A new study suggesting a link between breastfeeding and heart disease in later life was published on Friday 16th March in the British Medical Journal.(1) Media coverage has been extensive worldwide - within a day reports appeared  in Canada, Israel and India. In the UK numerous women are giving up breastfeeding because of it. 

Although the authors state that the observational data does not "establish a causal relationship between the length of breastfeeding and cardiovascular disease.." and that "further early dietary information was limited as the study was retrospective," such fine distinctions are not stated in the summary and have not been picked up by the media. 

Patti Rundall of Baby Milk Action states,  

"The fact that the study might actually say more about the risks of a Western diet later in life, or about poor infant feeding practices, is being over-looked. Although I am sure the scientists involved in this study did not intend this, infant health - in the UK and globally - will certainly suffer, while companies will reap the benefits. Some of them spend billions encouraging us later in life to eat high-fat, high-salt and high-sugar foods which are known be risky in relation to heart disease."

"Mothers are suffering terrible distress because of this, and in some cases have become ill with mastitis because they stopped breastfeeding so suddenly. The people most affected are those who have stood up to the social pressures to give up or to add other foods and have continued breastfeeding exclusively until 6 months."

"I am saddened to hear that the wrong messages are going out. It was never our intention that mothers should stop breastfeeding because of this very preliminary and incomplete data. If our theory proves to be correct that it is breastfeeding followed by a western style diet that accounts for our findings, then the public health message should be that we should deal with the Western style diet rather than breastfeeding which has so many advantages."

Prof. Alan Lucas has done extensive research which has demonstrated the clear advantages of breastfeeding, but at the same time is a well-known advocate of industry funding of research. His views, alongside those of Baby Milk Action were published in the British Medical Journal in 1998. (3) 

Only last month, Prof. Lucas published a randomised control which showed that premature breastfed babies are likely to have lower blood pressure and less risk of heart disease.(4) Other studies have shown the risks of too early introduction of complementary foods and that breastfeeding is likely to decrease the incidence of obesity in childhood - a major cause of heart disease. (5). 

For a number of reasons this latest study would not be used in a scientific review of infant feeding. It has shortcomings in its focus and in its methodology, which the authors themselves acknowledge. For example, its sample is self-selected and the research is based on recall - some 20 - 28 years after the event. Nor did it contain clear definitions on patterns of breastfeeding. In other areas of research, for example, in relation to obesity, HIV transmission or infections generally, whether - and for how long - breastfeeding has been exclusive (ie with nothing else added) or mixed with other foods, have proved to be key factors.  

For the last 3 - 6 millions years of evolution of our species, it has been normal to breastfeed until the child is aged 3 to 5 years. An editorial in the BMJ by Ian Booth, Leonard Parsons professor of paediatrics and child health stated:  

"Today's paper should not alter current recommendations about breast feeding being the best way to promote infant and maternal health... In developing countries the massive benefits of prolonged breast feeding for infant survival and health, together with child spacing, will probably never be outweighed by considerations of ischaemic heart disease 50 years later." 

This policy is in place in 61 countries but is continually challenged by the $8 billion dollar baby food industry which lobbies for weaker and weaker controls. If the industry can get global labelling standards to refer to foods as suitable 'from 4 months' rather than from 'about 6 months' it can sell an estimated extra $1 billion dollars worth of foods. 

The question is, will this study, which leaves so many questions unanswered be allowed to influence policy makers and undermine mothers who are trying to do the best for their babies? 
 

For more information contact:  

Patti Rundall, Policy Director, Baby Milk Action, 23 St Andrew's St, Cambridge, CB2 3AX Tel: +44 1223 464420, Fax: +44 1223 464417 email:prundall@babymilkaction.org 
 
 

refs:  

(1) Leeson et al, (2001) Duration of breastfeeding and arterial distensibility in early adult life: population based study, BMJ, Vol. 322, (643-647)  

(2) Brown P, (2001) Campaigners for breastfeeding claim partial victory, BMJ, Vol. 322  

(3) Lucas A, (1998) Collaborative research with infant formula companies should not always be censured, Rundall P, How much research in infant feeding comes from unethical marketing? BMJ, 317, 337- 339 (http://www.bmj.com/cgi/content/full/317/7154/333) 

(4) Singhal et al, (2001) Early nutrition in pre-term infants and later blood pressure: two cohorts after randomised trials, Lancet Vol. 357, no 9254 

(5) Van Kries et al (1999) Breastfeeding and obesity: cross sectional study, BMJ, 319: 147-150 

(6) WHA 47.5, WHA 49.15