Ain't nothing like the real thing, baby

Breastfed infants have a lower risk of heart problems in later life

By Raymond Reese

Chalk up another point on the plus side of the breastfeeding ledger. Researchers from the Institute of Child Health in London have just published a paper in the May 15 issue of The Lancet that points to mother's milk in warding off heart trouble later in life.

The research by Dr Atul Singhal and his colleagues was the first study ever to look prospectively rather than retrospectively at the benefits of breastfeeding. Dr Singhal focused on 926 premature infants born in the 1980s who were selected at random to receive either breast milk from milk banks or artificial milk formula. The use of premature infants allowed the effects of breast milk to be assessed unambiguously, without confounding factors associated with breastfeeding such as social class, according to Dr Singhal. He added that their present results have been seen "many times" in term infants.

The researchers were able to track down 216 of the former infants 13 to 16 years later. Blood samples from the teens were analyzed for reliable markers of heart disease: high- and low-density lipoproteins, apolipoproteins B and A-1, and C-reactive protein (CRP).

The results showed clear benefits for subjects who were breastfed as infants. Even years later, those who got breast milk were more likely to have markedly lower ratios of bad vs good cholesterol and apolipoprotein B vs A-1. The cholesterol ratio alone in the breastfed adolescents was 14% lower than their formula-fed counterparts. The breastfed kids also had a reduced risk of developing clogged arteries due to their lower CRP levels. The low ratios translated into a lowered risk of atherosclerosis for babies who got breast milk.

The findings bolstered the view that an infant's diet and the way it grows shapes its future health. Breastfeeding is known to reduce the risk of high blood pressure, obesity, insulin resistance and cardiovascular disease. How this all comes about is still unclear, but it may involve a reduced inflammatory response because of the hit of antibody-rich colostrums in breast milk early in life.

Another view favoured by Dr Singhal was that breast milk "prevents too rapid growth very early in life," when compared to the growth spurt pattern of formula-fed brethren. According to him, the "relative over nutrition" of calorie-laden formula might alter a baby's metabolism, for instance by changing cholesterol storage, paving the way for later difficulties.

Canadian breastfeeding pioneer and advocate Dr Jack Newman was "not at all surprised" by the latest findings. "There's more and more evidence that early feeding affects physiology and pathology many years later. I've been using the cardiovascular argument for years to help people, especially health professionals, to understand the importance of breastfeeding. It's generally been a futile effort, as most health professionals don't want to know."

In Canada and the US some 70% of newborns are breastfed. But the proportion drops to only 15% by the first birthday. The World Health Organization advocates breastfeeding for two years. "In Western populations the longterm advantages of breastfeeding are likely even greater than the shortterm effects," said Dr Singhal.