Breastfeeding and the Risk of Maternal Cardiovascular Disease: A Prospective Study of 300 000 Chinese Women

Abstract

BackgroundBreastfeeding confers substantial benefits to child health and has also been associated with lower risk of maternal cardiovascular diseases (CVDs) in later life. However, the evidence on the effects of CVD is still inconsistent, especially in East Asians, in whom the frequency and duration of breastfeeding significantly differ from those in the West.Methods and ResultsIn 2004–2008, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30 to 79 years from 10 diverse regions across China. During 8 years of follow‐up, 16 671 incident cases of coronary heart disease and 23 983 cases of stroke were recorded among 289 573 women without prior CVD at baseline. Cox regression yielded adjusted hazard ratios (HRs) and 95% CIs for incident CVD by breastfeeding. Overall, ≈99% of women had given birth, among whom 97% reported a history of breastfeeding, with a median duration of 12 months per child. Compared with parous women who had never breastfed, ever breastfeeding was associated with a significantly lower risk of CVD, with adjusted HRs of 0.91 (95% CI, 0.84–0.99) for coronary heart disease and 0.92 (95% CI, 0.85–0.99) for stroke. Women who had breastfed for ≥24 months had an 18% (HR, 0.82; 0.77–0.87) lower risk of coronary heart disease and a 17% (HR, 0.83; 0.79–0.87) lower risk of stroke compared with women who had never breastfed. Among women who ever breastfed, each additional 6 months of breastfeeding per child was associated with an adjusted HR of 0.96 (95% CI, 0.94–0.98) for coronary heart disease and 0.97 (95% CI, 0.96–0.98) for stroke.ConclusionsAmong Chinese women, a history of breastfeeding was associated with an ≈10% lower risk of CVD in later life and the magnitude of the inverse association was stronger among those with a longer duration of breastfeeding.

Impact of maternal obesity and breastfeeding intention on lactation intensity and duration

“…Women who breastfeed have decreased risk for metabolic syndrome (Choi, Kim, Cho, Kim, & Shim, ; Gunderson et al, ; Ram et al, ), Type 2 diabetes mellitus (T2DM; Ip et al, ; Schwarz et al, ; Stuebe, Rich‐Edwards, Willett, Manson, & Michels, ), cardiovascular disease (CVD; Peters et al, ; Schwarz et al, ; Stuebe et al, ), and cancer (Chowdhury et al, ; Ip et al, ) and decreased all‐cause mortality (Bartick et al, ) in later life compared with women who do not breastfeed. Several studies have reported that the degree of maternal health benefit is proportional to lactation intensity and duration, suggestive of a dose–response relationship (Gunderson et al, ; Peters et al, ; Ziegler et al, ). The greatest long‐term maternal health benefits have been shown in women who follow the World Health Organization recommendation for exclusive breastfeeding (EBF) for the first 6 months of life without formula supplementation or introduction of other foods or beverages (Organization, ).…”

Infant Feeding and Cardiovascular Disease: A multi-staged analysis from global to country data

“…The Kramer study (9) did not find any relationship between breastfeeding and cardiovascular health. On the other hand a prospective Study of 300 000 Chinese Women in 2017 in China (7) compared the parous women who had never breastfed with ever breastfeeding and found a significantly lower risk of CVD, with 10% lower risk of coronary heart disease and a 17% lower risk of stroke compared with women who had never breastfed. Each additional six months of breastfeeding per child was associated with a further decrease in risk of coronary heart disease and stroke.…”

“…Each additional six months of breastfeeding per child was associated with a further decrease in risk of coronary heart disease and stroke. They concluded that a longer duration of breastfeeding was preventive against CVD (7) .…”

“…Longer breastfeeding duration was found to be associated with a lower risk of cardiovascular disease (CVDs), especially hypertension (3,4,5,6) . A study of a cohort of 0.5 million Chinese women showed that breastfeeding for 24 months or more lowered the risk of coronary heart disease by 18% and risk of stroke by 17% and that increasing the duration of breastfeeding for 6 months or more reduced risk for coronary heart disease and stroke even further (7) .…”

New guidelines, and a new hypertensive population How to select women for menopausal hormone therapy

“…Among 0.5 million Chinese women aged 30 to 79 years from 10 diverse regions across China, history of breastfeeding was associated with a 10% lower risk of cardiovascular disease in later life; this association was stronger among those with a longer duration of breastfeeding (29) . In another study of 1.93 million adults without cardiovascular disease at baseline, light to moderate alcohol use was associated with a reduced risk of death compared to no alcohol consumption at all.…”