Estimated reading time: 9 minutes
Updated January 2016
Barbara Higham, Wharfedale, UK
Photo: Erin White
What’s in it for mothers?
Mothers know breastfeeding is good for babies. It’s the natural thing to do: human milk provides optimal nutrition and strengthens immune systems. We know too that formula-fed babies suffer more illnesses than breastfed babies.
But how often do mothers hear about the advantages that exist for their own short and long-term health?
The reporting of these ‘selfish’ benefits is often limited to the perk of speedier weight loss postpartum.
Any discussion of the emotional pluses tends to focus primarily on the baby and the ease of bonding with a more settled child.
Mothers want what’s best for their babies, whose needs will come first. But painting a one-sided picture of breastfeeding as an ideal gold standard gift means many mothers think it’s an unattainable ideal—on a par with never eating sugar or using silk diapers—rather than the biological norm, something that is simply meant to happen.
We are designed, like all mammals, to breastfeed and not doing so may have far-reaching consequences for both babies and their mothers.
Breastfeeding is a two-way relationship, not a sacrificial gift.
Women need to be well and content in order to be up to the job of mothering. It can be such hard work and personal rewards definitely help.
Women should be entitled to good health information and that includes what’s in it for us (free from misleading commercial promotion) when we are deciding how we want to feed our babies.
Good for mothers too
Following birth, immediate skin-to-skin contact and the baby’s suckling release oxytocin from the mother’s pituitary gland. This hormone signals the breasts to let down milk to the baby and simultaneously produces contractions in the uterus to expel the placenta naturally, helping prevent hemorrhage and promoting uterine involution.
As long as a mother breastfeeds without substituting formula, food or pacifiers for feedings, the return of her menstrual periods is delayed. (Why does no one tell women that?)
As natural family planning for the first six months, breastfeeding according to these criteria is considered up to 99% effective when used correctly (Kennedy et al 1992).
Lactational amenorrhea is variable, with some women reporting their first postpartum menses as late as 42 months. (I enjoyed 24 months with no periods following the birth of each of my children.)
Natural child spacing ensures both the optimal survival of each child and the mother’s physical recovery between pregnancies. In contrast, the formula-feeding mother requires contraception within six weeks of the birth.
The amount of iron a mother’s body uses in milk production is much less than the amount she would lose from menstrual bleeding, decreasing her risk of anemia.
The suppression of a woman’s menstrual cycle by exclusive breastfeeding reduces her lifetime exposure to estrogen, which ‘feeds’ cancers.
The recent research is particularly convincing.
In 2009, The American Institute for Cancer Research (a member of the International Agency for Research on Cancer, a part of the World Health Organization) released the largest review of research into lifestyle and breast cancer ever conducted, which reinforced previous findings that women can reduce their risk by maintaining a healthy weight, being physically active, drinking less alcohol, and breastfeeding their children.
In an eight-year study of over 60,000 women who had given birth, having breastfed at all provided up to a 59% reduction in the risk of developing pre-menopausal breast cancer in women with a family history of the disease (Stuebe et al 2009). That means, for women with a family history of breast cancer, breastfeeding can reduce the odds of developing pre-menopausal breast cancer by more than half.
Another meta study (compiling data from 47 smaller studies) concluded that a woman who breastfed for 12 months in her life reduced her risk of developing breast cancer by 4.3%. This benefit can be multiplied as a mother breastfeeds one child or several children. For example, a mother who has two children and breastfeeds each for two years can realize a 17.2% reduction in her risk of developing breast cancer later in her life (Collaborative Group on Hormonal Factors in Breast Cancer 2002).
The cumulative protective effect of lactation is one explanation for why developed countries, whose mothers breastfeed for shorter durations (or not at all) and have fewer children in their lifetimes, have higher rates of breast cancer.
The most recent review and meta-analysis (Islami et al. 2015) found that breastfeeding reduced the risk of hormone receptor negative tumors, a very aggressive type of breast cancer, by up to 20%. Even a brief period of breastfeeding reduced the risk of the tumors, which are more common in younger women.
Breastfeeding also lowers a mother’s risk of developing other cancers including ovarian, uterine and endometrial (Cramer 2012).
Production of milk is an active metabolic process, requiring the use of calories. Like any biological process, this varies from person to person, but if a mother exercises and eats a healthy diet, nature intends for her to lose the extra weight she puts on during pregnancy in the few years it intends her baby to get breast milk.
The reduction in BMI associated with just six months’ breastfeeding could importantly reduce women’s risk of obesity-related disease and their costs as they age (Bobrow et al 2013).
The findings of one study suggest that women who breastfeed have reduced amounts of abdominal fat, even decades later. Middle-aged women who consistently breastfed their children had waist circumferences that were an average of 2.6 inches smaller than women who had never breastfed (McClure et al 2010). Since the belly is the least healthy place for women to store fat, this is a compelling incentive to breastfeed.
Lactation may have persistent favorable effects on women’s cardiometabolic health, which is good news for diabetic mothers (Gunderson et al 2010) and an important consideration for all since heart attacks are the leading cause of death in women.
Breastfeeding substantially reduces the risk of type 2 diabetes in later life. (Liu et al 2010).
Researchers (Erica et al. 2015) evaluated nearly 1000 mothers from diverse backgrounds who had developed gestational diabetes during their pregnancies and monitored them closely for two years after the birth. Nearly 12% had gone on to develop type 2 diabetes. Those who breastfed for more than ten months cut their risk of a diabetes diagnosis by almost 60% in the two years they were followed. Of the women who only breastfed and used no formula for the first two months of the baby’s life, 8% developed diabetes, compared with 18% of the mothers who did not breastfeed and only used formula.
Calcium is necessary in the production of milk. Because women lose calcium while lactating, many people wrongly assumed an increased risk of osteoporosis for women who breastfed. However, current studies show that lactation is associated with greater maternal bone size and bone strength later in life (Wiklund et al 2012).
Women who breastfed had higher adjusted total body bone mineral content, total hip bone mineral density and lower fat mass than did parous non-breastfeeders (Paton et al 2003). Chantry et al (2004) concluded that breastfeeding may be protective to the bone health of adolescent mothers.
Women who had breastfed for 13 months or longer were half as likely to develop rheumatoid arthritis as those who had never breastfed. Those who breastfed for between one and 12 months had a 25% decreased risk (Pikwer et al 2008).
Breastfeeding mothers exhibit a less intense response to adrenaline (Altemus 1995). Breastfeeding compels mom to relax. For a start she is sitting or lying down. With an increase in maternal levels of natural opiates during lactation, the release of oxytocin (the hormone of love) followed by a release of prolactin (the milk-making and calming hormone), there comes a letting go, followed by a blissful serenity that helps her slow down to adopt this new pace of life, to cope and enjoy mothering.
All this is quite apart from the personal satisfaction and peace of mind she may have from doing what is best for her child, who will suffer fewer illnesses and will cost her nothing to feed for at least the first six months.
One study found that breastfeeding may protect against negative moods and stress. Breastfeeding mothers had more positive moods, reported more positive events and perceived less stress than formula-feeders (Groër 2005).
Doan et al (2007) found that mothers who exclusively breastfed slept an average of 40 minutes longer than mothers who supplemented with formula. Breastfeeding mothers are less tired and get more sleep than their formula or mixed-feeding counterparts and this lowers their risk of depression (Dorheim et al 2009). Doan and colleagues noted that supplementing with formula as a coping strategy for minimizing sleep loss can actually be detrimental because of its impact on prolactin production and secretion. Maintenance of breastfeeding, as well as deep restorative sleep stages, may be greatly compromised for new mothers who cope with infant feedings by supplementing in an effort to get more sleep.
A mother who feels that breastfeeding is the only thing that is working well in her life does well to continue if she chooses to take medication to treat her depression. Most antidepressants prescribed nowadays are compatible with breastfeeding, though not all GPs are aware of this.
Mothers who breastfeed may have a decreased risk of Alzheimer’s disease in later life (Fox et al 2013). The link may be down to breastfeeding’s action in restoring insulin sensitivity and glucose tolerance, which is significantly reduced during pregnancy. More research is needed to investigate the relationship between breastfeeding physiology and cognitive health.
The list of good things for mothers’ health resulting from breastfeeding is far from comprehensive and all women deserve to know about these very significant benefits.
From a mother’s perspective breastfeeding is a shared gift: one she gives to herself as well as to her baby.
Altemus, M. et al. Suppression of hypothalmic-pituitary-adrenal axis responses to stress in lactating women. J Clin Endocrinal Metab 1995; 80:2954.
Bobrow, K. et al. Persistent effects of women’s parity and breastfeeding patterns on their body mass index: results from the Million Women Study. International Journal of Obesity 2013; 37, 712–717.
Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet 2002; 360, 187–95.
Cramer, D. The epidemiology of endometrial and ovarian cancer. Hematol Oncol Clin North Am 2012; 26(1):1–12.
Doan, T. et al. Breastfeeding increases sleep duration of new parents Journal of Perinatal & Neonatal Nursing 2007; 21(3), 200–206.
Dorheim, S. et al. Sleep and depression in postpartum women: A population-based study. Sleep 2009; 32(7), 847–855.
Fox, M. et al. Maternal breastfeeding history and Alzheimer’s disease risk. Journal of Alzheimer’s Disease 2013; DOI 10.3233/JAD-130152.
Freudenheim, J. et al. Exposure to breastmilk in infancy and the risk of breast cancer. Epidemiology 1994; 5, 324–331.
Gunderson, E. et al. Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status: a 20-year prospective study in CARDIA (Coronary Artery Risk Development in Young Adults). Diabetes 2010; 59(2):495–504.
Gwinn, M. et al Pregnancy, breast feeding, and oral contraceptives and the risk of epithelial ovarian cancer. J Clin Epidemiol 1990; 43: 559–68.
Hunziker, U. et al. Increased carrying reduces infant crying: a randomized controlled trial. Pediatrics 1986;77(5):641–8.
Kennedy, K. et al. Contraceptive efficacy of lactational amenorrhoea. Lancet 1992; 25;339(8787):227–30.
McClure, C. et al. Presentation, American Heart Association’s Cardiovascular Disease Epidemiology and Prevention Annual Conference, San Francisco. 2010.
Paton, L. et al. Pregnancy and lactation have no long-term deleterious effect on measures of bone mineral in healthy women: a twin study. Am J Clin Nut 2003; 77: 707–14.
Stuebe, A. et al. Lactation and incidence of premenopausal breast cancer: a longitudinal study. Archives of Internal Medicine 2009; 169, 1364–1371.
World Cancer Research Fund and American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective Washington, DC: AICR, 2009.
Zinaman, M. et al. Acute prolactin and oxytocin responses and milk yield to infant suckling and artificial methods of expression in lactating women. Pediatrics 1992;89 (3): 437–40.
Barbara Higham has been a La Leche League Leader since 2004 and is managing editor of Breastfeeding Today for La Leche League International. She lives with Simon and their three children in Ilkley, Yorkshire, UK.