Breastfeeding and Cardiovascular Disease Risk

Study Questions:

Does breastfeeding lower the risk of maternal cardiovascular disease (CVD) in later life?

Methods:

Data were analyzed from the nationwide China Kadoorie Biobank, which recruited patients from five rural and five urban areas from 2004-2008, and followed them for 8 years.

Results:

There were 289,573 women without CVD at baseline; 99% had had at least one live birth, 97% had breastfed, and 91% had breastfed each child for at least 6 months. The median duration of breastfeeding was 12 months. Breastfeeding was associated with a lower risk of CVD, with adjusted hazard ratio 0.91 (95% confidence interval, 0.84-0.99) for coronary heart disease and 0.92 (0.85-0.99) for stroke. Breastfeeding for ≥24 months was associated with lower risk of CVD (18% less CHD and 17% less stroke) compared with women who had never breastfed. Each additional 6 months of breastfeeding was associated with a 3-4% reduction in CVD risk.

Conclusions:

Breastfeeding is associated with an approximate 10% reduction in CVD risk. Longer duration of breastfeeding confers greater maternal benefit.

Perspective:

This is a large, prospective study that confirms what prior studies have shown: Breastfeeding is associated with a reduction in maternal cardiovascular risk. Importantly, longer duration of breastfeeding confers greater benefit. In the United States, rates of breastfeeding are substantially lower and of shorter duration than in other countries. Despite well-documented maternal and infant benefits, only 52% of US women are breastfeeding at 6 months, and 31% at 12 months (data from CDC Breastfeeding Report Card 2016). Inadequate maternity leave and workplace policies in the United States make it difficult for women to establish and maintain lactation after returning to work. Cardiologists should be aware of the substantial CVD risk reduction associated with longer duration of breastfeeding. Improved maternity policies could help reduce the burden of CVD in women.

Clinical Topics: Prevention

Keywords: Breast Feeding, Cardiovascular Diseases, China, Coronary Artery Disease, Lactation, Live Birth, Parental Leave, Primary Prevention, Risk Factors, Stroke


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