Breastfeeding Benefits

Babies who are breastfed exclusively have a much reduced risk of developing pyloric stenosis, a condition affecting the band of muscle surrounding the area where the stomach empties into the small intestine, a study in Pediatrics concludes.  Since pyloric stenosis is the most common reason for surgery in infants, and bottle fed babies experience an almost fivefold increased risk of developing the condition, it seems well worth at least attempting breastfeeding, Rick and I agree on PodMed.  We're also startled and chagrined that in almost 8 years of recording the podcast we haven't yet delved into the multitude of benefits related to breastfeeding.  Mea culpa!

This study took data from the Danish National Birth Cohort between 1996 and 2002, containing information on infants and feeding practices.  This time period was selected because in Denmark, the frequency of breastfeeding increased during the 1990s, and the incidence of pyloric stenosis decreased.  Having made this association, the national registry allowed closer scrutiny of feeding practices and development of the condition.

Over 70,000 infants were included in this analysis.  Inclusion criteria included singleton birth, since multiples are at higher risk of pyloric stenosis even before feeding practices are considered, and having a mother who answered questions about feeding practices at a 6-month postpartum interview.  Moms were asked by telephone about whether they were currently breastfeeding, how long they had fully breastfed their child, and how old their children were if and when they stopped breastfeeding.

Information on surgery related to correcting pyloric stenosis was obtained from the Danish National Patient Register. A total of 65 cases were included in the this study. Of this number, 91% were male, and they developed the condition at a median age of 35 days.  The hazard ratio for infants who were bottlefed compared with those who were breastfed was 4.62. This association remained robust even among infants who were partially breastfed or in whom bottlefeeding was instituted after breastfeeding for a time.  Once again, the obvious conclusion seems to be that breastfeeding is preferable with regard to reducing the risk of pyloric stenosis. What's the potential as far as a mechanism?

The authors cite increased difficulty with digestion and delayed gastric emptying as possible reasons why bottlefeeding may precipitate pyloric stenosis.  They also speculate that boy infants may eat more at each feeding and therefore stress the pyloric valve more, perhaps at least partially accounting for the disproportionate number of boys with the condition.

Abundant previous research clearly establishes the superiority of breastfeeding for both mother and baby, and this study seems to add to it.  By whatever metric applied, breastfed babies seem more likely to thrive as well as their mothers.  Clearly, we need to support women in making this choice not just in medical circles but societally.

Other topics this week include the risk of recurrent gastric bleeds in people who've been taking warfarin and already experienced one in Archives of Internal Medicine, fumarate for multiple sclerosis in the New England Journal of Medicine, and long term outcomes of gastric bypass surgery in the Journal of the American Medical Association.  Until next week, y'all live well.

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{ 3 comments… read them below or add one }


ranjana April 1, 2013 at 8:01 am

Your tips for free breastfeeding guide are very helpful to new mothers. Thanks for sharing this informative post.


ranjana February 13, 2013 at 8:12 am

Thank you so much for sharing this informative post. I would understand the benefits of breastfeeding with the help of your blog,Thanks again.


Andy September 27, 2012 at 10:14 am

As a father who is in favor of breastfeeding for infants I was confused by your (and the study authors) use of the term "bottle feeding". My wife pumped breast milk and I bottle fed it to our son when my wife was not home. Page 3 of the article has this statement: "We therefore assumed that the bottle-fed infants were fed artificial formula milk. Information on the brand of formulas was not
available from the interview."
This makes me wonder where infants who are fed breast milk in bottles fall. At the very least this was a poor assumption to make. This may have more to do with Danish attitudes to breast feeding. In the United States, as determined by brisk sales of breast pumps, this report may not apply.


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