Breastfeeding may be a protective factor in stroke risk reduction in postmenopausal women.

New research published yesterday in the Journal of the American Heart Association reports on an association and dose‐response relationship between breastfeeding and lower risk of stroke among postmenopausal women, after adjustment for multiple stroke risk factors and lifestyle variables.

Stroke is the third leading cause of death among US Hispanic and non‐Hispanic black women aged 65 and older. Few studies have assessed the association between breastfeeding and stroke risk before and whether this association differs according to race and ethnicity.

The Women’s Health Initiative has been tracking medical events and the health of postmenopausal women recruited between 1993 and 1998. Researchers in the new study analyzed the data on 80,191 participants. At the time of recruitment, the average age was 63.7 years and the follow-up period was 12.6 years. All the women had given birth to one or more children. 58% reported ever having breastfed and 51% of those had breastfed for one to six months, 22% for seven to 12 months and 27% for 13 months or longer.

The researchers adjusted for the factors of age, family history, education, age at menarche, health, diet and smoking. They found stroke risk amongst women who had breastfed their babies was on average:

  • 23% lower in all women
  • 48% lower in black women
  • 32% lower in Hispanic women
  • 21% lower in white women
  • 19% lower in women who had breastfed for up to six months
Courtesy of Lena Ostroff

This association of a lower risk of stroke among postmenopausal women and particularly non‐Hispanic black women remained statistically significant even after adjustment for other stroke risk factors potentially modified by or associated with lactation.

The findings might partially be explained by the fact that breastfeeding women tend to live healthier lives than those who do not breastfeed, indicating that breastfeeding is more of a risk marker than risk factor. We may still conclude, however, that breastfeeding along with other risk factors or markers during women’s early reproductive years may be associated with stroke risk later in life, and this information may help health care providers when assessing risk profiles.

Taking account of these risks, the medical and behavioral science communities may be better able to design, implement and administer culturally informed programs to help mitigate stroke risk while promoting healthy behaviors and breastfeeding in populations that are most at risk. Future studies are warranted to investigate the effectiveness of these types of intervention. Increasing public awareness of the potential impact of breastfeeding on maternal health outcomes later in life may assist in the initiation and continuation of breastfeeding for those at greatest risk.

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Battling Over BirthJacobson, L.T., Hade, E.M., Collins, T.C., Margolis, K.L., Waring, M.E., Van Horn, L.V., Silver, B., et al. Breastfeeding history and risk of stroke among parous postmenopausal women in the Women’s Health Initiative. JAHA, August, 22, 2018;7:e008739