Breastfeeding and Health

SOME FIND BENEFITS FOR CANCER, OTHER SERIOUS DISEASES

By Barbara Feder Ostrov Mercury News

Breast milk isn’t just for babies at the Mothers’ Milk Bank in San Jose, which quietly offers it to adults with cancer and other serious illnesses to ease their symptoms.

The milk bank is one of just six in the United States. It distributes donated breast milk primarily to premature and low-birth-weight babies. However, it also will provide breast milk to adults with a doctor’s prescription.

Adult use of breast milk is rare, according to Pauline Sakamoto of the milk bank in San Jose, which has served 28 adult patients in the past four years. Adults with cancer, digestive disorders and immune disorders may drink several ounces of milk daily or weekly to ease the ravages of chemotherapy, bolster their immune systems and improve their digestion, she said.

No national figures exist for adult use of breast milk, but an informal survey of the nation’s milk banks suggest that they currently serve dozens of adult patients.

Breast milk’s benefits for babies have been well documented, with research showing that it helps fight infection, improves immune system function, increases intelligence and combats obesity in later life.

But can it help sick grown-ups? No one knows because so little research has been done.

In 1995 Swedish researchers isolated a protein in mothers’ milk that seemed to kill cancer cells in a test tube. And they are still working on developing a drug that takes advantage of that protein. In 2004 the same research team found another compound that destroys many kinds of skin warts, raising expectations that the compound could help treat cervical cancer and other diseases caused by the human papilloma virus.

Still, most doctors are skeptical about the value of breast milk for adults, and mainstream medicine seems to consider it to be on the fringe.

Although Dr. Michelle Melisko, an oncologist at the University of California-San Francisco, acknowledges that mothers’ milk probably won’t hurt her patients, she worries about quality control -- some viral particles can be passed through breast milk -- and said she would advise them against using it.

A potential risk

 

“I’d say the same thing I say to all my patients who want to do alternative things: I don’t know how it’s tested,” Melisko said. “Patients are potentially exposing themselves to as many risks by taking milk from an unknown source than by taking herbs that come in a bag.”

Yet Margit Hamosh, professor emeritus at Georgetown University and an expert in the biochemistry of human milk, says breast milk contains compounds “that might definitely help in people who have compromised immune systems in the same way they might help the newborn.”

Howard Cohen, a Palo Alto software consultant with a doctorate in theoretical physics, says he can live with the lack of medical evidence. Indeed, he’s his own research study. Cohen believes that the twice-weekly smoothies he makes with breast milk and fruit have helped put his prostate cancer into remission and allowed him to avoid more invasive treatment, such as surgery.

“You give this stuff to newborn babies," Cohen said. "It can’t be toxic.”

After Cohen was diagnosed in 1999, his wife found an article about the Swedish research on breast milk and cancer cells. A friend who was lactating donated some milk, and Cohen soon found that his levels of prostate-specific antigen, a warning sign of cancerous cells, dropped back to normal. His doctor, a UC-San Francisco urologist, was skeptical but open to Cohen’s self-treatment as long as his blood work looked fine. Cohen undergoes blood tests and other screenings religiously, and in the past 2 1/2 years, there have been no signs of cancer, he said. It’s possible, of course, that without the breast milk, Cohen’s prostate cancer might have grown so slowly that his health would not be compromised; that happens in many cases.

‘It works’

Still, Cohen believes. After all, when he temporarily stopped the breast milk, his PSA levels went up. “It works,” he says simply.

Patty, an East Bay health educator who asked that her last name not be used, said breast milk seems to be helping her 15-year-old son, who this spring was diagnosed with Crohn’s disease, a serious bowel disorder that can stunt growth and destroy the liver. Daily doses of breast milk mixed with chocolate syrup kept her son’s symptoms under control, allowing him to gain weight and tolerate a regular diet, she said.

Although her son experienced a flare-up of symptoms that landed him in the hospital after five months on breast milk, Patty still gives him eight ounces a day, until their supplies are used up. Her son is now on anti-inflammatory drugs that control his disease. He can no longer tolerate chocolate syrup and must hold his nose to get the milk down, Patty said, but he’s in remission. Because of the stigma surrounding adults drinking breast milk, her son wants to keep it a secret from his high school friends, she said.

“This is like liquid gold. We have this incredible untapped resource that we’ve only looked at for what it can give babies," Patty said. "I’d love for more studies to be done on this. There’s got to be something helpful going on.”


More information about the Mothers Milk Bank, located at Valley Medical Center in San Jose, is available at mothersmilk.org or toll Free at (877) 375-6645.

Contact Barbara Feder Ostrov at This email address is being protected from spambots. You need JavaScript enabled to view it. or (408) 920-5064.

Nursing lowers rheumatoid arthritis risk

Moms whose breastfeeding totals 24 months are only half as likely to develop the disease as other women, researchers found

By ANDRÉ PICARD PUBLIC HEALTH REPORTER 
The Globe and Mail 
Thursday, November 4, 2004

The longer a woman breastfeeds her children, the lower her risk of developing rheumatoid arthritis later in life, according to a new study.

Women who breastfeed for a total of 24 months see their risk plummet by half, researchers found. And even those who fed their babies naturally for as little as 12 months still saw the risk decline by 20 per cent.

The research, published in today’s edition of the medical journal Arthritis & Rheumatism, also found that women with irregular menstrual periods and those who start menstruating at an early age (10 or younger) have a greater risk of developing rheumatoid arthritis.

The study did not find a link between the use of oral contraceptives or hormone-replacement therapy and rheumatoid arthritis.

There is a lot of evidence linking sex hormones to rheumatoid arthritis, a debilitating autoimmune disease. (It is not to be confused with osteoarthritis, a more common form of joint pain.) But this is the first study to look at a range of reproductive factors.

Rheumatoid arthritis afflicts far more women than men; it usually strikes around the time of menopause, or the months just after pregnancy.

Dr. Elizabeth Karlson of the Harvard School of Public Health and the lead researcher said it is believed that a woman’s risk of developing rheumatoid arthritis grows as levels of the female sex hormones estrogen and progesterone fall.

She said that while the benefits of breastfeeding are clear in the new study, the biological mechanisms remain murky. Levels of progesterone and estradiol (a form of estrogen) soar during pregnancy but fall sharply in the postpartum period.

"We hypothesized that breastfeeding would increase the risk of rheumatoid arthritis," Dr. Karlson said. "However, our findings demonstrated the opposite."

Similarly, researchers thought women who took hormone-replacement therapy (a pill that usually combines estrogen and progesterone) would lessen their risk of developing rheumatoid arthritis, but they found no such link.

Dr. Karlson said this leads her to believe that other factors are at play. In particular, she believes that other hormones such as prolactin and cortisol -- whose production increases sharply when a woman breastfeeds -- may play a role in preventing rheumatoid arthritis.

"The complex relationship between RA and reproductive hormones clearly warrants further study," she said.

Data were derived from the Nurses' Health Study, a massive research project that has been ongoing since 1976. Of the 121,700 participants, 674 were confirmed to have developed rheumatoid arthritis. On average, the disease was detected 25 years after their last pregnancy -- at a median age of 56. But among women who breastfed their children, the risk of rheumatoid arthritis fell sharply, and when they did develop the condition, the onset came much later.

Analysis of the data showed that the number of children a woman had and the age at which she gave birth did not appear to make a difference, but the cumulative time she spent breastfeeding did.

"This suggests that breastfeeding confers long-lasting protection against developing RA," Dr. Karlson said.

Women who described their menstrual periods as "very irregular" from ages 20 to 35 saw their risk of developing rheumatoid arthritis increase by about 40 per cent, while those who experienced menarche (first menstruation) before age 10 had a risk that was 60-per-cent higher.

One in seven Canadians, about four million people, suffer from one or more of the more than 100 conditions that constitute the inflammatory joint diseases known as arthritis. These include osteoarthritis, rheumatoid arthritis, gout, lupus and fibromyalgia. For every two men who have rheumatoid arthritis, there are five women.

Most of the research on breastfeeding has focused on the impact on children who are breastfed, not on their mothers.

Previous studies have shown that children who are breastfed have a lower risk of developing high blood pressure, obesity, insulin resistance (a precursor to diabetes) and cardiovascular disease.

The biological mechanism is not entirely clear, but all these conditions are linked to a person’s metabolism and, more specifically, to the body’s inflammatory (or immune) response.

Rheumatoid arthritis is also a result of dysfunction in the body’s inflammatory response.

Lack of Breastfeeding Linked to Increased Risk of Atherosclerosis

Featured on the Web page of The Lancet

A healthy start

Breastfeeding in infancy is likely to reduce the risk of atherosclerosis--and therefore cardiovascular disease--in adult life, according to the authors of a UK study. Atul Singhal and colleagues suggest that infant nutrition permanently affects the lipoprotein profile later in life, and specifically that breastmilk feeding has a beneficial effect. In an accompanying Viewpoint article, two of the authors discuss their findings along with other relevant evidence, and propose a synthesis with major implications for public-health practice and future research.

Breastmilk feeding and lipoprotein profile in adolescents born preterm: follow-up of a prospective randomised study

Atul Singhal, Tim J Cole, Mary Fewtrell, Alan Lucas

MRC Childhood Nutrition Research Centre

(A Singhal MD, M Fewtrell MD, A Lucas FRCP)

and Centre for Paediatric Epidemiology and Biostatistics

(T J Cole ScD),

Institute of Child Health, London, UK

Correspondence to:

Dr A Singhal, 
MRC Childhood Nutrition Research Centre, 
Institute of Child Health, 
30 Guilford Street, 
London WC1N 1EH, UK

(e-mail:This email address is being protected from spambots. You need JavaScript enabled to view it.)

Summary

Background

Breastfeeding is associated with reduced cholesterol concentration later in life, but previous studies have not used random assignment of infant diet with prospective follow-up. We tested the hypothesis that breastmilk feeding benefits the lipoprotein profile in adolescents born preterm, in whom randomisation to different diets at birth is feasible.

Methods

926 infants born preterm were randomly assigned in two parallel trials to receive (trial 1) donated banked breastmilk or preterm formula, or (trial 2) standard term formula or preterm formula, as sole diet or as supplements to mother’s milk in both trials. We followed up 216 participants at age 13-16 years and measured ratio of low-density to high-density lipoprotein cholesterol (LDL to HDL), ratio of apolipoprotein B to apolipoprotein A-1 (apoB to apoA-1), and concentration of C-reactive protein (CRP; a measure of the inflammatory process associated with atherosclerosis).

Results

Adolescents who had been randomised to banked breastmilk had a lower CRP concentration (p=0.006) and LDL to HDL ratio (mean difference 0.34 [14% lower], 95% CI -0.67 to -0.01; p=0.04) than those given preterm formula. A greater proportion of human milk intake in infancy was associated with lower ratios of LDL to HDL (p=0.03) and apoB to apoA-1 (p=0.004)--independent of gestation and potential confounding factors--and with lower CRP concentration (p=0.03). CRP concentration correlated with the two lipoprotein ratios (p=0.0001 and p=0.003, respectively).

Interpretation

Our data provide experimental evidence for the long-term benefits of breastmilk feeding on the risk of atherosclerosis.

Lancet 2004; 363: 1571-78


Media Coverage of the Study:

Canada: Breast milk may prevent later heart disease

The Globe and Mail Newspaper 
By ANDRÉ PICARD PUBLIC HEALTH REPORTER 
Friday, May 14, 2004 - Page A17

Mother’s milk may well be the best "drug" available for preventing heart disease.

New research suggests that babies who are breastfed are less likely to develop atherosclerosis (clogged arteries) as adults, and the lower risk may be due to breast milk permanently altering the way cholesterol is stored by the body.

"The findings suggest that infant nutrition permanently affects the lipoprotein profile later in life, and specifically that breast-milk feeding has a beneficial effect," said Atul Singhal from the Institute of Child Health in London.

The research, published in today’s edition of the medical journal The Lancet, was conducted on 926 premature babies who, at birth, were assigned to get breast milk or formula.

Researchers tracked down 216 of the children when they had reached age 14 to 16 and tested their blood for several markers of heart disease: high-density lipoprotein (HDL, or good cholesterol), LDL (low-density lipoprotein, or bad cholesterol), apolipoprotein B and A-1 (apoB and apoA-1), and C-reactive protein (CRP).

They found the breastfed children had markedly lower ratios of HDL to LDL and of apoB to apoA-1, both of which are measures of atherosclerosis risk. The children fed on mother’s milk also had lower concentrations of CRP, another marker of atherosclerosis.

Dr. Singhal said the study is important because it is the first to prospectively look at the benefits of breastfeeding, with two groups of children assigned randomly to get breast milk or formula. All other research on the link between cardiovascular disease and breastfeeding was retrospective, asking people with heart disease whether they had been breastfed.

The researcher said the findings also bolster the growing body of evidence that the way infants are fed, and consequently the way they grow in the early stages of life, can have lasting impacts on their health.

Dr. Singhal said breastfeeding has been shown to reduce a person’s risk of developing high blood pressure, obesity, insulin resistance (a precursor to diabetes) and cardiovascular disease.

The biological mechanism is not entirely clear, but all these conditions are linked to a person’s metabolism and, more specifically, to the body’s inflammatory response.

One belief is that colostrum is the key. Colostrum is produced in the early days of breastfeeding, before true milk; it is low in fat, but rich in protein and in antibodies that protect a child from infection. Infections, because they cause an inflammatory response, seem to play a role in the development of a number of chronic conditions, such as asthma, heart disease and Alzheimer’s disease.

Another school of thought is related to the fact that breastfed children tend to grow more slowly and steadily in the early months of life, while formula-fed babies often have growth spurts. That is because mother’s milk contains far fewer calories than formula.

Dr. Singhal said it appears that the "relative overnutrition" provided by formula feeding can alter the body’s metabolism and lead to significant health risks in adult life.

About 70 per cent of women breastfeed their newborns, but that falls to less than 15 per cent by the baby’s first birthday.

According to the World Health Organization, babies should breastfeed exclusively until the age of six months, and continue to be breastfed for at least two years for optimal health.


Media Coverage of the Study:UK:

This study was in several UK newspapers today. Headlines and coverage varied.

Interestingly, in the Telegraph, we are told that 'breastfeeding protects etc etc etc': Breastfeeding 'cuts heart risks in adult life'.

The Guardian, however, reflects what the study actually says, that formula has risks.

And the article here: Bottle-fed babies 'face higher risk of heart death'

Thanks to Heather Welford Neil for media monitoring in the UK


Media Coverage of the Study: United States:

From USA Today website Posted 5/13/2004 7:01 PM

Study: Breast-feeding linked to better cholesterol later in life

Breastfeeding protects against cancer, study confirms

By CAROLYN ABRAHAM 
Globe and Mail Update 
POSTED AT 6:30 PM EDT Thursday, July 18, 2002

Women in the Western world could sharply decrease their chances of developing breast cancer by having more children and breastfeeding longer, according to a massive new international study teeming with tricky social implications.

Researchers have long considered reasons why breast cancer rates in developed countries dwarf those in poorer nations. While childbearing is known to offer a protective benefit, it was unclear if breastfeeding itself provides a significant defense against the disease.

But after crunching numbers and dissecting data from nearly 150,000 women in 30 countries, researchers now confirm that if Western women breastfed each of the few babies they do have for even six months longer, 25,000 cases of breast cancer could be prevented each year or 5 per cent of all breast cancer cases in industrialized countries.

"We have shown that these factors (childbearing and breastfeeding) alone account for the high rates of breast cancer in more-developed settings," said Valerie Beral, one of the study leaders at the Cancer Research UK Epidemiology Unit in Oxford.

The study, published today in the British science journal Lancet, found that women who developed breast cancer had spent an average of 10 months breastfeeding in their lives. And women who did not develop the disease had breastfed an average of 16 months.

The researchers concludes that a woman’s relative risk of breast cancer drops by 4.3 per cent for every 12 months she has spent breastfeeding in her life, in addition to a 7 per cent drop with each birth.

Yet just as Canada’s 2001 census shows women having fewer children than ever before - an average of 1.5 - the researchers themselves acknowledge that their findings do not easily fit the dynamics of modern society, where women are equal contributors to the labour force and maternity leaves are limited.

"To expect that substantial reductions in breast-cancer incidence could be brought about today by women returning to the pattern of childbearing and breastfeeding that typified most societies until a century or so ago is unrealistic," the study authors write.

They even suggest developing a therapy to somehow mimic the protective benefits of breastfeeding - although the actual anti-cancer effects of childbearing and breastfeeding remain a mystery.

Richard Gallagher, head of Cancer Control Research at the B.C. Cancer Agency, which contributed data from more than 2,000 Canadian women to the project, stressed that "In a modern Western society, this study is not an exhortation to go out and have six or seven kids ... but any breastfeeding is better than none and more breastfeeding is better than some."

The study also raises questions about whether the incidence of breast cancer is linked to the duration of maternity leaves. Dr. Gallagher agreed that it’s valid to consider whether the high rates of the disease in the U.S., for example, is related to their short paid maternity leaves of just six weeks.

"There’s a wake up call for governments here, for each birth we reduce breast cancer risks ... with each year of lactation there’s a reduction of risk," he said. "It’s pretty tough to breastfeed when you're at work."

Donna Stewart, chair of women’s health for the University Health Network and the University of Toronto, cautions against over-interpreting the study results., She pointed out that the most dramatic protective benefit accumulate after the third child. "You’ve got to be a real breeder to benefit," she said.

The study analyzed information from 50,302 women with breast cancer and 96,973 women without breast cancer in 47 studies from 30 countries. The major findings included:

  • Women with breast cancer had an average of 2.2 children. Women without the disease had an average of 2.6.
  • Women who developed breast cancer had a lifetime duration of breastfeeding of about 10 months. Women who did not develop the disease had breastfed an average of 16 months during their lifetime.
  • For every 100 women up to the age of 70 in the developed world, where children are breastfed for an average of three months, there were between five to seven cases of breast cancer in 1990.
  • In Asian and African countries, where a child is breastfed for an average of 24 months, there were only one to two cases of breast cancer for every 100 women.
  • Researchers also note that as women in developing countries have fewer children, their breast cancer rates are rising.