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Health effects of breast feeding for mothers: a critical review

Published online by Cambridge University Press:  14 December 2007

M. Jane Heinig
Affiliation:
Department of Nutrition, University of California, Davis, CA 95616, USA
Kathryn G. Dewey
Affiliation:
Department of Nutrition, University of California, Davis, CA 95616, USA
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Abstract

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Lactation results in a number of physiological adaptations which exert direct effects on maternal health, some of which may confer both short and long term advantages for breast feeding mothers. Breast feeding in the early postpartum period promotes a more rapid return of the uterus to its prepregnant state through the actions of oxytocin. Breast feeding may also lead to a more rapid return to prepregnancy weight. Among studies that had good data on duration and intensity of lactation, the majority show a significant association between lactation and weight loss. However, there is no evidence that lactation prevents obesity. Lactation also affects glucose and lipid metabolism. The long term effects of these adaptations are unknown but may have implications for preventing subsequent development of diabetes and heart disease. Lactation delays the return of ovulation and significantly reduces fertility during the period of lactational amenorrhoea. This process is linked with feeding patterns and may therefore be affected by practices such as scheduled feedings and the timing of introduction of complementary foods. While the evidence from epidemiologic studies is mixed, several large studies have shown that extended lactation is associated with reduced risk of premenopausal breast, ovarian and endometrial cancers. Although bone mineralization declines during lactation, repletion takes place after weaning. As a result, breast feeding does not appear to cause long term depletion of bone nor does it increase risk of osteoporosis. Many of the physiological effects of lactation are dependent on the stimulation of the hypothalamic-pituitary axis and milk removal and thus may vary with infant feeding practices. Well controlled studies are needed that include detailed information regarding infant feeding practices in addition to the total duration of any breast feeding. Future feeding recommendations should reflect careful consideration of how such practices affect both infant and maternal health.

Type
Research Article
Copyright
Copyright © The Nutrition Society 1997

References

Adair, L. S. & Popkin, B. M. (1992). Prolonged lactation contributes to depletion of maternal energy reserves in Filipinowomen. Journal of Nutrition 122, 16431655.CrossRefGoogle Scholar
Adami, H. O., Bergstrom, R., Lund, E, & Meirik, O. (1990). Absence of association between reproductive variables and the risk of breast cancer in young women in Sweden and Norway. British Journal of Cancer 62, 122126.CrossRefGoogle ScholarPubMed
Alderman, B. W., Weiss, N. S., Daling, J. R., Ure, C. L. & Ballard, J. H. (1986). Reproductive history and postmenopausal risk of hip and forearm fracture. American Journal of Epidemiology 124, 262267.CrossRefGoogle ScholarPubMed
Aloia, J. F., Cohn, S. H., Vaswani, A.Yeh, J. K., Yuen, K. & Ellis, K. (1985). Risk factors for postmenopausal osteoporosis. American Journal of Medicine 78, 95100.CrossRefGoogle ScholarPubMed
Aloia, J. F.Vaswani, A. N., Yeh, J. K., Ross, P.Ellis, K. & Cohn, S. H. (1983). Determinants of bone mass in postmenopausal women. Archives of Internal Medicine 143, 17001704.CrossRefGoogle ScholarPubMed
Atkinson, P. J., & West, R. R. (1970). Loss of skeletal calcium in lactating women. Journal of Obstetrics and Gynaecology of the British Commonwealth 77, 555560.CrossRefGoogle ScholarPubMed
Baird, D. T., McNeilly, A. S., Sawers, R. S. & Sharpe, R. M. (1979). Failure of estrogen-induced discharge of luteinizing hormone in lactating women. Journal of Clinical Endocrinology and Metabolism 49, 500506.CrossRefGoogle ScholarPubMed
Bauchner, H., Leventhal, J. M, & Shapiro, E. D. (1986). Studies of breastfeeding and infections: How good is the evidence? Journal of the American Medical Association 256, 887892.CrossRefGoogle ScholarPubMed
Bauer, D. C., Browner, W. S., Cauley, J. A., Orwoll, E. S., Scott, J. C., Black, D. M., Tao, J. L. & Cummings, S. R. (1993). Factors associated with appendicular bone mass in older women. Annals of Internal Medicine 118, 657665.CrossRefGoogle ScholarPubMed
Berning, B., van Kuijk, C., Schutte, H. E., Kuiper, J. W., Drogendijk, A. C. & Fauser, C. J. M. (1993). Determinants of lumbar bone mineral density in normal weight, non-smoking women soon after menopause. A study using clinical data and quantitative computed tomography. Bone and Mineral 21. 129139.CrossRefGoogle ScholarPubMed
Bjorkelund, C., Lissner, L., Andersson, S., Lapidus, L. & Bengtsson, C. (1996). Reproductive history in relation to relative weight and fat distribution. International Journal of Obesity and Related Metabolic Disorders 20, 213219.Google ScholarPubMed
Boardley, D. J., Sargent, R. G., Coker, A. L., Hussey, J. R. & Sharpe, P. A. (1995). The relationship between diet, activity, and other factors, and postpartum weight change by race. Obstetrics and Gynecology 86. 834838.CrossRefGoogle ScholarPubMed
Brewer, M. M., Bates, M. R. & Vannoy, L. P. (1989). Postpartum changes in maternal weight and body fat depots in lactating vs nonlactating women. American Journal of Clinical Nutrition 49. 259265.CrossRefGoogle ScholarPubMed
Brinton, L. A., Berman, M. L., Mortel, R., Twiggs, L. B., Barrett, R. J., Wilbanks, G. D., Lannom, L. & Hoover, R. N. (1992). Reproductive, menstrual, and medical risk factors for endometrial cancer: results from a case-control study. American Journal of Obstetrics and Gynecology 167, 13171325.CrossRefGoogle ScholarPubMed
Brinton, L. A., Hoover, R. & Fraumeni, J. F. (1983). Reproductive factors in the aetiology of breast cancer. British Journal of Cancer, 47, 757762.CrossRefGoogle ScholarPubMed
Brommage, R. & DeLuca, H. F. (1985). Regulation of bone mineral loss during lactation. American Journal of Physiology 248, E182E187.Google ScholarPubMed
Byers, T.Graham, S., Rzepka, T. & Marshall, J. (1985). Lactation and breast cancer. Evidence for a negative association in premonenopausal women. American Journal of Epidemiology 121, 664–674.CrossRefGoogle ScholarPubMed
Caird, L. E., Reid-Thomas, V., Hannan, W. J., Gow, S. & Glasier, A. F. (1994). Oral progestogen-only contraception may protect against loss of bone mass in breast-feeding women. Clinical Endocrinology 41. 739–45.CrossRefGoogle ScholarPubMed
Campbell, O. M. R. & Gray, R. H. (1993). Characteristics and determinants of postpartum ovarian function in women in the United States. American Journal of Obstetrics and Gynecology 169, 5560.CrossRefGoogle ScholarPubMed
Cann, C. E. (1989). Pregnancy and lactation cause reversible trabecular bone loss in humans. Journal of Bone and Mineral Research 4, S384.Google Scholar
Chan, G. M., McMurry, M., Westover, K., Engelbert-Fenton, K. & Thomas, M. R. (1987). Effect of increased dietary calcium intake upon the calcium and bone mineral status of lactating adolescent and adult women. American Journal of Clinical Nutrition 46. 319323.CrossRefGoogle ScholarPubMed
Chan, G. M., Slater, P., Nonie, R., Ronald, N., Roberts, C. C., Thomas, M. R., Folland, D. & Jackson, R. (1982). Bone mineral status of lactating mothers of different ages. American Journal of Obstetrics and Gynecology 144, 438441.CrossRefGoogle ScholarPubMed
Chilvers, C. E. D. (Ed.) (1993). Breast feeding and risk of breast cancer in young women. British Medical Journal 307, 1720.Google Scholar
Cohn, S. H., Abesamis, C.Yasumura, S., Aloia, J. F., Zanzi, I. & Ellis, K. J. (1977). Comparative skeletal mass and radial bone mineral content in black and white women. Metabolism 26, 171178.CrossRefGoogle ScholarPubMed
Cramer, D. W., Hutchison, G. B., Welch, W. R., Scully, R. E. & Ryan, K. J. (1983). Determinants of ovarian cancer risk. I. Reproductive experiences and family history. Journal of the National Cancer Institute 71, 711716.Google Scholar
Cross, N. A., Hillman, L. S., Allen, S. H. & Krause, G. F. (1995 a). Changes in bone mineral density and markers of bone remodeling during lactation and postweaning in women consuming high amounts of calcium. Journal of Bone and Mineral Research 10, 13121320.CrossRefGoogle ScholarPubMed
Cross, N. A., Hillman, L. S., Allen, S. H., Krause, G. F. & Vieira, N. E. (1995 b). Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study. American Journal of Clinical Nutrition 61, 514523.CrossRefGoogle ScholarPubMed
Cumming, R. G. & Klineberg, R. J. (1993). Breastfeeding and other reproductive factors and the risk of hip fractures in elderly women. International Journal of Epidemiology 22. 684691.CrossRefGoogle ScholarPubMed
Daly, S. E. & Hartmann, P. E. (1995). Infant demand and milk supply. Part 2: The short-term control of milk synthesis in lactating women. Journal of Human Lactation 11, 2737.CrossRefGoogle ScholarPubMed
Dewey, K. G., Cohen, R. J., Landa Rivera, L., Canahuati, J. & Brown, K. H. (1997). Effects of age at introduction of complementary foods to breastfed infants on duration of lactational amenorrhea in Honduran women. American Journal of Clinical Nutrition 65, 14031409.CrossRefGoogle ScholarPubMed
Dewey, K. G., Heinig, M. J. & Nommsen, L. A. (1993). Maternal weight-loss patterns during prolonged lactation. American Journal of Clinical Nutrition 58, 162166.CrossRefGoogle ScholarPubMed
Diaz, S., Cardenas, H., Brandeis, A., Miranda, P., Salvatierra, A. M. & Croxatto, H. B. (1992). Relative contributions of anovulation and luteal phase defect to the reduced pregnancy rate of breastfeeding women. Fertility and Sterility 58, 498503.CrossRefGoogle Scholar
Dugdale, A. E. & Eaton-Evans, J. (1989). The effect of lactation and other factors on post-partum changes in body weight and triceps skinfold thickness. British Journal of Nutrition 61, 149153.CrossRefGoogle ScholarPubMed
Feldblum, P. J., Zhang, J., Rich, L. E., Fortney, J. A. & Talmage, R. V. (1992). Lactation history and bone mineral density among perimenopausal women. Epidemiology 3, 527531.CrossRefGoogle ScholarPubMed
Fox, K. M., Magaziner, J., Sherwin, R., Scott, J. C., Plato, C. C., Nevitt, M. & Cummings, S. (1993). Reproductive correlates of bone mass in elderly women. Journal of Bone and Mineral Research 8, 901908.CrossRefGoogle ScholarPubMed
Frenay, M., Milano, G., Formento, J. L., Franconal, M., Moll, J. L. & Namer, M. (1991). Oestrogen and progesterone receptor status in bone biopsy specimens from patients with breast cancer. European Journal of Cancer 27, 115118.CrossRefGoogle ScholarPubMed
Garner, S. C., Boass, A. & Toverud, S. U. (1990). Parathyroid hormone is not required for normal milk composition or secretion or lactation-associated bone loss in normocalcemic rats. Journal of Bone and Mineral Research 5, 6975.CrossRefGoogle ScholarPubMed
Glasier, A. & McNeilly, A. S. (1990). Physiology of lactation. In: Bailliere's Clinical Ehrinology and Metabolism: Endocrinology of Pregnuncy, pp. 379395 [Franks, S, editor]. London: Bailliere Tindall.Google Scholar
Goldsmith, N. F. & Johnston, J. 0. (1975). Bone mineral: effect of oral contraceptives, pregnancy, and lactation. Journal of Bone and Joint Surgery 57A, 657–468.CrossRefGoogle Scholar
Greene, G. W., Smicklas-Wright, H., Scholl, T. O. & Karp, R. J. (1988). Postpartum weight change. How much of the weight gained in pregnancy will be lost after delivery? Obstetrics and Gynecology 71, 701707.Google Scholar
Gross, B. A. & Eastman, C. J. (1985). Prolactin and the return of ovulation in breast-feeding women. Journal of Biosocial Science 9 (Suppl), 2542.CrossRefGoogle ScholarPubMed
Gwinn, M. L., Lee, N. C., Modes, P. H., Layde, P. M. & Rubin, G. L. (1990). Pregnancy, breastfeeding and oral contraceptives and the risk of epithelial ovarian cancer. Journal of Clinical Epidemiology 43, 559568.CrossRefGoogle ScholarPubMed
Haram, K., Thordarson, H. & Hervig, T. (1993). Calcium homeostasis in pregnancy and lactation. Acta Obstetricia et Gynecologica Scandinavica 72, 509513.CrossRefGoogle ScholarPubMed
Hartge, P., Schiffman, M. H., Hoover, R., McGowan, L., Lesher, L. & Noms, H. J. (1989). A case-control study of epithelial ovarian cancer. American Journal of Obstetrics and Gynecology 161, 1016.CrossRefGoogle ScholarPubMed
Hayslip, C. C., Klein, T. A., Wray, H. L. & Duncan, W. E. (1989). The effects of lactation on bone mineral content in healthy postpartum women. Obstetrics and Gynecology 73, 588592.Google Scholar
Heinig, M. J. & Dewey, K. G. (1996). Health advantages of breast feeding for infants: a critical review. Nutrition Research Reviews 9, 89110.CrossRefGoogle ScholarPubMed
Henderson, B. E., Ross, R. K., Pike, M. C. & Casagrande, J. T. (1982). Endogenous hormones as a major factor in human cancer. Cancer Research 42, 3232–3239.Google Scholar
Hildreth, N. G., Kelsey, J. L., LiVolsi, V. A., Fisher, D. B.Holford, T. R., Mostow, E. D., Schwartz, P. E. & White, C. (1981). An epidemiologic study of epithelial carcinoma of the ovary. American Journal of Epidemiology 114, 398450.CrossRefGoogle ScholarPubMed
Hodnett, D. W., DeLuca, H. F. & Jorgensen, N. A. (1992). Bone mineral loss during lactation occurs in absence of parathyroid tissue. American Journal of Physiology 262, E230E233.Google ScholarPubMed
Howie, P. W. & McNeilly, A. S. (1982). Effect of breast feeding patterns on human birth intervals. Journal of Reproduction and Fertility 65, 545557.CrossRefGoogle ScholarPubMed
Howie, P. W., McNeilly, A. S., Houston, M. J., Cook, A. & Boyle, H. (1981). Effect of supplementary food on suckling patterns and ovarian activity during lactation. British Medical Journal 283, 757759.CrossRefGoogle ScholarPubMed
Hreshchyshyn, M. M., Hopkins, A., Zylstra, S. & Anbar, M. (1988). Associations of parity, breastfeeding. and birth control pills with lumbar spine and femoral neck bone densities. American Journal of Obstetrics and Gynecology 159, 318322.CrossRefGoogle ScholarPubMed
Ing, R.Ho, J. H. C. & Petrakis, N. L. (1977). Unilateral suckling and breast cancer. Lancet ii, 656657.Google Scholar
Institute of Medicine (1991). Nutrition during Lactation. Washington, D. C.: National Academy Press.Google Scholar
Janney, C. A., Zhang, D. & Sowers, M. F. (1996). Lactarion and Weight Retention. Washington, DC: Federation of American Societies for Experimental Biology.Google Scholar
Jen, K.-L. C., Juuhl, N. & Lin, P. K. H. (1988). Repeated pregnancy without lactation. Effects on carcass composition and adipose tissue cellularity in rats. Journal of Nutrition 118, 9398.CrossRefGoogle ScholarPubMed
Jimenez, D. M., Pocovi, M., Ramon-Cajal, J., Romero, M. A., Martinez, H. & Grande, F. (1988). Longitudinal study of plasma lipids and lipoprotein cholesterol in normal pregnancy and puerperium. Gynecological and Obstetric Investigation 25, 158164.CrossRefGoogle ScholarPubMed
John, E. M., Whittemore, A. S., Harris, R. & Itnyre, J. (1993). Characteristics relating to ovarian cancer risk: collaborative analysis of seven United States case-conaol studies. Epithelial ovarian cancer in black women. Journal of the National Cancer Institute 85, 142147.CrossRefGoogle ScholarPubMed
Josephy, P. D. (1996). The role of peroxidase-catalyzed activation of aromatic amines in breast cancer. Mutagenesis 11, 37.CrossRefGoogle ScholarPubMed
Kalkwarf, H. J. & Specker, B. L. (1995). Bone mineral loss during lactation and recovery after weaning. Obstetrics and Gynecology 86, 2632.CrossRefGoogle ScholarPubMed
Kallio, M. T., Siimes, M. A., Perheentupa, J., Salmenperä, L. & Miettinen, T. A. (1989). Cholesterol and its precursors in human milk during prolonged exclusive breastfeeding. American Journal of Clinical Nutrition 50, 782785.CrossRefGoogle Scholar
Kallio, M. J. T., Siimes, M. A., Perheentupa, J., Salmenperä, L. & Miettinen, T. A. (1992). Serum cholesterol and lipoprotein concentrations in mothers during and after prolonged exclusive lactation. Metabolism 41, 13271330.CrossRefGoogle ScholarPubMed
Kampert, J. B., Whittemore, A. S. & Paffenbarger, R. S. (1988). Combined effect of childbearing, menstrual events, and body size on age-specific breast cancer risk. American Journal of Epidemiology 128, 962979.CrossRefGoogle ScholarPubMed
Katsouyanni, K., Lipworth, L., Trichopoulou, A., Samoli, E., Stuver, S. & Trichopoulos, D. (1996). A case-control study of lactation and cancer of the breast. British Journal of Cancer 73. 814818.CrossRefGoogle ScholarPubMed
Kennedy, K. I., Rivera, R. & McNeilly, A. S. (1989). Consensus statement on the use of breastfeeding as a family planning method. Contraception 39, 477496.CrossRefGoogle ScholarPubMed
Kent, G. N., Price, R. I., Gutteridge, D. H., Smith, M., Allen, J. R., Bhagat, C. I., Barnes, M. P., Hickling, C. J., Retallack, R. W., Wilson, S. G., Devlin, R. D., Davies, C. & St. John., A. (1990). Human lactation: forearm trabecular bone loss, increased bone turnover, and renal conservation of calcium and inorganic phosphate with recovery of bone mass following weaning. Journal of Bone and Mineral Research 5, 361369.CrossRefGoogle ScholarPubMed
Keppel, K. G. & Taffel, S. M. (1993). Pregnancy-related weight gain and retention: implications of the 1990 Institute of Medicine guidelines. American Journal of Public Health 83, 11001103.CrossRefGoogle ScholarPubMed
King, J. C., Halloran, B. P., Huq, N., Diamond, T. & Buckendahl, P. E. (1992). Calcium metabolism during pregnancy and lactation. Mechanisms regulating Lactation and Infant Nutrient Utilization, vol. 15, pp. 129146 [Picciano, M. F. and Lonnerdal, B., editors]. New York: Wiley-Liss.Google Scholar
Kjos, S. L., Henry, O., Lee, R. M., Buchanan, T. A. & Mishell, D. R. (1993). The effect of lactation on glucose and lipid metabolism in women with recent gestational diabetes. Obstetrics and Gynecology 82, 451455.Google ScholarPubMed
Knopp, R. H., Bergelin, R. O., Wahl, P. W., & Walden, C. E. (1985 a). Effects of pregnancy, postpartum lactation and oral contraceptive use on the lipoprotein cholesterol/triglyceride ratio. Metabolism 34, 893899.CrossRefGoogle ScholarPubMed
Knopp, R. H., Bergelin, R. O., Wahl, P. W., Walden, C. E., Chapman, M. & Irvine, S. (1982). Population based lipoprotein lipid reference values for pregnant women compared to nonpregnant women classified by sex hormone usage. American Journal of Obstetrics and Gynecology 143. 626637.CrossRefGoogle ScholarPubMed
Knopp, R. H., Walden, C. E., Wahl, P. W., Bergelin, R., Chapman, M., Irvine, S. & Albers, J. J. (1985 b). Effect of postpartum lactation on lipoprotein lipids and apoproteins. Journal of Clinical Endocrinology and Metabolism 60, 542547.CrossRefGoogle ScholarPubMed
Kramer, F. M., Stunkard, A. J., Marshall, K. A., McKinney, S. & Liebschutz, J. (1993). Breastfeeding reduces maternal lower-body fat. Journal of the American Dietetic Association 93, 429433.CrossRefGoogle ScholarPubMed
Kreiger, N., Kelsey, J. L., Holford, T. R. & O‘Connor, T. (1982). An epidemiologic study of hip fracture in postmenopausal women. American Journal of Epidemiology 116, 141148.CrossRefGoogle ScholarPubMed
Kritz-Silverstein, D., Barren-Connor, E. & Hollenbach, K. A. (1992). Pregnancy and lactation as determinants of bone mineral density in postmenopausal women. American Journal of Epidemiology 136, 10521059.CrossRefGoogle ScholarPubMed
Kuhns, J. G. & Ackermann, D. M. (1995). Microscopic anatomy of the breast. In Cancer of the Breast, pp. 1621 [Donnegan, W. L. and Spratt, J. S., editors]. Philadelphia, PA: W. B. Saunders Co.Google Scholar
Kvale, G. & Heuch, I. (1987). Lactation and cancer risk: is there a relation specific to breast cancer? Journal of Epidemiology and Community Health 42, 30–37.CrossRefGoogle Scholar
Laing, A. E., Demenais, F. M., Williams, R., Kissling, G., Chen, V. W. & Bonney, G. E. (1993). Breast cancer risk factors in African-American women: the Howard University Tumor Registry experience. Journal of the National Medical Association 85, 931939.Google ScholarPubMed
Lamke, B., Brundin, I. & Moberg, P. (1977). Changes in bone mineral content during pregnancy and lactation. Acta Obstetricia et Gynecologica Scandianavica 56, 217219.CrossRefGoogle ScholarPubMed
Lawrence, R. A. (1994). Breastfeeding: a Guide for the Medical Profession, 4th edn. St. Louis, MO: Mosby.Google Scholar
Layde, P. M., Webster, L. A., Baughman, A. L., Wingo, P. A., Rubin, G. L. & Ory, H. W. (1989). The independent associations of parity, age at first full term pregnancy, and duration of breastfeeding with the risk of breast cancer. Cancer and Steroid Hormone Study Group. Journal of Clinical Epidemiology 42, 963973.CrossRefGoogle ScholarPubMed
Lenz, S., Kiihl, C., Hornnes, P. J. & Hagen, C. (1981). Influences of lactation on oral glucose tolerance in the puerperium. Acta Endocrinologica 98, 428431.Google ScholarPubMed
Lissner, L., Bengtsson, C. & Hansson, T. (1991). Bone mineral content in relation to lactation history in pre- and postmenopausal women. Calcified Tissue International 48, 319325.CrossRefGoogle ScholarPubMed
London, S. J., Colditz, G. A., Stampfer, M. J., Willett, W. C., Rosner, B. A., Corsano, K. & Speizer, F. E. (1990). Lactation and risk of breast cancer in a cohort of United States women. American Journal of Epidemiology 132, 1726.CrossRefGoogle Scholar
McNeilly, A. S., Tay, C. C. & Glasier, A. (1994). Physiological mechanisms underlying lactational amenorrhea. Annals of the New York Academy of Sciences 709, 145155.CrossRefGoogle ScholarPubMed
McTiernan, A. & Thomas, D. B. (1986). Evidence for a protective effect of lactation on risk of breast cancer in young women. Results from a case-control study. American Journal of Epidemiology 124, 353358.CrossRefGoogle ScholarPubMed
Manning-Dalton, C. & Allen, L. H. (1983). The effects of lactation on energy and protein consumption, postpartum weight change and body composition of well nourished North American women. Nutrition Research 3, 293308.CrossRefGoogle Scholar
Mansfield, C. M. (1993). A review of the etiology of breast cancer. Journal of the National Medical Association 85, 217221.Google ScholarPubMed
Mehta, S. (1993). Bone loss, contraception and lactation. Acta Obstetricia et Gynecologica Scandinavica 72, 148156.CrossRefGoogle ScholarPubMed
Melton, L. J. & Riggs, B. L. (1983). Epidemiology of age related fractures. In The Osteoporotic Syndrome: Detection, Prevention, and Treatment, pp. 4572 [Avioli, L. V., editor]. New York: Grune and Stratton.Google Scholar
Mepham, T. B. (1987). Physiology of Lactation. Milton Keynes: Open University Press.Google Scholar
Michels, K. B., Willett, W. C., Rosner, B. A., Manson, J. E., Humer, D. J., Colditz, G. A., Hankinson, S. E. & Speizer, F. E. (1996). Prospective assessment of breastfeeding and breast cancer incidence among 89 887 women. Lancet 347, 431436.CrossRefGoogle Scholar
Moore, B. J., Gerardo-Gettens, T., Horwitz, B. A. & Stem, J. S. (1986). Hyperprolactinemia stimulates food intake in the female rat. Brain Research Bulletin 17, 563569.CrossRefGoogle ScholarPubMed
Negri, E., Braga, C, La Vecchia, C., Levi, F.Talamini, R. & Franceschi, S. (1996). Lactation and the risk of breast cancer in an Italian population. International Journal of Cancer 67, 161164.3.0.CO;2-R>CrossRefGoogle Scholar
Neville, M. C. & Neifert, M. R., Eds. (1983). Luctationt: Physiology, Nutrition. and Breast-feeding. New York: Plenum Press.CrossRefGoogle Scholar
Newcomb, P. A., Storer, B. E., Longnecker, M. P., Mittendorf, R., Greenberg, E. R., Clapp, R. W., Burke, K. P., Willett, W. C. & MacMahon, B. (1994). Lactation and a reduced risk of premenopausal breast cancer. New England Journal of Medicine 330, 8187.CrossRefGoogle Scholar
Ohlin, A. & Rössner, S. (1990). Maternal body weight development after pregnancy. International Journal of Obesity 14, 159173.Google Scholar
Parker, J. D. (1993). Postpartum weight change. Clinical Obstetrics and Gynecology 37, 528537.CrossRefGoogle Scholar
Perez, A. (1981). Natural family planning: postpartum period. International Journal of Fertility 26, 219221.Google ScholarPubMed
Perez, A., Vela, P., Masnick, G. S. & Potter, R. G. (1972). First ovulation after childbirth: the effect of breastfeeding. American Journal of Obstetrics and Gynecology 114, 1041047.CrossRefGoogle Scholar
Petrakis, N. L., Wrensch, M. R.Ernster, V. L., Miike, R., Murai, J.Simberg, N. & Siiteri, P. K. (1987). Influence of pregnancy and lactation on serum and breast fluid estrogen levels: implications for breast cancer risk. International Journal of Cancer 40, 587591.CrossRefGoogle ScholarPubMed
Potter, S., Hannum, S., McFarlin, B.Essex-Sorlie, D., Campbell, E. & Trupin, S. (1991). Does infant feeding method influence maternal postpartum weight loss? Journal of the American Dietetic Association 91, 441446.CrossRefGoogle ScholarPubMed
Prentice, A., Jarjou, L. M. A., Cole, T. J., Stirling, D. M., Dibba, B. & Fairweather-Tait, S. (1995). Calcium requirements of lactating Gambian mothers: effects of a calcium supplement on breast-milk calcium concentration. maternal bone mineral content, and urinary calcium excretion. American Journal of Clinical Nutrition 62, 5867.CrossRefGoogle ScholarPubMed
Riordan, J. (1993). Anatomy and psychophysiology of lactation. In Breastfeeding and Human Lactation. pp. 81104 [Riordan, J. and Auerbach, K. G., editors]. Boston, MA: Jones and Bartlett.Google Scholar
Risch, H. A., Weiss, N. S., Lyon, J. L., Daling, J. R. & Liff, J. M. (1983). Events of reproductive life and the incidence of epithelial ovarian cancer. American Journal of Epidemiology 117, 128139.CrossRefGoogle ScholarPubMed
Romieu, I.Hernandez-Avila, M., Iazcano, E.Lopez, L. & Romero-Jaime, R. (1996). Breast cancer and lactation history in Mexican women. American Journal of Epidemiology 143. 543552.CrossRefGoogle ScholarPubMed
Rosenblatt, K. A. & Thomas, D. B. (1995). Prolonged lactation and endometrial cancer. WHO Collaborative Study of Neoplasia and Steroid Contraceptives. International Journal of Epidemiology 24, 499503.CrossRefGoogle ScholarPubMed
Rosenblatt, K. A., Thomas, D. B., Berry, G.MacLennan, R.Shearman, R., Jelikovsky, T., Booth, J. C., Molina, R., Martinez, L. & Sales, O. (1993). Lactation and the risk of epithelial ovarian cancer. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. International Journal of Epidemiology 22. 192–197.CrossRefGoogle ScholarPubMed
Rosero-Bixby, L., Oberle, M. W. & Lee, N. C. (1987). Reproductive history and breast cancer in a population of high fertility, Costa Rica. 198&85. International Journal of Cancer 40, 747754.CrossRefGoogle Scholar
Rush, D., Lumey, L. H., Ravelli, A. C. J. & Myers, B. (1996). The indirect association of lactation with subsequent perimenopausal body weight. European Journal of Clinical Nutrition 50, 1216.Google ScholarPubMed
Russo, J. & Russo, I. H. (1995). The etiopathogenesis of breast cancer prevention. Cancer Letters 90, 8189.CrossRefGoogle ScholarPubMed
Russo, J., Tay, L. K. & Russo, I. H. (1982). Differentiation of the mammary gland and susceptibility to carcinogenesis, a review, Breast Cancer Research and Treatment 2 573.CrossRefGoogle Scholar
Schauberger, C. W., Rooney, B. L. & Brimer, L. M. (1992). Factors that influence weight loss in the puerperium. Obstetrics and Gynecology 79, 424429.CrossRefGoogle ScholarPubMed
Scholl, T. O.Hediger, M. L., Schall, J. I.Ances, L. G. & Smith, W. K. (1995). Gestational weight gain, pregnancy outcome, and postpartum weight retention. Obstetrics and Gynecology 86, 423427.CrossRefGoogle ScholarPubMed
Shaw, C.-K. (1993). An epidemiologic study of osteoporosis in Taiwan. Annals of Epidemiology 3, 264271.CrossRefGoogle ScholarPubMed
Shi, Y. E.Liu, Y. L. E., Lippman, M. E. & Dickson, R. B. (1994). Progestins and antiprogestins in mammary tumour growth and metastasis. Human Reproduction 9 (Suppl. 1) 162173.CrossRefGoogle ScholarPubMed
Short, R. V., Lewis, P. R.Renfree, M. B. & Shaw, C. (1991). Contraceptive effects of extended lactational amenorrhoea. Beyond the Bellagio Consensus. Lancet 337, 715717.CrossRefGoogle ScholarPubMed
Siskind, V.Schofield, F., Rice, D. & Bain, C. (1989). Breast cancer and breastfeeding. Results from an Australian case-control study. American Journal of Epidemiology 130, 229236.CrossRefGoogle ScholarPubMed
Sowers, M. R., Clark, M. K., Hollis, B.Wallace, R. B. & Jannausch, M. (1992). Radial bone mineral density in pre- and perimenopausal women: a prospective study of rates and risk factors for loss. Journal of Bone and Mineral Research 7, 647–457.CrossRefGoogle ScholarPubMed
Sowers, M., Corton, G., Shapiro, B., Jannausch, M. L., Crutchfield, M., Smith, M. L., Randolph, J. F. & Hollis, B. (1993). Changes in bone density with lactation. Journal of the American Medical Association 269, 31303135.CrossRefGoogle ScholarPubMed
Sowers, M., Eyre, D., Hollis, B. W., Randolph, J. F., Shapiro, B., Jannausch, M. L. & Crutchfield, M. (1995). Biochemical markers of bone turnover in lactating and nonlactating postpartum women. Journal of Clinical Endocrinology and Metabolism 80, 22102216.Google ScholarPubMed
Sowers, M. F., Hollis, B. W.Shapiro, B., Randolp, J., Janney, C. A., Zhang, D., Schork, A., Crutchfield, M., Stanczyk, F. & Russell-Aulet, M. (1996). Elevated parathyroid hormone-related peptide associated with lactation and bone density loss. Journal of the American Medical Association 276, 549554.CrossRefGoogle ScholarPubMed
Specker, B. L., Tsang, R. C & Ho, M. L (1991). Changes in calcium homeostasis over the first year postpartum: effect of lactation and weaning. Obstetrics and Gynecology 78, 5662.Google ScholarPubMed
Spicer, D. V. & Pike, M. C (1994). Steroids and breast cancer prevention. Journal of the National Cancer Institute Monographs 16, 139147.Google Scholar
Stevenson, J. C., Lees, B.Davenpon, M., Cust, M. P & Ganger, K. F (1989). Determinants of bone density in normal women: Risk factors for future osteoporosis? British Medical Journal 298, 924928.CrossRefGoogle ScholarPubMed
Tao, S.-C., Yu, M. C., Ross, R. K. & Xiu, K.-W. (1988). Risk factors for breast cancer in women of Beijing. International Journal of Cancer 42, 495498.CrossRefGoogle ScholarPubMed
Thomas, D. B. & Noonan, E. A. (1993). Breast cancer and prolonged lactation. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. International Journal of Epidemiology 22, 619–426.CrossRefGoogle ScholarPubMed
Tuppurainen, M., Kroger, H., Saarikoski, S., Honkanen, R. & Alhava, E. (1995). The effect of gynecological risk factors on lumbar and femoral bone mineral density in pen- and postmenopausal women. Maturitas 21, 137145.CrossRefGoogle Scholar
Tylavsky, F. A, Curtis, R. C., Anderson, J. J. B. & Metz, J. A. (1989). Changes in radial and vertebral bone mass due to pregnancy and lactations in humans. Journal of Bone and Mineral Research 4, S414.Google Scholar
Voigt, L. F. & Weiss, N. S. (1989). Epidemiology of endometrial cancer. Cancer Treatment and Research 49, 121.Google ScholarPubMed
Wang, D. Y., de Stavola, B. L., Bulbrook, R. D., Allen, D. S., Kwa, H. G., Fentiman, I. S., Hayward, J. L. & Millis, R (1992). Relationship of blood prolactin levels and the risk of subsequent breast cancer. International Journal of Epidemiology 21, 214221.CrossRefGoogle ScholarPubMed
Wang, I. Y. & Fraser, I. S. (1994). Reproductive function and contraception in the postpartum period. Obstetrical and Gynecological Survey 49, 5663.CrossRefGoogle ScholarPubMed
Wardlaw, G. M. & Pike, A. M. (1986). The effect of lactation on peak adult shaft and ultra-distal forearm bone mass in women. American Journal of Clinical Nutrition 44, 283286.CrossRefGoogle ScholarPubMed
Wasnich, R., Yano, K. & Vogel, J. (1983). Postmenopausal bone loss at multiple skeletal sites: relationship to estrogen use. Journal of Chronic Diseases 36, 781790.CrossRefGoogle ScholarPubMed
West, R. O (1966). Epidemiologic study of malignancies of the ovaries. Cancer 19, 10011007.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Whittemore, A. S. (1994). Characteristics relating to ovarian cancer risk: implications for prevention and detection. Gynecologic Oncology 55, S15–19.CrossRefGoogle ScholarPubMed
Whittemore, A. S.Harris, R.Itnyre, J. & Group, C. O. C. (1992). Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women. American Journal of Epidemiology 136, 11841203.CrossRefGoogle ScholarPubMed
Wilde, C. J., Addey, C. V. P., Casey, M. J., Batchford, D. R. & Peaker, M. (1988). Feedback inhibition of milk secretion: the effect of a fraction of goat milk on milk yield and composition. Quarterly Journal of Experimental Physiology 73. 391397.CrossRefGoogle ScholarPubMed
Wu, A. H.Ziegler, R. G., Pike, M. C.Nomura, A. M. Y., West, D. W., Kolonel, L. N., Horn-Ross, P. L., Rosenthal, F. & Hoover, R. N. (1996). Menstrual and reproductive factors and risk of breast cancer in Asian-Americans. British Journal of Cancer 73. 680–486.CrossRefGoogle ScholarPubMed
Wynder, E. L., Dodo, H. & Barber, H. R. K. (1969). Epidemiology of cancer of the ovary. Cancer 23, 352370.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
Yang, C. P.Weiss, N. S.Band, P. R.Gallagher, R. P.White, E. & Daling, J. R. (1993). History of lactation and breast cancer risk. American Journal of Epidemiology 138, 10501056.CrossRefGoogle ScholarPubMed
Yano, K., Wasnich, R. D., Vogel, J. M. & Heilbrun, L. K. (1984). Bone mineral measurements among middle aged and elderly Japanese residents in Hawaii. American Journal of Epidemiology 119, 751764.CrossRefGoogle ScholarPubMed
Yoo, K. Y., Tajima, K., Kuroishi, T., Hirose, K., Yoshida, M., Miura, S. & Murai, H. (1992). Independent protectiveeffect of lactation against breast cancer: A case-control study in Japan. American Journal of Epidemiology 135, 726733.CrossRefGoogle Scholar
Yuan, J. M., Yu, M. C., Ross, R. K., Gao, Y. T. & Henderson, B. E. (1988). Risk factors for breast cancer in Chinese women in Shanghai. Cancer Research 48, 19491953.Google ScholarPubMed