Clinical Questions List
Breastfeeding Duration and Risk of Mortality Among US Women

CQ #263 - November 21, 2022

by Anne Eglash MD, IBCLC, FABM

#LactFact

Women with a shorter lifetime duration of breastfeeding have an increased risk of mortality.

Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort study
eClinicalMedicine2022;54:101693
What is the relationship between lifetime duration of breastfeeding and risk of maternal death?

There is mounting evidence regarding the differences in health between women who breastfeed and those who don’t. Women who don’t breastfeed, or who breastfeed for short periods of time, have a higher risk of many illnesses including cancer (particularly breast and ovarian), high blood pressure, high cholesterol, heart disease, stroke, diabetes, and endometriosis.

The authors of the study for this week looked at the relationship between breastfeeding duration and maternal mortality.

The authors used 2 sets of data, the Nurses Health Study (NHS), and the Nurses Health Study II (NHSII) because they provide an abundance of demographic, lifestyle, and health data over 3 decades. In addition, the studies have collected data on the duration of breastfeeding, described as ‘cannot remember’, ‘did not breastfeed’, <1, 1-3, 4-6, 7-11, 12-17, 18-23, 24-35, 36-47, and ≥ 48 months.

The NHS and NHS II studies recruited 121,700 nurses in 1976 and 116,329 in 1989, respectively. Because they excluded women who didn’t carry a child to at least 24 weeks, or who already had cardiovascular disease or cancer at the time of enrollment, there were a total of 166,708 women in the final analysis.

They found that the women with the greatest number of months of lactation had lower mortality rates.

What else? See the question!

According to this study, women who don’t breastfeed or who breastfeed for shorter periods of time have a higher risk for mortality. What do you think are accurate statements regarding these findings? Choose 1 or more:
  1. The only reason that breastfeeding women had lower mortality is because of a lower rate of death from breast cancer.
  2. Breastfeeding is associated with lower mortality risk because women who breastfed have healthier lifestyles than women who didn’t.
  3. Breastfeeding reduces the risk of mortality by 5-7%.
  4. Breastfeeding for a total of 15 months is not more protective from death than breastfeeding for 9 months.

Click here to view the answer to this question.

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Comments (5)
    Aruna Sangisetty

    Death and breastfeeding is more coincidental and lifestyle choices and eating habits possibly is the cause of the difference
    Before the formula days when breastfeeding was norm for women death rates were no different

    IABLE

    Actually, this study does not support your comment. This research shows that the association between breastfeeding and mortality is NOT about a difference in lifestyle, since they were able to measure healthy eating and exercise indices. When healthy eating and exercise were taken into account, there was still a difference in mortality. Breastfeeding women had less cardiovascular and cancer mortality than non-breastfeeding women. This makes sense, since we understand the protection that breastfeeding affords against cardiovascular disease, breast and ovarian cancer.

    Aruna Sangisetty

    Just like Breastfeeding is norm healthy eating especially fresh unprocessed and non additive diet is also norm
    Lot of physical activity is also norm
    In general women now with breast feeding living some what closer to that natural life style may be the cause
    This is just my hypothesis!!

    IABLE

    I would say that physical activity and healthy eating are not necessarily the norm among people who have breastfed. As a family physician, I have watched my lactating patients grow old over 30 years, and I know for a fact that this is presumptuous. It is also presumptuous to assume that people who didn’t lactate don’t have healthy diets and exercise. In fact, many people who didn’t lactate or who lactated for a short period had a high intention to breastfeed (the same characteristics as those who successfully breastfed) but were unable to due to insufficient glandular tissue or other factors out of their control.

    Tara Williams

    Interesting study. Thanks for sharing Anne. Yet more data to support breastfeeding as beneficial not just for the baby but also for the mom.

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