Breast-feeding Lowers Your Breast Cancer Risk

CDC’s Dr. Lisa Richardson explains why breastfeeding your babies can lower your risk of breast cancer

Watch Dr. Lisa Richardson, an oncologist and Director of the Division of Cancer Prevention and Control at CDC, explain why breastfeeding your babies can lower your risk of breast cancer.

Promouvoir et Généraliser l’Allaitement Maternel

Quel avenir pour les seins plats ?

Publié par Luc Perino, médecin généraliste, humeur du 08/05/2018

Lorsqu’un marché s’annonce mirobolant par l’énormité de sa clientèle potentielle, l’art du marketing est de transformer chaque évidence en question et chaque angoisse en un problème soluble. Au moment du baby-boom et de l’agro-alimentaire florissant, remplacer le lait maternel par du lait industriel était un rêve mercatique sans précédent. Mais, vendre ce que la nature offre toujours, et convaincre que du lait de vache en poudre est plus profitable au nourrisson que du lait liquide au sein, nécessitait de copieux argumentaires.

Pendant les deux ou trois jours qui suivent l’accouchement, une mère produit du colostrum, encore plus précieux que le lait, mais dont l’aspect jaunâtre n’inspire pas la sympathie. Des mères furent ainsi subtilement persuadées qu’elles n’avaient pas de lait ou qu’il n’était pas de bonne qualité. Avec la preuve par les faits : au bout de trois jours, elles n’avaient vraiment plus de lait, car c’est la tétée du colostrum qui déclenche la lactation.

L’argument des petits seins a convaincu d’autres mères de leur misère lactique. Même si l’on savait que des seins plats produisent autant de lait que les autres, puisque chez tout mammifère, le lait se fabrique au moment de la tétée.

L’argument de la libération a été le plus efficace : les femmes pourraient travailler et se libérer du poids de la maternité. Les seins, n’étant plus soumis à la voracité du bébé, seraient définitivement protégés de l’avachissement (notez la racine ‘vache’ du mot). « Les femmes ne sont pas des vaches tout de même ! » Le marché a réussi à faire prononcer cette phrase à des femmes de haut niveau d’éducation.

Mieux encore, plusieurs de ces arguments ont su convaincre l’Afrique puisque le lait blanc des blancs a pénétré les colonies, provoquant une hausse spectaculaire de la mortalité infantile, à côté de laquelle les génocides sont un « détail » de l’histoire, comme dirait un populiste.

Aujourd’hui encore, l’allaitement artificiel est la première cause de morbidité infantile, et l’une des causes de cancer du sein. Voilà un véritable enjeu de santé publique. Mais le piège dialectique et politique est infernal : promouvoir l’allaitement maternel sans passer pour machiste ou rétrograde.

Au-delà de la gestion des médicaments et autres leurres ou babioles, un ministre de santé devrait étudier comment assurer la carrière professionnelle, l’égalité salariale, la protection sociale et tous les aspects de la reconnaissance, à celles qui allaitent nos enfants.

J’entends tous les jours qu’il faut penser aux générations futures. Soudoyer des entrepreneurs qui garantiraient la protection, le salaire et la promotion des femmes allaitantes me parait plus adéquat que de soudoyer des entrepreneurs qui vendent des milliards de médicaments qui ne font pas gagner un jour de vie à nos vieillards. Je concède cependant qu’il sera très difficile d’évaluer, sans biais, la balance bénéfices/risques pour le PIB, la Sécurité sociale et la santé publique.

En Savoir Plus

Breast feeding associated with a lower risk of endometriosis

History of breast feeding and risk of incident endometriosis: prospective cohort study

2017 Study Abstract

Objective
To investigate the association between lifetime breast feeding, exclusive breast feeding, postpartum amenorrhea, and incidence of endometriosis among parous women.

Design
Prospective cohort study.

Setting
Nurses’ Health Study II, 1989-2011.

Participants
72 394women who reported having one or more pregnancies that lasted at least six months, 3296 of whom had laparoscopically confirmed endometriosis. For each pregnancy, women reported duration of total breast feeding, exclusive breast feeding, and postpartum amenorrhea.

Main outcome measures
Incident self reported laparoscopically confirmed endometriosis (96% concordance with medical record) in parous women. Multivariable Cox proportional hazard models were used to calculate hazard ratios and 95% confidence intervals for diagnosis of endometriosis.

Results
Duration of total and exclusive breast feeding was significantly associated with decreased risk of endometriosis. Among women who reported a lifetime total length of breast feeding of less than one month, there were 453 endometriosis cases/100 000 person years compared with 184 cases/100 000 person years in women who reported a lifetime total of ≥36 months of breast feeding. For every additional three months of total breast feeding per pregnancy, women experienced an 8% lower risk of endometriosis (hazard ratio 0.92, 95% confidence interval 0.90 to 0.94; P<0.001 for trend) and a 14% lower risk for every additional three months of exclusive breast feeding per pregnancy (0.86, 0.81 to 0.90; P<0.001 for trend). Women who breastfed for ≥36 months in total across their reproductive lifetime had a 40% reduced risk of endometriosis compared with women who never breast fed (0.60, 0.50 to 0.72). The protective association with breast feeding was strongest among women who gave birth within the past five years (P=0.04 for interaction). The association with total breast feeding and exclusive breast feeding on endometriosis was partially influenced by postpartum amenorrhea (% mediated was 34% (95% confidence interval 15% to 59%) for total breast feeding and 57% (27% to 82%) for exclusive breast feeding).

Conclusion
Among women who experienced at least one pregnancy that lasted at least six months, breast feeding was inversely associated with risk of incident endometriosis. This association was partially, but not fully, influenced by postpartum amenorrhea, suggesting that breast feeding could influence the risk of endometriosis both through amenorrhea and other mechanisms. Given the chronic and incurable nature of endometriosis, breast feeding should be further investigated as an important modifiable behavior to mitigate risk for pregnant women.

  • History of breast feeding and risk of incident endometriosis: prospective cohort study, BMJ 2017;358:j3778, 29 August 2017.
  • Featured image credit @bmj_latest, 2 sept. 2017.

Mothers need to limit their consumption of added sugars when breastfeeding

From mother to baby: ‘Secondhand sugars’ can pass through breast milk

A new study by researchers at the Keck School of Medicine of USC indicates that a “secondhand sugar” – derived from a mom’s diet – is passed from mother to infant through breast milk.

Even a small amount of fructose – a sweetener linked to health issues ranging from obesity to diabetes – in breast milk is associated with increases in a baby’s body weight.

2017 Study Abstract

Fructose in Breast Milk Is Positively Associated with Infant Body Composition at 6 Months of Age, Nutrients, doi:10.3390/nu9020146, 16 February 2017.

From mother to baby: ‘Secondhand sugars’ can pass through breast milk, news.usc.edu, MARCH 2, 2017.

Cake credit waferboard.

Dietary sugars have been shown to promote excess adiposity among children and adults; however, no study has examined fructose in human milk and its effects on body composition during infancy.

Twenty-five mother–infant dyads attended clinical visits to the Oklahoma Health Sciences Center at 1 and 6 months of infant age. Infants were exclusively breastfed for 6 months and sugars in breast milk (i.e., fructose, glucose, lactose) were measured by Liquid chromatography-mass spectrometry (LC-MS/MS) and glucose oxidase. Infant body composition was assessed using dual-energy X-ray absorptiometry at 1 and 6 months. Multiple linear regression was used to examine associations between breast milk sugars and infant body composition at 6 months of age. Fructose, glucose, and lactose were present in breast milk and stable across visits (means = 6.7 μg/mL, 255.2 μg/mL, and 7.6 g/dL, respectively).

Despite its very low concentration, fructose was the only sugar significantly associated with infant body composition. A 1-μg/mL higher breast milk fructose was associated with a 257 g higher body weight (p = 0.02), 170 g higher lean mass (p = 0.01), 131 g higher fat mass (p = 0.05), and 5 g higher bone mineral content (p = 0.03).

Conclusion

Overall, this study suggests a novel mechanism by which infants may be inadvertently exposed to fructose through breast milk, before sugar sweetened beverages and other fructose-containing foods are introduced to the infant diet.

This work also opens the door for interventions aimed towards decreased consumption of added sugars while lactating.

Future work should be performed with larger samples with longer follow-up (>6 months) in order to establish whether the relationships observed between fructose exposure and infant growth meaningfully impact the development of obesity phenotypes in later childhood and to investigative the mechanism of such an effect at very low levels of fructose.

In conclusion, we provide preliminary evidence that fructose is present in breast milk and may be transmitted to the infant, impacting growth and body composition by 6 months of age.

Breast-Feeding with Breast Implants : is it Safe for My Baby ?

Infant drinks milk tainted with breast implant filler

The Korean Ministry of Food and Drug Safety launched an investigation after a mother found breast implant gel in her breast milk.

“while breast-feeding my baby, I found a transparent, sticky substance mixed with the breast milk.”

the mother said.

The rupture of silicon filler is a common side effect of breast implants…

Read Infant drinks milk tainted with breast implant filler, koreatimes, 2017-01-13. Image credit c3.staticflickr.

Breast feeding premature babies may improve their heart function as adults

Breastfed preterm babies may have better IQs, working memory, motor function

Abstract

BACKGROUND AND OBJECTIVES:
Preterm birth relates to long-term alterations in cardiac morphology and function. Understanding whether preterm postnatal life is a tractable period of cardiovascular development that can be positively altered by nutrition is relevant to long-term outcomes. We hypothesized that being fed human breast milk during early postnatal life is beneficial to long-term cardiac structure and function in preterm-born individuals compared with infant formulas.

Breast Milk Consumption in Preterm Neonates and Cardiac Shape in Adulthood, pediatrics, June 2016.

METHODS:
A total of 926 preterm-born infants originally took part in a randomized controlled trial of postnatal milk-feeding regimens between 1982 and 1985 across 5 different UK centers. Preterm-born individuals were randomly assigned to either breast milk donated by unrelated lactating women or nutrient-enriched formulas. We followed 102 individuals from this cohort: 30 of whom had been randomized to being fed exclusively human milk and 16 to being fed exclusively formula. As a comparison group, we recruited an additional 102 individuals born term to uncomplicated pregnancies. Cardiac morphology and function were assessed by MRI.

Breast feeding premature babies improves their heart function as adults, study shows, The BMJ 2016;353:i3307, 14 June 2016.

RESULTS:
Preterm-born individuals fed exclusively human milk as infants had increased left and right ventricular end-diastolic volume index (+9.73%, P = .04 and +18.2%, P < .001) and stroke volume index (+9.79%, P = .05 and +22.1%, P = .01) compared with preterm-born individuals who were exclusively formula fed as infants.

Pediatrics / Children’s Health
Pregnancy / Obstetrics
Women’s Health / Gynecology
Breastfed preterm babies may have better IQs, working memory, motor function, medicalnewstoday, 02.08.2016.

CONCLUSIONS:
This study provides the first evidence of a beneficial association between breast milk and cardiac morphology and function in adult life in those born preterm and supports promotion of human milk for the care of preterm infants to reduce long-term cardiovascular risk.

Widespread misconception that the benefits of breastfeeding only relate to poor countries

UK ‘world’s worst’ at breastfeeding

breastfeeding-rates
Global distribution of breastfeeding at 12 months Data are from 153 countries between 1995 and 2013. Rates of breastfeeding in the UK are the lowest in the world.

Summary

Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect, the lancet, Volume 387, No. 10017, p475–490, 30 January 2016.

The importance of breastfeeding in low-income and middle-income countries is well recognised, but less consensus exists about its importance in high-income countries.

In the UK, 81% of mothers had tried breastfeeding at some point, but only 34% were breastfeeding at six months and 0.5% at 12 months.

In low-income and middle-income countries, only 37% of children younger than 6 months of age are exclusively breastfed. With few exceptions, breastfeeding duration is shorter in high-income countries than in those that are resource-poor.

Our meta-analyses indicate protection against child infections and malocclusion, increases in intelligence, and probable reductions in overweight and diabetes. We did not find associations with allergic disorders such as asthma or with blood pressure or cholesterol, and we noted an increase in tooth decay with longer periods of breastfeeding. For nursing women, breastfeeding gave protection against breast cancer and it improved birth spacing, and it might also protect against ovarian cancer and type 2 diabetes.

The scaling up of breastfeeding to a near universal level could prevent 823 000 annual deaths in children younger than 5 years and 20 000 annual deaths from breast cancer. Recent epidemiological and biological findings from during the past decade expand on the known benefits of breastfeeding for women and children, whether they are rich or poor.

Antibiotic developed from human breast milk could combat certain drug-resistant bacteria

Breast milk protein could be used in fight against antibiotic resistance

image of breastfeeding
Scientists from NPL and UCL have converted a breast milk protein into an artificial virus that kills bacteria on contact. Breastfeed.

Building antimicrobial viruses from breast milk, National Physical Laboratory, 27 Jan 2016.

As well as providing all the energy and nutrients that infants need for the first months of life, breast milk protects against infectious diseases. Lactoferrin is a protein in milk which provides antimicrobial protection to infants, effectively killing bacteria, fungi and even viruses.

The antimicrobial activities of this protein are mainly due to a tiny fragment, less than a nanometre across, made up of six amino acids. Based on the metrology of antimicrobial mechanisms, the team predicted that copies of this fragment gather at the same time, and at the same point, to attack bacterial cells by targeting and disrupting microbial membranes.

Recognising the potential applications in the fight against antimicrobial resistance, the team of scientists from the National Physical Laboratory (NPL) and the University College London (UCL) re-engineered the fragment into a nanoscale building block which self-assembles into virus-like capsules, to effectively target bacteria. Not only can these capsules recognise and bind to bacteria, but they also rapidly convert into membrane-damaging holes at precise landing positions.

To monitor the activity of the capsules in real time we developed a high-speed measurement platform using atomic force microscopy. The challenge was not just to see the capsules, but to follow their attack on bacterial membranes. The result was striking: the capsules acted as projectiles porating the membranes with bullet speed and efficiency

explains Hasan Alkassem, a joint NPL/UCL EngD student who worked on the project.

Remarkably, however, these capsules do not affect surrounding human cells. Instead, they infected them like viruses do. When viruses are inside human cells they release their genes, which then use the body’s cellular machinery to multiply and produce more viruses. But if viral genes are replaced with drugs or therapeutic genes, viruses become effective tools in the pursuit of gene therapy to cure many diseases, from cancer to cystic fibrosis.

Structurally plastic peptide capsules for synthetic antimicrobial viruses, Chemical Science, 17th December 2015.

The research team explored this possibility and inserted model genes into the capsules. These genes were designed to switch off, or silence, a target process in human cells. The capsules harmlessly delivered the genes into the cells and effectively promoted the desired silencing. With therapeutic genes, this capability could be used to treat disorders resulting from a single mutated gene. Sickle-cell disease, cystic fibrosis or Duchenne muscular dystrophy are incurable at present, but can be cured by correcting corresponding mutated genes. The capsules therefore can serve as delivery vehicles for cures.

Antimicrobial resistance is an increasing public health threat which requires a strong and coordinated response. This work demonstrates the power of combining physics and engineering principles with innovative measurement methods to create new strategies for tackling the problem. It is exactly the sort of high priority problem that the National Physical Laboratory should be active in addressing in collaboration with others.

said Jason Crain, Director of Research at NP.

More press releases
  • Breast milk protein could be used in fight against antibiotic resistance, theguardian, 23 January 2016.
  • Possible solution to antibiotic resistance found in human breast milk, mnn, January 27, 2016.

Risks to babies and mothers associated with everyday exposure to toxic chemicals

International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals

figo image
Two European health and environment groups strongly welcome the statement released by the International Federation of Gynecology and Obstetrics (FIGO) addressing the risks to babies and mothers associated with everyday exposure to toxic chemicals.

Abstract

Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes. Discrimination, other social factors, economic factors, and occupation impact risk of exposure and harm. Documented links between prenatal exposure to environmental chemicals and adverse health outcomes span the life course and include impacts on fertility and pregnancy, neurodevelopment, and cancer. The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm. FIGO recommends that reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice.

Sources and more information
  • Contaminating Our Bodies With Everyday Products, nytimes, NOV. 28, 2015.
  • International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals, sciencedirect, doi:10.1016/j.ijgo.2015.09.002, 1 October 2015.
  • Global Obstetrics and Gynaecology group warn of harm to babies from toxic chemicals in consumer products, HEAL, 1 October 2015.

Association between breastfeeding and reduced risk of aggressive breast cancer

Breastfeeding and breast cancer risk by receptor status—a systematic review and meta-analysis

breastfeeding image
A large international study shows that breastfeeding is associated with a lower risk of developing an aggressive form of breast cancer called hormone-receptor negative. This new combined evidence shows the risk was reduced by up to 20% in women who breastfed. Breastfeeding by Maja.

2015 Study Abstract

Background
Breastfeeding is inversely associated with overall risk of breast cancer. This association may differ in breast cancer subtypes defined by receptor status, as they may reflect different mechanisms of carcinogenesis. We conducted a systematic review and meta-analysis of case–control and prospective cohort studies to investigate the association between breastfeeding and breast cancer by estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status.

Design
We searched the PubMed and Scopus databases and bibliographies of pertinent articles to identify relevant articles and used random-effects models to calculate summary odds ratios (ORs) and 95% confidence intervals (CIs).

Results
This meta-analysis represents 27 distinct studies (8 cohort and 19 case–control), with a total of 36 881 breast cancer cases. Among parous women, the risk estimates for the association between ever (versus never) breastfeeding and the breast cancers negative for both ER and PR were similar in three cohort and three case–control studies when results were adjusted for several factors, including the number of full-term pregnancies (combined OR 0.90; 95% CI 0.82–0.99), with little heterogeneity and no indication of publication bias. In a subset of three adjusted studies that included ER, PR, and HER2 status, ever breastfeeding showed a stronger inverse association with triple-negative breast cancer (OR 0.78; 95% CI 0.66–0.91) among parous women. Overall, cohort studies showed no significant association between breastfeeding and ER+/PR+ or ER+ and/or PR+ breast cancers, although one and two studies (out of four and seven studies, respectively) showed an inverse association.

Conclusions
This meta-analysis showed a protective effect of ever breastfeeding against hormone receptor-negative breast cancers, which are more common in younger women and generally have a poorer prognosis than other subtypes of breast cancer. The association between breastfeeding and receptor-positive breast cancers needs more investigation.

Sources and more information
  • Breastfeeding and breast cancer risk by receptor status—a systematic review and meta-analysis, Oxford Journals, Medicine & Health, Annals of Oncology, Advance Access, 10.1093/annonc/mdv379, October 26, 2015.
  • Study shows association between breastfeeding and reduced risk of aggressive breast cancer, American Cancer Society, 27-OCT-2015.