and allergic diseases, without any negative effects on growth.
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What are the causal effects of breastfeeding on IQ, obesity and blood pressure? Evidence from comparing high-income with middle-income cohorts.

Brion MJ, Lawlor DA, Matijasevich A, Horta B, Anselmi L, Araújo CL, Menezes AM, Victora CG, Smith GD.
Int J Epidemiol. 2011 Jun;40(3):670-80.

Abstract

BACKGROUND: A novel approach is explored for improving causal inference in observational studies by comparing cohorts from high-income with low- or middle-income countries (LMIC), where confounding structures differ. This is applied to assessing causal effects of breastfeeding on child blood pressure (BP), body mass index (BMI) and intelligence quotient (IQ).

METHODS: Standardized approaches for assessing the confounding structure of breastfeeding by socio-economic position were applied to the British Avon Longitudinal Study of Parents and Children (ALSPAC) (N ≃ 5000) and Brazilian Pelotas 1993 cohorts (N ≃ 1000).
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Chronic disease and infant nutrition: is it significant to public health?

Smith JP, Harvey PJ.
Public Health Nutr. 2010 Jul 13:1-11.

Abstract

OBJECTIVE: To assess the public health significance of premature weaning of infants from breast milk on later-life risk of chronic illness.

DESIGN: A review and summary of recent meta-analyses of studies linking premature weaning from breast milk with later-life chronic disease risk is presented followed by an estimation of the approximate exposure in a developed Western country, based on historical breast-feeding prevalence data for Australia since 1927. The population-attributable proportion of chronic disease associated with current patterns of artificial feeding in infancy is estimated.

RESULTS: After adjustment for major confounding variables, current research suggests that the risks of chronic disease are 30-200 % higher in those who were not breast-fed compared to those who were breast-fed in infancy.
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Duration of Lactation and Risk Factors for Maternal Cardiovascular Disease

Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB, Freiberg MS, Cauley JA.
Obstet Gynecol. 2009 May;113(5):974-982.

Abstract

OBJECTIVE: To examine dose-response relationships between the cumulative number of months women lactated and postmenopausal risk factors for cardiovascular disease.

METHODS: We examined data from 139,681 postmenopausal women (median age 63 years) who reported at least one live birth on enrolling in the Women’s Health Initiative observational study or controlled trials. Multivariable models were used to control for sociodemographic (age, parity, race, education, income, age at menopause), lifestyle, and family history variables when examining the effect of duration of lactation on risk factors for cardiovascular disease, including obesity (body mass index [BMI] at or above 30), hypertension, self-reported diabetes, hyperlipidemia, and prevalent and incident cardiovascular disease.
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Evidence on the long-term effects of breastfeeding: systematic review and meta-analyses

Bernardo L. Horta, Rajiv Bahl, José C. Martines, Cesar G. Victora
World Health Organization 2007

Executive summary

Background: Breastfeeding presents clear short-term benefits for child health, mainly protection against morbidity and mortality from infectious diseases. On the other hand, there is some controversy on the long-term consequences of breastfeeding. Whereas some studies reported that breastfed subjects present a higher level of school achievement and performance in intelligence
tests, as well as lower blood pressure, lower total cholesterol and a lower prevalence of overweight
and obesity, others have failed to detect such associations.

Objectives: The primary objective of this series of systematic reviews was to assess the effects of breastfeeding on blood pressure, diabetes and related indicators, serum cholesterol, overweight and obesity, and intellectual performance.
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Infant feeding and components of the metabolic syndrome: findings from the European Youth Heart Study

D A Lawlor, C J Riddoch, A S Page, L B Andersen, N Wedderkopp, M Harro, D Stansbie and G Davey Smith

Archives of Disease in Childhood 2005;90:582-588

Aims: To assess the associations of type and duration of infant feeding with components of the metabolic syndrome in children aged 9 and 15.

Methods: A total of 2192 randomly selected schoolchildren aged 9 and 15 years from Estonia (n = 1174) and Denmark (n = 1018) were studied. Insulin resistance (homoeostasis model assessment), triglyceride levels, high density lipoprotein cholesterol, and systolic blood pressure were measured.

Results: Children who had ever been exclusively breast fed had lower systolic blood pressures than those who were not.
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Infant feeding and adult glucose tolerance, lipid profile, blood pressure, and obesity

BACKGROUND – It is generally accepted that breast feeding has a beneficial effect on the health of infants and young children. Recently, a few studies have shown that the method of infant feeding is also associated with cardiovascular disease and its risk factors in adult life.
AIMS – To examine the association between the method of infant feeding in the first weeks after birth and glucose tolerance, plasma lipid profile, blood pressure, and body mass in adults aged 48-53 years.
Arch Dis Child 2000;82:248-252 ( March )

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