Women's Health and Breastfeeding

The degree to which breastfeeding affects mothers' health needs more focus. A lot of popular literature about breastfeeding makes it sound like a rather time-consuming, difficult and even painful experience that women must endure for the sake of their babies' health. No wonder some mothers are left with the impression that they must "martyr" themselves and breastfeed for their baby's sake. Howvever, breastfeeding is good for mothers, too! Not only that, but it is a joyful, relaxing experience. Although breastfeeding advocates have been criticized for oversimplifying and not informing mothers of potential problems of breastfeeding, the truth of the matter is that when practiced optimally breastfeeding is an enjoyable experience, pure and simple. We must remember that many of the problems and inconveniences so commonly described in the lay literature and passed around by word of mouth as "horror stories" are due to the fact that we live in a bottle-feeding society, with little family or social support and little understanding of breastfeeding by many health care professionals. Thus, problems such as "insufficient milk syndrome," engorgement, cracked and bleeding nipples, all of which would be rare in a breastfeeding society, have become commonplace.

Physical Benefits for Breastfeeding Mothers

First, what's good for babies is good for mothers. In other words, healthier babies are less stressful to care for, and the decreased medical costs are a boon to the family. Furthermore, the optimal neurological and intellectual development provide potential long-term benefits to the family.

Second, there are many very direct health benefits to breastfeeding mothers. Immediately after birth, repeated bursts of oxytocin released in response to the baby's sucking cause contraction of the uterus. This protects mothers from postpartum hemorrhage (bottle-feeding mothers get oxytocin intravenously immediately after birth, but for the next 24-48 hours during which risk of hemorrhage is highest, they're on their own). Continued exclusive nursing (i.e., breastfeeding without added bottles of formula or solids) tends to delay the return of ovulation and menstruation. In fact, the lactational amenorrhea method (LAM) is a well-studied method of child spacing which is 99% effective in preventing pregnancy in the first six months as long as exclusive nursing is practiced. For mothers who don't practice exclusive breastfeeding, there is still some relative protection; and most contraceptives including barrier methods, IUD's and even progesterone-only hormonal contraceptives such as the "mini-pill" or injectable "depo" progesterone, are all compatible with breastfeeding. So there's no need to stop breastfeeding in order to use effective birth control. In addition to the child-spacing advantage, the delayed menses also decrease the mother's iron losses. When combined with improved iron absorption from the gut, the net effect (despite some iron use for breastmilk production) is decreased risk of iron deficiency anemia.

Another well-documented benefit of breastfeeding is more rapid and sustained weight loss. Milk production uses up 200-500 calories a day. To burn off an equivalent number of calories, a bottle-feeding mother would need to swim 30 laps or ride a bicycle for over an hour. In our opinion, breastfeeding is definitely easier! Mothers who have had gestational diabetes benefit particularly from the efficient use of calories during breastfeeding, since a return to optimal weight may prevent subsequent development of diabetes. Furthermore, diabetic mothers who breastfeed tend to need less insulin or medication for their diabetes.

The prolonged suppression of ovulatory cycles also appears to be associated with significant long-term health advantages as well. Mothers who breastfeed for at least 6 months throughout their lifetime have a decreased risk of breast cancer, and similar reduced rates have been shown for ovarian and uterine cancers. Even being breastfed has been associated with decreased risk of breast cancer, over and above the fact that women who were breastfed themselves are more likely to breastfeed their own children.

For some time, there was concern about calcium loss during lactation and potential for osteoporosis. In fact, some literature actually lists breastfeeding as a risk factor for osteoporosis. Current medical literature demonstrates that not only is the loss in bone density during breastfeeding temporary, reverting to normal after weaning, but that bones may actually be stronger after prolonged breastfeeding. Far from a risk factor for osteoporosis, breastfeeding may actually protect against it.

The impact of breastfeeding on other women's illnesses needs further study. One example is the connection between breastfeeding and cholesterol levels. Breastfeeding mothers tend to have high total cholesterol levels, made up largely of the HDL ("good") fraction. This may prove to decrease the risk of coronary artery disease.

Are there any known harmful effects of breastfeeding on women's health? A couple of studies have demonstrated an increased risk of rheumatoid arthritis flare-ups and increased severity of arthritis in nursing mothers. Whether it is breastfeeding or some other confounding factor which causes this increase remains to be determined.