Skip to main content Accessibility help
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 1
  • Print publication year: 2010
  • Online publication date: February 2010

Chapter 11 - Maternal and offspring benefits of breast-feeding

from Section 2 - Nutritional regulation and requirements for lactation and infant growth


Individualized fetal growth curves can be used to assess the appropriateness of fetal growth given the nonpathological characteristics or predict size at birth given all growth-determining characteristics of the pregnancy. Fetal growth may be affected by the mother's nutrition throughout her life. In developed countries, adequate micronutrition before conception and avoidance of teratogens in early pregnancy are the nutritional factors most relevant to optimal fetal growth. Under famine or near-famine conditions, fetal growth appears increasingly restrained by a lack of maternal energy supply as pregnancy progresses. In the developed world, the major causes of fetal growth pathology are maternal vascular disease, particularly preeclampsia, maternal infections, particularly of the genitourinary tract, chromosomal and genetic anomalies, and, increasingly, syndrome X, the metabolic anomaly that includes diabetes and insulin resistance. There is some evidence that these may respond to micronutritional therapy.


1. LawrenceRA, and LawrenceRM, Breast-Feeding: A Guide for the Medical Profession, 5th edn (St. Louis, MO: Mosby, 1999).
2. Centers for Disease Control and Prevention, Breast-feeding Practices – Results from the National Immunization Survey (2007). Available at: (accessed October 1, 2007).
3. Ross Laboratories Mothers’ Survey,1965–2006, Columbus, OH. Wenjun Zhou, personal communication.
4. JensenRG, and Lammi-KeefeCJ, Current status of research on the composition of bovine and human milk lipids. In: ed. HuangYS and SinclairAJ, Lipids in Infant Nutrition (Champaign, IL: AOCS Press, 1998), pp. 168–91.
5. FosterLH and SumarS, Infant formulas – a brief insight. Nutr Food Sci (1997), 97(3):112–116.
6. U.S. Department of Health and Human Services, Healthy People 2010: Objectives for Improving Health Volume 2, 2nd edn (Washington, DC: U.S. Government Printing Office, 2000). Available at: (accessed October 30, 2007).
7. RothmanKJ, and GreenlandS, Modern Epidemiology, 2nd edn (Philadelphia: Lippincott-Raven, 1998).
8. World Health Organization, Indicators for Assessing Breast-Feeding Practices (1991). Available at: health/New_Publications/NUTRITION/WHO_CDD_SER_91.14.pdf (accessed August 6, 2007).
9. HansonLA, Session 1: Feeding and infant development breast-feeding and immune function. Proc Nutr Soc (2007), 66:384–96.
10. KramerMS, ChalmersB, HodnettED, SevkovskayaZ, DzikovichI, and ShapiroS, et al., Promotion of Breast-feeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA (2001), 285:413–20.
11. DuncanB, EyJ, HolbergCJ, WrightAL, MartinezFD, and TaussigLM, Exclusive breast-feeding for at least 4 months protects against otitis media. Pediatrics (1993), 91:867–72.
12. QuigleyMA, KellyYJ, and SackerA, Breast-feeding and hospitalization for diarrheal and respiratory infection in the United Kingdom Millennium Cohort Study. Pediatrics (2007), 119:e837–42.
13. WHOCollaborative Study Team on the Role of Breast-feeding on the Prevention of Infant Mortality, Effect of breast-feeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet (2000), 355:451–5.
14. BhandariN, BahlR, MazumdarS, MartinesJ, BlackRE, BhanMK, et al., Effect of community-based promotion of exclusive breast-feeding on diarrhoeal illness and growth: a cluster randomised controlled trial. Lancet (2003), 361:1418–23.
15. Centers for Disease Control and Prevention, Does breast-feeding reduce the risk of pediatric overweight? (2007). Available at: (accessed August 31, 2007).
16. TorgusJ and GotschG, for La Leche League International, The Womanly Art of Breast-Feeding, 7th rev. edn (Schaumburg, IL: La Leche League International, 2004).
17. HeinigMJ, NommsenLA, PeersonJM, LonnerdalB, and DeweyKG, Energy and protein intakes of breast-fed and formula-fed infants during the first year of life and their association with growth velocity: the DARLING Study. Am J Clin Nutr (1993), 58:152–61.
18. ErikssonJ, ForsenT, TuomilehtoJ, OsmondC, and BarkerD, Size at birth, childhood growth and obesity in adult life. Int J Obes Relat Metab Disord (2001), 25:735–40.
19. ChellakootyM, JuulA, BoisenKA, DamgaardIN, KaiCM, SchmidtIM, et al., A prospective study of serum insulin-like growth factor I (IGF-I) and IGF-binding protein-3 in 942 healthy infants: associations with birth weight, gender, growth velocity, and breast-feeding. J Clin Endocrinol Metab (2006), 91:820–6.
20. LucasA, SarsonDL, BlackburnAM, AdrianTE, Aynsley-GreenA, and BloomSR, Breast vs bottle: endocrine responses are different with formula feeding. Lancet (1980), 1:1267–9.
21. SavinoF, CostamagnaM, PrinoA, OggeroR, and SilvestroL, Leptin levels in breast-fed and formula-fed infants. Acta Paediatr (2002), 91:897–902.
22. TaverasEM, Rifas-ShimanSL, ScanlonKS, Grummer-StrawnLM, SherryB, and GillmanMW, To what extent is the protective effect of breast-feeding on future overweight explained by decreased maternal feeding restriction?Pediatrics (2006), 118:2341–8.
23. OwenCG, MartinRM, WhincupPH, SmithGD, and CookDG, Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics (2005), 115:1367–77.
24. MichelsKB, WillettWC, GraubardBI, VaidyaRL, CantwellMM, SansburyLB, et al., A longitudinal study of infant feeding and obesity throughout life course. Int J Obes (2007), 31:1078–85.
25. FarquharsonJ, JamiesonEC, AbbasiKA, PatrickWJ, LoganRW, and CockburnF, Effect of diet on the fatty acid composition of the major phospholipids of infant cerebral cortex. Arch Dis Child (1995), 72:198–203.
26. Crawford, MA, The role of essential fatty acids in neural development: implications for perinatal nutrition. Am J Clin Nutr (1993), 57(Suppl):703S–10S.
27. AndersonJW, JohnstoneBM, and RemleyDT, Breast-feeding and cognitive development: a meta-analysis. Am J Clin Nutr (1999), 70:525–35.
28. DerG, BattyGD, and DearyIJ, Effect of breast feeding on intelligence in children: prospective study, sibling pairs analysis, and meta-analysis. BMJ (2006), 333:945.
29. JacobsonSW, ChiodoLM, and JacobsonJL, Breast-feeding effects on intelligence quotient in 4- and 11-year-old children. Pediatrics (1999), 103:e71.
30. ZhouSJ, BaghurstP, GibsonRA, and MakridesM, Home environment, not duration of breast-feeding, predicts intelligence quotient of children at four years. Nutrition (2007), 23:236–41.
31. OddyWH, A review of the effects of breast-feeding on respiratory infections, atopy, and childhood asthma. J Asthma (2004), 41:605–21.
32. GdalevichM, MimouniD, and MimouniM, Breast-feeding and the risk of bronchial asthma in childhood: a systematic review with meta-analysis of prospective studies. J Pediatr (2001), 139:261–6.
33. BurgessSW, DakinCJ, and O'CallaghanMJ, Breast-feeding does not increase the risk of asthma at 14 years. Pediatrics (2006), 117:e787–92.
34. SearsMR, GreeneJM, WillanAR, TaylorDR, FlanneryEM, CowanJO, et al., Long-term relation between breast-feeding and development of atopy and asthma in children and young adults: a longitudinal study. Lancet (2002), 360:901–7.
35. EnglerMM, EnglerMB, KroetzDL, BoswellKD, NeeleyE, and KrassnerSM, The effects of a diet rich in docosahexaenoic acid on organ and vascular fatty acid composition in spontaneously hypertensive rats. Prostaglandins Leukot Essent Fatty Acids (1999), 61:289–95.
36. MartinRM, GunnellD, and SmithGD, Breast-feeding in infancy and blood pressure in later life: systematic review and meta-analysis. Am J Epidemiol (2005), 161:15–26.
37. SarkarNH and MooreDH, On the possibility of a human breast cancer virus. Nature (1972), 236:103–6.
38. MartinRM, MiddletonN, GunnellD, OwenCG, and SmithGD, Breast-feeding and cancer: the Boyd Orr cohort and a systematic review with meta-analysis. J Natl Cancer Inst (2005), 97:1446–57.
39. MichelsKB, TrichopoulosD, RosnerBA, HunterDJ, ColditzGA, HankinsonSE, et al., Being breast-fed in infancy and breast cancer incidence in adult life: results from the two nurses’ health studies. Am J Epidemiol (2001), 153:275–83.
40. VaaralaO, Is type 1 diabetes a disease of the gut immune system triggered by cow's milk insulin?Adv Exp Med Biol (2005), 569:151–6.
41. HarrisonLC and HoneymanMC, Cow's milk and type 1 diabetes: the real debate is about mucosal immune function. Diabetes (1999), 48:1501–7.
42. NorrisJM and ScottFW, A meta-analysis of infant diet and insulin-dependent diabetes mellitus: do biases play a role?Epidemiology (1996), 7:87–92.
43. CouperJJ, SteeleC, BeresfordS, PowellT, McCaulK, PollardA, et al., Lack of association between duration of breast-feeding or introduction of cow's milk and development of islet autoimmunity. Diabetes (1999), 48:2145–9.
44. HolmbergH, WahlbergJ, VaaralaO, LudvigssonJ, and the ABIS Study Group, Short duration of breast-feeding as a risk-factor for beta-cell autoantibodies in 5-year-old children from the general population. Br J Nutr (2007), 97:111–16.
45. ZieglerAG, SchmidS, HuberD, HummelM, and BonifacioE, Early infant feeding and risk of developing type 1 diabetes-associated autoantibodies. JAMA (2003), 290:1721–8.
46. OwenCG, MartinRM, WhincupPH, SmithGD, and CookDG, Does breast-feeding influence risk of type 2 diabetes in later life? A quantitative analysis of published evidence. Am J Clin Nutr (2006), 84:1043–54.
47. RussoJ and RussoIH, Toward a physiological approach to breast cancer prevention. Cancer Epidemiol Biomarkers Prev (1994), 3:353–64.
48. HendersonBE, RossRK, JuddHL, KrailoMD, and PikeMC, Do regular ovulatory cycles increase breast cancer risk?Cancer (1985), 56:1206–8.
49. LipworthL, BaileyLR, and TrichopoulosD, History of breast-feeding in relation to breast cancer risk: a review of the epidemiologic literature. J Natl Cancer Inst (2000), 92:302–12.
50. DewaillyE, AyotteP, and BrissonJ, Protective effect of breast feeding on breast cancer and body burden of carcinogenic organochlorines. J Natl Cancer Inst (1994), 86:803.
51. Collaborative Group on Hormonal Factors in Breast Cancer, Breast cancer and breast-feeding: 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.
52. RosenblattKA, Li GaoD, RayRM, and ThomasDB, Re: History of breast-feeding in relation to breast cancer risk: a review of the epidemiologic literature. J Natl Cancer Inst (2000), 92:942; author reply 943.
53. MichelsKB, WillettWC, RosnerBA, MansonJE, HunterDJ, ColditzGA, et al., Prospective assessment of breast-feeding and breast cancer incidence among 89,887 women. Lancet (1996), 347:431–6.
54. TryggvadottirL, TuliniusH, EyfjordJE, and SigurvinssonT, Breast-feeding and reduced risk of breast cancer in an Icelandic cohort study. Am J Epidemiol (2001), 154:37–42.
55. WatsonCJ, Post-lactational mammary gland regression: molecular basis and implications for breast cancer. Expert Rev Mol Med (2006), 8:1–15.
56. ZahorickM and WebberV, Postpartum body image and weight loss. New Beginnings (2000), 17:156–9. Available at: (accessed June 30, 2007).
57. DeweyKG, Energy and protein requirements during lactation. Annu Rev Nutr (1997), 17:19–36.
58. DeweyKG, Impact of breast-feeding on maternal nutritional status. Adv Exp Med Biol (2004), 554:91–100.
59. JanneyCA, ZhangD, and SowersM, Lactation and weight retention. Am J Clin Nutr (1997), 66:1116–24.
60. DeweyKG, CohenRJ, BrownKH, and RiveraLL, Effects of exclusive breast-feeding for four versus six months on maternal nutritional status and infant motor development: results of two randomized trials in Honduras. J Nutr (2001), 131:262–7.
61. SichieriR, FieldAE, Rich-EdwardsJ, and WillettWC, Prospective assessment of exclusive breast-feeding in relation to weight change in women. Int J Obes Relat Metab Disord (2003), 27:815–20.
62. DeweyKG, HeinigMJ, and NommsenLA, Maternal weight-loss patterns during prolonged lactation. Am J Clin Nutr (1993), 58:162–6.
63. BrewerMM, BatesMR, and VannoyLP, Postpartum changes in maternal weight and body fat depots in lactating vs nonlactating women. Am J Clin Nutr (1989), 49:259–65.
64. ButteNF, HopkinsonJM, MehtaN, MoonJK, and SmithEO, Adjustments in energy expenditure and substrate utilization during late pregnancy and lactation. Am J Clin Nutr (1999), 69:299–307.
65. DinizJM and Da CostaTH, Independent of body adiposity, breast-feeding has a protective effect on glucose metabolism in young adult women. Br J Nutr (2004), 92:905–12.
66. JonesRG, IlicV, and WilliamsonDH, Physiological significance of altered insulin metabolism in the conscious rat during lactation. Biochem J (1984), 220:455–60.
67. StuebeAM, Rich-EdwardsJW, WillettWC, MansonJE, and MichelsKB, Duration of lactation and incidence of type 2 diabetes. JAMA (2005), 294:2601–10.
68. KnoppRH, WaldenCE, WahlPW, BergelinR, ChapmanM, IrvineS, et al., Effect of postpartum lactation on lipoprotein lipids and apoproteins. J Clin Endocrinol Metab (1985), 60:542–7.
69. StuebeAM, MichelsKB, WillettWC, MansonJE, and Rich-EdwardsJW, Duration of lactation and incidence of myocardial infarction. Am J Obstet Gynecol (2006), 195:S34.
70. LeeSY, KimMT, JeeSH, and YangHP, Does long-term lactation protect premenopausal women against hypertension risk? A Korean women's cohort study. Prev Med (2005), 41:433–8.
71. GundersonEP, LewisCE, WeiGS, WhitmerRA, QuesenberryCP, and SidneyS, Lactation and changes in maternal metabolic risk factors. Obstet Gynecol (2007), 109:729–38.