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PubMed1977

Unilateral breast-feeding and breast cancer.

Women of fishing villages in Hong Kong by custom breast-feed with only the right breast. The hypothesis that the unsuckled breast may have an altered risk of cancer development was investigated. Records of the radiotherapy divisions in Hong Kong between 1958 and 1975 were searched, and breast-cancer patients were interviewed for a detailed history of lactation. The overall left/right ratio of cancer in the breasts of 2372 women with unilateral breast carcinoma was 0-97, indicating that breast cancer was equally distributed between the two sides. Of 73 patients with a history of exclusively one-sided breast-feeding, 27 of 34 patients aged 55 or over (79-4%) and 19 of 39 patients under age 55 (48-7%) had a carcinoma in the unsuckled breast. Comparisons of patients who had nursed unilaterally with nulliparous patients and with patients who had borne children but had not breast-fed indicated a highly significant increased risk of cancer in the unsuckled breast. No statistically significant differences in laterality of breast cancer were found in 52 patients who had for convenience nursed to a greater extent from one side than the other. This study indicates that in post-menopausal women who have breast-fed unilaterally, the risk of cancer is significantly higher in the unsuckled breast and that breast-feeding may help to protect the suckled breast against cancer.

Adult↗
PubMed1990

[Breast feeding following breast reduction-plasty and mastopexy?].

A certain amount of breast tissue remains connected with the nipple after aesthetic breast surgery, except in cases of free nipple grafting. Breast feeding is therefore possible. The obstetrician or the midwife are often with the question, whether breast feeding can be recommended. In this study we have investigated, whether lactation is adversely affected by breast surgery. 105 patients who had been operated for unilateral or bilateral mammahyperplasia or mammoptosis, were examined and questioned about breast feeding after operation. The operative techniques of McKissock, Pitanguy and Strömbeck had been used. Breast feeding attitude of our patients was compared with a corresponding collective without breast surgery from the 2nd University Clinic, Gynaecological Department. Five of 14 patients breastfed their babies. The remaining patients did not breastfeed, either after having been counselled not to breastfeed or because of admission of the newborn to a neonatal care unit. Only in two patients no lactation was observed. In our opinion, patients should be informed and encouraged, that breastfeeding is possible after aesthetic breast surgery.

Adult↗
PubMed1992

[Breast feeding after breast reduction].

Few authors have addressed the feasibility of breast-feeding after a reduction mammaplasty. Nowadays, the majority of plastic surgeons perform breast reductions with techniques preserving the continuity of the nipple-areola complex with the retained breast tissue. These pedicle techniques should permit lactation as opposed to the free nipple grafting technique used earlier. To find out how many women nurse their children after a reduction mammaplasty, we reviewed 806 charts to identify 243 women having had a pedicle technique breast reduction, between 1967-1987, at the age of 15 to 35 years. These women were contacted and 98 of them were reached. Eighteen women had become pregnant after their surgery. They agreed to answer a questionnaire regarding their decision to nurse their children, the duration of breast-feeding and the difficulties encountered. Eight of eighteen mothers (45%) nursed their children up to 32 weeks (mean 11 weeks). Among them, 3 nursed for less than 3 weeks and 5 nursed from 3 to 32 weeks (mean 20 weeks). Only one mother had to supplement nursing with formula. Two mothers used mixed formula and breast-feeding when they returned to work. Ten of eighteen mothers (55%) did not breast-feed for the following reasons: 6 by personal choice, 2 due to premature delivery, one was advised that nursing was not feasible and one had no lactation. We believe that the nursing capacity of the breast is preserved after a breast reduction and that women should be encouraged to nurse their children.

Adolescent↗
PubMed1985

Should hepatitis B surface antigen positive mothers breast feed?

Breast fed infants may be at greater risk of mother to infant hepatitis B virus infection compared with formula fed infants. We studied 85 infants born to 84 hepatitis B surface antigen positive mothers (only two of whom were hepatitis B e positive), and who had received immunisation against hepatitis B virus. Our results indicate that breast feeding does not increase the risk of developing hepatitis B virus infection in infants born to these mothers if immunisation is carried out.

Breast Feeding↗
PubMed2006

Pregnancies, breast-feeding, and breast cancer risk in the International BRCA1/2 Carrier Cohort Study (IBCCS).

BACKGROUND: Multiparity, young age at first childbirth, and breast-feeding are associated with a reduced risk of breast cancer in the general population. The breast cancer predisposition gene, BRCA1, regulates normal cell differentiation. Because mammary gland cells divide and differentiate during pregnancy, reproductive factors may influence breast cancer risk in BRCA1/2 mutation carriers differently than they do in noncarriers. METHODS: We performed a retrospective cohort study of 1601 women in the International BRCA1/2 Carrier Cohort Study cohort, all of whom carried a mutation in BRCA1 or BRCA2. Information on reproductive factors was obtained from a questionnaire. At the time of interview 853 subjects were classified with breast cancer. Data were analyzed by using a weighted cohort approach. All statistical tests were two-sided. RESULTS: There was no statistically significant difference in the risk of breast cancer between parous and nulliparous women. Among parous women, an increasing number of full-term pregnancies was associated with a statistically significant decrease in the risk of breast cancer (Ptrend = .008); risk was reduced by 14% (95% confidence interval [CI] = 6% to 22%) for each additional birth. This association was the same for carriers of mutations in either BRCA1 or BRCA2 and was restricted to women older than 40 years. In BRCA2 mutation carriers, first childbirth at later ages was associated with an increased risk of breast cancer compared with first childbirth before age 20 years (20-24 years, hazard ratio [HR] = 2.33 [95% CI = 0.93 to 5.83]; 25-29 years, HR = 2.68 [95% CI = 1.02 to 7.07]; > or = 30 years, HR = 1.97 [95% CI = 0.67 to 5.81]), whereas in BRCA1 mutation carriers, first childbirth at age 30 years or later was associated with a reduced risk of breast cancer compared with first childbirth before age 20 years (HR = 0.58 [95% CI = 0.36 to 0.94]). Neither history of interrupted pregnancies (induced abortions or miscarriage) nor history of breast-feeding was statistically significantly associated with the risk of breast cancer. CONCLUSIONS: BRCA1 and BRCA2 mutation carriers older than 40 years show a similar reduction in breast cancer risk with increasing parity as non-carriers.

Abortion, Induced↗
PubMed1993

Breast-feeding and breast cancer in the offspring.

The causation of breast cancer in certain strains of mice by a virus that can be transmitted vertically, through the milk produced during lactation, has led to the hypothesis that a similar phenomenon could exist in humans. There have been laboratory-based studies in humans suggesting that a virus may be involved in the etiology of female breast cancer although other investigations did not support this hypothesis. Descriptive data and epidemiologic evidence of ecologic nature do not indicate a role of lactation in the causation of human breast cancer, but the hypothesis has not been adequately assessed in analytic epidemiologic studies. A nested case-control study undertaken in Sweden to examine the role of prenatal factors on breast cancer risk in the offspring, allowed the evaluation of the importance of breast-feeding in the causation of this disease. Standardised records concerning women born at the Uppsala University Hospital from 1874 to 1954 were linked with invasive breast cancer incident cases, identified through their unique national registration number in the Swedish Cancer Registry during 1958-1990. For each case with breast cancer, the females born to the first three mothers admitted after the case's mother were selected as potential matching controls. Only controls living in Sweden and free from breast cancer until the time of diagnosis of breast cancer in the corresponding case were eventually included in the study. The analysis was based on 458 cases of breast cancer born in singleton pregnancies and 1,197 singleton age- and birth date-matched controls. Breast-feeding was not a significant or suggestive risk factor for breast cancer in the offspring; compared to women who at discharge were wholly or partly breastfed, women who as newborn were not breastfed had a relative risk of breast cancer of 0.97 with 95% confidence interval 0.44-2.17 (P = 0.95).

Breast Feeding↗
PubMed1998

Early and late effects of breast-feeding: does breast-feeding really matter?

Breast-feeding protects the newborn against infectious diseases in developing as well as in industrialized countries. Protection is conferred against gastrointestinal and respiratory tract diseases as well as against otitis media. This protection provided by specific (antibody dependent) and broad, nonspecific protective factors in human milk (proteins, glycoproteins, and lipids) is associated with lower global morbidity and mortality of breast-fed infants as compared with formula-fed infants. While protection against diseases that develop later in life, such as insulin-dependent diabetes mellitus, inflammatory bowel disease, and childhood cancer, has been reported, well-planned prospective studies are essential in order to confirm these observations. Similar studies are essential in order to ascertain the small but consistently reported higher cognitive ability of breast-fed infants.

Anti-Infective Agents↗
PubMed1997

Dynamics of human milk extraction: a comparative study of breast feeding and breast pumping.

We describe a mathematical model of the flow and deformation in a human teat. Our aim is to compare the theoretical milk yield during infant breast feeding with that obtained through the use of a breast pump. Infants use a peristaltic motion of the tongue, along with some suction, to extract milk, whereas breast pumps use a cyclic pattern of suction only. Our model is based on quasi-linear poroelasticity whereby the teat is modelled as a cylindrical porous elastic material saturated with fluid. We impose a cyclic axial suction pressure difference across the teat and impose a radial compressive force moving along the teat which mimics infant suckling. This is compared to the case of cyclic and steady pumping only which models the action of breast pumps. The results illustrate that there is an optimal time to apply the compressive force during the suction cycle that will increase the flow rate in our theoretical teat. The model and results may be of use in the future design of effective breast pumps.

Breast Feeding↗
PubMedDate not supplied

A community study of a decade of in-hospital breast-feeding: implications for breast-feeding promotion.

Information concerning a subject of interest to the health community may be gathered through simple, low-cost minisurveys. Data were gathered on postpartum breast-feeding in one community in 1974, 1979, and 1984. This community mirrored national trends and offered additional information on areas of programmatic interest; findings also confirmed the hypothesis that education and national trends over time had statistically significant relationships with the choice to breast-feed. Of special note is the finding that the level of knowledge concerning infant feeding is closely linked to the choice to breast-feed, as is the relationship between the primary influence of another woman and the choice to breast-feed. With level of education controlled for, both associated variables remained significant for women with lower levels of education, the group least likely to select breast-feeding. This would suggest the probable advantage of breast-feeding promotion based on woman-to-woman contact during preconception and antepartum periods; such a program might be particularly effective with women of lower educational levels.

Adult↗
PubMed1997

Evaluation of biochemical indicators of vitamin A status in breast-feeding and non-breast-feeding Indonesian women.

Indicators of vitamin A status were evaluated in nonpregnant breast-feeding (n = 265) and nonpregnant non-breast-feeding (n = 49) Indonesian women. The concentration of vitamin A (not including provitamin A carotenoids) and fat in breast milk was 30% and 20% higher, respectively, for women with a breast-fed child 7-18 mo old than for women with an infant 3-6 mo old. The vitamin A content of milk fat was constant throughout lactation. Breast-milk vitamin A was most sensitive to changes in vitamin A status when expressed per volume. Sensitivity and specificity for detecting serum retinol concentrations < 0.70 mumol/L were < 75% for the concentration of breast-milk vitamin A and serum retinol binding protein (RBP). The modified-relative-dose-response (MRDR) method suffers from a relatively large intraindividual variation in the ratio of dehydroretinol to retinol because of vulnerability of the dehydroretinol concentration to laboratory errors and to variation in dosing and absorption. Within categories of dehydroretinol:retinol, serum retinol concentration was lower in breast-feeding women than in non-breast-feeding women. Thus, it may be necessary to use different cutoff values for the ratio and for serum retinol concentration. Serum retinol concentration, which was just above marginal (0.85 mumol/L), had the smallest within-person variation and was also the most sensitive indicator for detecting a difference between groups in change in vitamin A status postintervention, requiring only 19 subjects per group. Serum RBP concentration, breast-milk vitamin A expressed per volume or per gram milk fat, and the MRDR method required groups of 35, 36, 139, and 53 subjects, respectively.

Adolescent↗
PubMed2000

[Seven years of experience at a specialized breast feeding clinic. Incorrect breast feeding technique and milk stasis are the most common problems].

Breastfeeding is internationally important, providing benefits both immunologically and emotionally. A specialized breastfeeding-unit at the hospital Södersjukhuset in Stockholm has evolved continually since its inception in 1993. Attendance figures for 1994-1998 are shown, and the treatments for the most frequent diagnoses are described. The most common complications in breastfeeding seen at this unit are 1) problems in breastfeeding technique, e.g. nipple wounds cause breastfeeding difficulties; 2) breast engorgement, both with and without bacterial infection; and 3) pain of unknown etiology and infections without mastitis, including Candida and bacterial infections. The most important strategy for treatment is to observe the moment of breastfeeding and give individual advice (the procedure is described).

Breast Diseases↗