̽��ֱ�� of Cambridge - breastfeeding

Breastfeeding linked to lower risk of postnatal depression

cjb250 — Tue, 19 Aug 2014 23:01:00 +0000

A new study of over 10,000 mothers has shown that women who breastfed their babies were at significantly lower risk of postnatal depression than those who did not.

̽��ֱ��study, by researchers in the UK and Spain, and published today in the journal Maternal and Child Health, shows that mothers who planned to breastfeed and who actually went on to breastfeed were around 50% less likely to become depressed than mothers who had not planned to, and who did not, breastfeed. Mothers who planned to breastfeed, but who did not go on to breastfeed, were over twice as likely to become depressed as mothers who had not planned to, and who did not, breastfeed.

̽��ֱ��relationship between breastfeeding and depression was most pronounced when babies were 8 weeks old, but much smaller when babies were 8 months or older.

̽��ֱ��research, funded by the Economic and Social Research Council, used data drawn from the Avon Longitudinal Survey of Parents and Children (ALSPAC), a study of 13,998 births in the Bristol area in the early 1990s. Maternal depression was measured using the Edinburgh Postnatal Depression Scale when babies were 8 weeks, and 8, 21 and 33 months old. Depression was also assessed at two points during pregnancy, enabling the researchers to take into account mothers’ pre-existing mental health conditions.

This is one of the largest studies of its kind; as well as being one of the few studies taking into account mothers’ previous mental health, it also controls for socioeconomic factors such as income and relationship status, and for other potential confounders such as how babies were delivered, and whether they were premature.

“Breastfeeding has well-established benefits to babies, in terms of their physical health and cognitive development; our study shows that it also benefits the mental health of mothers,” says Dr Maria Iacovou, from the ̽��ֱ�� of Cambridge’s Department of Sociology and a Bye Fellow at Fitzwilliam College.

“In fact, the effects on mothers’ mental health that we report in this study are also likely to have an impact on babies, since maternal depression has previously been shown to have negative effects on many aspects of children’s development.”

Dr Iacovou believes that health authorities should not only be encouraging women to breastfeed, but should also provide a level of support that will help mothers who want to breastfeed succeed.

“Lots of mothers and babies take to breastfeeding pretty easily. But for many others, it doesn’t come naturally at all; for these mothers, having someone with the training, the skills, and perhaps most importantly the time to help them get it right, can make all the difference,” she adds.

“However good the level of support that’s provided, there will be some mothers who wanted to breastfeed and who don’t manage to. It’s clear that these mothers need a great deal of understanding and support; there is currently hardly any skilled specialist help for these mothers, and this is something else that health providers should be thinking about.”

Around one in 12 women in the sample experienced depressive symptoms during pregnancy, while one in eight experienced depression at one or more of the four measurement points after giving birth.

According to figures from the UK’s Department of Health, almost three-quarters of mothers initiated breastfeeding in 2012/13; by the time of the 6-8 week check, only 47% of babies were being breastfed. This is one of the lowest rates of breastfeeding in Europe.

̽��ֱ��study was carried out in collaboration with Dr Almudena Sevilla from Queen Mary ̽��ֱ�� of London and Cristina Borra from Universidad de Sevilla, Spain.

A new study of over 10,000 mothers has shown that women who breastfed their babies were at significantly lower risk of postnatal depression than those who did not.

Breastfeeding has well-established benefits to babies. Our study shows that it also benefits the mental health of mothers

Maria Iacovou

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Mothering Touch (cropped)

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Breastfeeding may reduce Alzheimer’s risk

tdk25 — Mon, 05 Aug 2013 08:04:23 +0000

Mothers who breastfeed their children may have a lower risk of developing Alzheimer’s Disease, with longer periods of breastfeeding also lowering the overall risk, a new study suggests.

̽��ֱ��report, newly published in the Journal of Alzheimer’s Disease, suggests that the link may be to do with certain biological effects of breastfeeding. For example, breastfeeding restores insulin tolerance which is significantly reduced during pregnancy, and Alzheimer’s is characterised by insulin resistance in the brain.

Although they used data gathered from a very small group of just 81 British women, the researchers observed a highly significant and consistent correlation between breastfeeding and Alzheimer’s risk. They argue that this was so strong that any potential sampling error was unlikely.

At the same time, however, the connection was much less pronounced in women who already had a history of dementia in their family. ̽��ֱ��research team hope that the study – which was intended merely as a pilot – will stimulate further research looking at the relationship between female reproductive history and disease risk.

̽��ֱ��findings may point towards new directions for fighting the global Alzheimer’s epidemic – especially in developing countries where cheap, preventative measures are desperately needed.

More broadly, the study opens up new lines of enquiry in understanding what makes someone susceptible to Alzheimer’s in the first place. It may also act as an incentive for women to breastfeed, rather than bottle-feed – something which is already known to have wider health benefits for both mother and child.

Dr Molly Fox, from the Department of Biological Anthropology at the ̽��ֱ�� of Cambridge, who led the study, said: “Alzheimer’s is the world’s most common cognitive disorder and it already affects 35.6 million people. In the future, we expect it to spread most in low and middle-income countries. So it is vital that we develop low-cost, large-scale strategies to protect people against this devastating disease.”

Previous studies have already established that breastfeeding can reduce a mother’s risk of certain other diseases, and research has also shown that there may be a link between breastfeeding and a woman’s general cognitive decline later in life. Until now, however, little has been done to examine the impact of breastfeeding duration on Alzheimer’s risk.

Fox and her colleagues – Professor Carlo Berzuini and Professor Leslie Knapp – interviewed 81 British women aged between 70 and 100. These included both women with, and without, Alzheimer’s. In addition, the team also spoke to relatives, spouses and carers.

Through these interviews, the researchers collected information about the women’s reproductive history, their breastfeeding history, and their dementia status. They also gathered information about other factors that might account for their dementia, for example, a past stroke, or brain tumour.

Dementia status itself was measured using a standard rating scale called the Clinical Dementia Rating (CDR). ̽��ֱ��researchers also developed a method for estimating the age of Alzheimer’s sufferers at the onset of their disease, using the CDR as a basis and taking into account their age and existing, known patterns of Alzheimer’s progression. All of this information was then compared with the participants’ breastfeeding history.

Despite the small number of participants, the study revealed a number of clear links between breastfeeding and Alzheimer’s. These were not affected when the researchers took into account other potential variables such as age, education history, the age when the woman first gave birth, her age at menopause, or her smoking and drinking history.

̽��ֱ��researchers observed three main trends:

• Women who breastfed exhibited a reduced Alzheimer’s Disease risk compared with women who did not.

• Longer breastfeeding history was significantly associated with a lower Alzheimer’s Risk.

• Women who had a higher ratio of total months pregnant during their life to total months breastfeeding had a higher Alzheimer’s risk.

̽��ֱ��trends were, however, far less pronounced for women who had a parent or sibling with dementia. In these cases, the impact of breastfeeding on Alzheimer’s risk appeared to be significantly lower, compared with women whose families had no history of dementia.

̽��ֱ��study argues that there may be a number of biological reasons for the connection between Alzheimer’s and breastfeeding, all of which require further investigation.

One theory is that breastfeeding deprives the body of the hormone progesterone, compensating for high levels of progesterone which are produced during pregnancy. Progesterone is known to desensitize the brain’s oestrogen receptors, and oestrogen may play a role in protecting the brain against Alzheimer’s.

Another possibility is that breastfeeding increases a woman’s glucose tolerance by restoring her insulin sensitivity after pregnancy. Pregnancy itself induces a natural state of insulin resistance. This is significant because Alzheimer’s is characterised by a resistance to insulin in the brain (and therefore glucose intolerance) to the extent that it is even sometimes referred to as “Type 3 diabetes”.

“Women who spent more time pregnant without a compensatory phase of breastfeeding therefore may have more impaired glucose tolerance, which is consistent with our observation that those women have an increased risk of Alzheimer’s disease,” Fox added.

̽��ֱ��full paper: Maternal Breastfeeding History and Alzheimer’s Disease Risk can be found here.

For more information about this story, please contact Tom Kirk, Tel: 01223 332300, thomas.kirk@admin.cam.ac.uk

A new study suggests that mothers who breastfeed run a lower risk of developing Alzheimer’s, with longer periods of breastfeeding further reducing the risk.

In the future, we expect Alzheimer's to spread most in low and middle-income countries, so it is vital that we develop low-cost, large-scale strategies to protect people against it.

Molly Fox

Anton Nossik via Wikimedia Commons

Breastfeeding.

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Much ado about babies

amb206 — Tue, 23 Jul 2013 15:04:44 +0000

In 1697, Matthew Henry, a Presbyterian minister, wrote to his mother about the health of his family. His letter survives in a collection of family correspondence in the British Library, although its immediate context is hazy. Matthew recalls returning from business to find his infant daughter, Nancy, close to death.

A doctor is called. Matthew states that the physician “was very apprehensive of her peril” and attributed Nancy’s illness to “the badness of her Mother’s Milk”. Matthew’s wife was forbidden by the doctor from breastfeeding the child any longer, an instruction which Matthew recorded “put her in much adoe”. He concluded his letter by informing his mother that “we got a wet nurse into the house”, which, as the doctor promised, returned Nancy to health.

Contemporary documents like this one reveal that early modern women from relatively affluent families desired to breastfeed, and in some cases were successful at breastfeeding, their infants themselves. Hiring a wet nurse was not a universal practice, and when parents were compelled to resort to outside help, the infant and wet nurse were sometimes accommodated within the home itself.

Scholars have previously argued that only royal babies enjoyed the proximity of both their mother and wet nurse, and that middling and upper class families invariably sent their infants away from home to live with the wet nurse and her family until weaning was judged appropriate.

Henry’s letter provides a small but intimate window into the relationship of parents, medical practitioners and infants in 17th-century England. Mortality rates in early modern England were high and parents knew that their children might well not survive infancy, let alone reach adulthood. It has been estimated that a quarter of all infants did not reach their first birthday. Neonatal death was particularly common.

Nevertheless, parents were eager to employ all kinds of means to secure the ongoing health of their offspring after birth. Matthew and his wife knew the life of the infant Nancy was precarious but they also knew that she could be saved. Vignettes such as theirs indicate that when infant illness occurred, parents were flexible in their post-natal regimes, willing to make changes, and loving and tender in their concern for their offspring.

My research looks at the theory and practice of maternal and infant health, and how their respective bodies were perceived to function in relation to one another. I am part of the Wellcome Trust funded Generation to Reproduction project at the ̽��ֱ�� of Cambridge, a group of scholars investigating the history of reproduction from ancient to contemporary times. My work focuses on pregnancy, childbirth and post-natal care, bringing personal documents to bear on published medical literature in order to investigate the intersection between prescriptive advice and practice.

Sources such as diaries, correspondence and journals offer a fresh perspective on older debates about the practice of medicine within the home and bodily understanding in the past. Still at an early stage, my research into documents such as these has already thrown up a number of surprises.

Perhaps the most interesting discovery is the frequency with which babies were bathed and cleaned in the 16th and 17th centuries. Current NHS guidelines recommend refraining from submersing newborns in water for a full week after birth, to preserve the protective white substance that covers the baby’s skin at birth to prevent dryness and cracking. After this initial period, the NHS recommends washing newborn babies in plain water once or twice a week. In contrast, 16th- and 17th-century medical authorities recommend baths at least once a day and sometimes as often as three or four times a day.

This finding – evident in the regimes printed in childbearing manuals - challenges popular assumptions about the comparatively lax attitude to personal hygiene of Tudor and Stuart society.

Early modern infants were swaddled (tightly wrapped) shortly after birth. Medical texts provided instructions to parents and nurses as the best way to bind the infant body to support the body and make the limbs grow straight. Other sources indicate that this appears to have been standard practice. Infancy is typically represented on funerary monuments as a swaddled figure. Other representations of swaddling include the famous image, on display at Tate Britain, of the Cholmondeley sisters tenderly holding their wrapped infants.

No clear time limit confined the period of swaddling. Parents were advised by medical writers to observe the baby’s movement. When infants appeared frustrated by their bindings and moved their arms, their limbs were released, usually at four months old. ̽��ֱ��entire body was freed at a later stage, sometimes up to a year after birth, depending on an assessment of the baby’s health.

Older histories of the early modern family have tended to see swaddling as emblematic of the perceived negligence and abuse of children by their parents.
However, post-natal schedules set out in medical literature suggest that the process of swaddling and changing the infant was couched in terms that allowed regular periods of physical intimacy and affection between mother or nurse and infant.

Contemporary sources suggest that the infant was ritually bathed, rubbed and stroked, before being carefully dried and wrapped in clean swaddling cloths. Wadges of ‘clouts’, or cloths, were placed to act as a kind of nappy. To me, it seems that swaddling provided an opportunity for parents and other caregivers to be physically close to the infant; it was not an act of emotionally distancing the newborn as previous scholars have argued.

̽��ֱ��fact that wrapping of newborns remains popular today is one of the many reasons why I have chosen to do my research. So many of our social, cultural, emotional and medical values and understandings are reflected in the way we care for our young. Pregnancy, childbirth and post-natal care are subject to trends and fashions, whether they are endorsed through social or medical arguments. Infant and maternal healthcare has always been hotly contested, because it is an activity involving not just parental reputation and identity but also the perpetuation of communities.

An examination of things which we care about deeply can reveal the discontinuities but also equally as important the continuities between past and present. ̽��ֱ��media coverage surrounding the arrival of the Duke and Duchess of Cambridge’s baby is picking up the same themes that were prominent in early modern sources, among them pain relief during labour and the post-natal schedule of sleeping and feeding.

Even our concept of demand feeding, which has recently become part of the new movement of attachment parenting, has an earlier precedent. Correspondence between two sisters – Ann D’Ewes and Joan Ellyot – that survives in the D’Ewes family papers at the British Library shows that debate about the pros and cons of imposing a regime on a baby or allowing it to sleep and feed on demand was as alive in the mid-17th century as it has been over the past few decades.

When Ann’s infant son was ailing, Joan wrote to her with urgent advice. Joan told Ann to stop breastfeeding the infant herself, for the baby’s ailing state was a powerful indication that Ann’s breast milk was corrupt and “stale”. Instead, Joan suggested that Ann should hire a wet nurse, whom she should house at home so she could monitor the diet and conduct of the hired nurse. ̽��ֱ��baby ought not to be “kept from sleepe or suck which I know has bin the way of very good docters in this case but let it haue a full breast of new milke at command and all the quiet and content”.

In a similarly liberal vein, that would find favour with many modern baby manuals, the Welsh medical writer John Jones wrote in 1579 parents and nurses must “take it [the baby] uppe and laye it downe as ofte as neede shal require”.

An exploration of the way in which the infant body was perceived to function, and how its needs were to be met, in the past reveals the impressive flexibility of parents in attending to their offspring. Parents engaged actively in the care of their babies and read bodily signs to predict infants’ medical needs. Most strikingly however, post-natal narratives reveal the physical affection which parents bestowed on their offspring in bathing, swaddling, feeding and lulling babies to sleep and how parents were deeply concerned to ensure their offspring survived.

For more information on this story contact Alex Buxton, Office of Communications, ̽��ֱ�� of Cambridge amb206@admin.cam.ac.uk 01223 761673.

̽��ֱ��management of childbirth and care of newborns have always been hotly-debated topics. PhD candidate Leah Astbury looks at narratives of reproduction in the 16th and 17th centuries and finds evidence for many of the same concerns.

Let it [the baby] haue a full breast of new milke at command and all the quiet and content

Joan D'Ewes writing to her sister Ann, mid-17th century

Wellcome Library, London

Aristotle's compleat and experienc'd midwife

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