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11/07/2024

Breastfeeding makes an important contribution to mother’s health too.

Table of Contents

Breastfeeding is not just about feeding a baby. Important processes take place in the breastfeeding mother’s body that have a positive long-term influence on her health. The Lancet 2016 https://www.thelancet.com/series/breastfeeding

As a result, breastfeeding also has many benefits for maternal health. It promotes post-partum weight loss, lowers the risk of type 2 diabetes, hypertension, cardiovascular disease, breast and ovarian cancer, helps prevent anaemia and osteoporosis, helps space births (LAM), promotes mental health and attachment by creating a strong mother-child bond.

Obesity

Check alos our dedicated page on Obesity

Breastfeeding protects against maternal obesity.

“Rates of prepregnancy obesity are rising in many countries around the globe, and epidemiologic data suggest a direct link between maternal prepregnancy BMI and offspring obesity. Maternal obesity coupled with lack of breastfeeding has been associated with a sixfold increased risk for child obesity. Moreover, population subgroups of women in many countries with the highest burden of obesity also have the lowest rates of initiation and shortest durations of breastfeeding, presenting an alarming possibility of a transgenerational cycle of obesity and associated chronic disease. Evidence is also mounting that lactation may be beneficial to women’s future health including protection against development of cardiovascular and metabolic diseases later in life.”

Cancer

    • Breastfeeding and particularly the cumulative period of ⩾12 months is related to the maximum of the protection from breast cancer. Bothou et al 2022 https://pmc.ncbi.nlm.nih.gov/articles/PMC9229285/
    • Swiss Leaggue against cancer : https://www.krebsliga.ch/krebs-vorbeugen/praevention-und-frueherkennung/stillen/
    • 2020 : Association between breastfeeding and ovarian cancer risk. Babic A et al. JAMA Oncol 2020. https://pubmed.ncbi.nlm.nih.gov/32239218/
    • 2020 : Breastfeeding and risk of breast cancer: a meta-analysis of published studies. Bernier MO et al. Human Reproduction Update, Volume 6, Issue 4, July 2000, Pages 374–386, https://doi.org/10.1093/humupd/6.4.374
    • 2018 : Histological subtypes of ovarian cancer associated with parity and breastfeeding in the prospective Million Women Study. Gaitskell K et al. Int J Cancer 2018 ; 142(2) : 281-9. https://pubmed.ncbi.nlm.nih.gov/28929490/
    • 2018 : Reproductive history, breast-feeding and risk of tripple negative breast cancer : the Breast Cancer etiology in Minorities (BEM) study. John EM et al. Int J Cancer 2018 ; 142(11) : 2273-85.
    • 2017 : Le World Cancer Research Fund et l’American Institute for Cancer Research ont émis une série de 10 grandes recommandations pour prévenir le cancer, dont une portant sur l’allaitement. La protection de l’allaitement face au risque de cancer du sein : « strong evidence ». World Cancer Research Fund/American Institute for Cancer Research. https://www.wcrf.org/int/continuous-update-project/cup-findings-reports/breast-cancer
    • 2017 : Grossesse, allaitement, ménopause et risque de cancer du sein chez des femmes coréennes. Risk reduction of breast cancer by childbirth, breastfeeding, and their interactions in Korean women : heterogeneous effects across menopausal status, hormone receptor status, and pathological subtypes. Jeong SH et al. J Prev Med Public Health 2017 ; 50 : 401-10.
    • 2016 : Allaitement et expression du Ki-67, du p54 et du BCL2 dans les cancers du seinBreastfeeding and immunohistochemical expression of Ki-67, p53 and BCL2 in infiltrating lobular breast carcinoma. Gonzalez-Sistal A et al. PloS ONE 2016 ; 11(3) : e0151093.
    • 2014 : Allaitement et prévention du cancer du sein. Breastfeeding and the prevention of breast cancer : a retrospective review of clinical history. González-Jiménez E et al. J Clin Nurs 2014
    • 2013 : Facteurs reproductifs, récepteurs hormonaux, et risque de cancer du sein. Association between chronological change of reproductive factors and breast cancer risk defined by hormone receptor status : results from the Seoul breast cancer study. Chung S et al. Breast Cancer Res Treat 2013 ; 140(3) : 557-65.
    • 2013 : Lactation et risque de cancer du sein après la ménopause. Investigating the association of lactation history and postmenopausal breast cancer risk in the Women’s Health Initiative. Stendell-Hollis NR et al. Nutr Cancer 2013 ; 65(7) : 969-81.
    • 2012 : Allaitement et réduction du risque de cancer du sein. Breastfeeding and its relationship with reduction of breast cancer : a review. Franca-Bothelho Ado C et al. Asian Pac J Cancer Prec 2012 ; 13(11) : 5327-32.
    • 2002 : Lancet. 2002 Jul 20;360(9328):187-95. Professor Valérie Beral’s team at the Oxford Cancer Research Centre has proved that prolonged breastfeeding reduces the risk of developing cancer. The researchers brought together data from 47 studies carried out in 30 different countries, involving a total of almost 150,000 women: Results of the Lancet 2002 study 1) Women with cancer breastfed less often and for shorter periods than controls. 2) The risk of cancer was reduced by 4.3% for each additional year of breastfeeding (bearing in mind that the risk was already reduced by 7% for each birth).

    Epigenetics

    see our dedicated page Epigenetics

    Prolactine

    What is the link between prolactin and the health of breastfeeding mothers? Prolactin appears to have a positive effect on mental health.

    Prolactin may also be a marker of breast cancer. Cureus. 2024 Apr; 16(4): e58375.
    Serum Prolactin Levels as a Novel, Practical Marker for Predicting Malignant Diseases of the Breast. But the study concerns only 67 cases https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097618/

    Uterus

    In the immediate postpartum period, breastfeeding and skin-to-skin contact, under the effect of the oxytocin naturally released in the mother’s body, allow the uterus to involve rapidly. Muscular contractions allow the uterus (which is above all a muscle) to return to its pre-pregnancy state and limit blood loss in the post-partum period.

    This study suggests that skin-to-skin contact and breastfeeding immediately after birth may be effective in reducing PPH rates in women, regardless of their level of risk of PPH primary postpartum haemorrhage. Saxton et al. 2015

    See also:

    Anemia

    Breastfeeding helps delay the return of menstruation and, under certain conditions, acts as a natural contraceptive. It allows rapid involution of the uterus after pregnancy through muscular contractions (the uterus is above all a muscle) under the effect of oxytocin naturally released into the body during breastfeeding.

    Osteoporosis

    Muriel E. Babey et al. published an article on July 10, 2024 A maternal brain hormone that builds bone, https://www.nature.com/articles/s41586-024-07634-3 In lactating mothers, the high calcium (Ca2+) demand for milk production triggers significant bone loss1. Although oestrogen normally counteracts excessive bone resorption by promoting bone formation, this sex steroid drops precipitously during this postpartum period. Here we report that brain-derived cellular communication network factor 3 (CCN3) secreted from KISS1 neurons of the arcuate nucleus (ARCKISS1) fills this void and functions as a potent osteoanabolic factor to build bone in lactating females. We began by showing that our previously reported female-specific, dense bone phenotype2 originates from a humoral factor that promotes bone mass and acts on skeletal stem cells to increase their frequency and osteochondrogenic potential. This circulatory factor was then identified as CCN3, a brain-derived hormone from ARCKISS1 neurons that is able to stimulate mouse and human skeletal stem cell activity, increase bone remodelling and accelerate fracture repair in young and old mice of both sexes. The role of CCN3 in normal female physiology was revealed after detecting a burst of CCN3 expression in ARCKISS1 neurons coincident with lactation. After reducing CCN3 in ARCKISS1 neurons, lactating mothers lost bone and failed to sustain their progeny when challenged with a low-calcium diet. Our findings establish CCN3 as a potentially new therapeutic osteoanabolic hormone for both sexes and define a new maternal brain hormone for ensuring species survival in mammals.

    This study joins others on the subject of breastfeeding and osteoporosis which show that breastfeeding women regain normal bone density some time after weaning. Metabolic adjustments are assumed.

    • Cooke-Hubley S et al, Spine bone mineral density increases after 6 months of exclusive lactation even in women who keep breastfeeding, Arch Osteopor 2017 ; 12(1) : 73), la densité osseuse lombaire avait augmenté de 4 % entre 6 et 12 mois, et la densité osseuse au niveau des vertèbres dorsales avait augmenté de 5 %. https://pubmed.ncbi.nlm.nih.gov/28815389/
    • Kalkwarf HJ et al., Bone mineral loss during lactation and recovery after weaning, Obstet Gynecol 1995 ; 86(1) : 26-32) https://pubmed.ncbi.nlm.nih.gov/7784018/
    • Sowers M et al., Prospective study of bone density and pregnancy after an extended period of lactation with bone loss, Obstet Gynecol 1995 ; 85 : 285-89. Même après un allaitement prolongé. https://pubmed.ncbi.nlm.nih.gov/7824246/
    • Cummings RG, Klineberg RJ, Breastfeeding and other reproductive factors and the risk of hip fractures in elderly women, International Journal of Epidemiology 1993 ; 22 : 684-691) Des études faites sur des femmes ménopausées ayant allaité plusieurs enfants ont montré que ces femmes avaient moins de fractures de la hanche que la moyenne. https://pubmed.ncbi.nlm.nih.gov/8225744/
    • Aloia JF, Cohn SH, Vaswani A, Yeh JK, Yuen K, Ellis K, Risk factors for postmenopausal : moins de fractures vertébrales que la moyenne. https://pubmed.ncbi.nlm.nih.gov/3966495/
    • osteoporosis, American Journal of Medicine 1985 ; 78 : 95-100) https://pubmed.ncbi.nlm.nih.gov/3966495/

    Hypertension

    Breastfeeding has a protective effect on maternal hypertension

    Cardiovascular diseases

    Breastfeeding is protective against cardiovascular diseases in women.

    Endometriosis

    Breastfeeding reduces the risk of endometriosis.

    • History of breast feeding and risk of incident endometriosis : prospective cohort study. Farland LV et al. BMJ 2017 ; 358 : 3778)

      Endometriosis is a chronic gynaecological condition affecting around 10% of women in the United States. Breastfeeding (and the lactational amenorrhoea that accompanies it) could be a modifiable risk factor for endometriosis. – The study concluded that the total duration of exclusive breastfeeding had a significant impact on the risk of endometriosis.

    Breastfeeding reduces the pain associated with endometriosis

    • Effects of breastfeeding on endometriosis-related pain : a prospective observational study. Porta RP et al., Int J Env Res Public Health 2021 ; 18 : 10602. https://pubmed.ncbi.nlm.nih.gov/34682348/

      Breastfeeding, particularly if exclusive, may cause improvement in dysmenorrhea and CPP (chronic pelvic pain) proportional to the duration of breastfeeding, as well as a reduction in the size of ovarian endometriomas.

    Maternal mental health

    To some extent, breastfeeding also has a positive impact on maternal mental health. However, the experience of a mother who wishes to breastfeed and encounters difficulties also represents a significant stress and distress factor. This situation reinforces the idea that all women who wish to breastfeed need appropriate support.

    A 2022 study concluded that, overall, breastfeeding was correlated with better maternal mental health. However, this impact was influenced by the course of breastfeeding, the difficulties encountered, the discrepancy between maternal expectations and experience, and the importance attached to breastfeeding by the mother in her role as mother. Further research on this subject is needed.

    Regaining normal weight after pregnancy

    Exclusive breastfeeding for more than 6 months is associated with a slimmer waistline.

    • Breastfeeding Greater Than 6 Months Is Associated with Smaller Maternal Waist Circumference Up to One Decade After Delivery. GG Snyder et al. Journal of Women’s Health, Vol. 28, No. 4, 22 April 2019. https://pubmed.ncbi.nlm.nih.gov/30481097/

    Contraception

    The LAM method – Lactational amenorrhea method of birth control – is a contraceptive method based on lactational suppression of ovulation through breastfeeding. Prolactin, a hormone involved in the production of breast milk, is secreted when the baby sucks. One of the effects of this hormone is to prevent ovulation.

    This contraception is 98% reliable, provided certain rules are followed:

    • exclusive breastfeeding, i.e. nothing other than the mother’s milk
    • the baby is less than 6 months old
    • maximum 6 hours between feeds to maintain prolactin levels
    • the mother has not returned from childbirth

    Sources for information

    Avoidable maternal deaths

    In 2016, Bartick et al. simulated avoidable maternal deaths using Monte Carlo analysis. Five maternal diseases (breast cancer, ovarian cancer, diabetes, hypertension and myocardial infarction) served as the basis. With optimal breastfeeding, the study calculated an average of 2,619 avoidable deaths per year. It concludes: Policies aimed at increasing optimal breastfeeding could result in substantial gains in terms of public health. Breastfeeding has a greater impact on women’s health than previously thought. Bartick et al. 2016 Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs. https://onlinelibrary.wiley.com/doi/ftr/10.1111/mcn.12366