The concern expressed recently about the English study by Fall of the
relationship between breastfeeding and coronary artery disease is well
stated.  I was asked the same question by one of my colleagues who is an
epidemiologist/obstetrician and was troubled by this paper - especially after
hearing my OB/GYN grand rounds lecture on the benefits of breastfeeding.  He
sent me the paper to read - which I did.  The authors of the paper were also
concerned about their finding and they indicate the likely explanation for
the unexpected finding that breastfeeding for more than one year was
associated with increased rates of coronary disease.  The paper reveals that
the mothers who breastfed for these longer periods were doing so in an
attempt to delay the onset of the next pregnancy.  These were poor women and
had large families.  Socially and demographically the extended breastfeeders
were very different from the shorter duration breastfeeders.  The major
impact on coronary artery disease may have come from later life styles
(diet, drinking habits, etc.) rather than from the early nutritional
experiences of infancy and early childhood.  I came away from my careful reading the
paper with the conclusion that there was NO evidence that breastfeeding into
the second year of life was a risk factor for coronary artery disease.  I
urge everyone to get the paper and read it carefully for themselves.  It is
unfortunate that only the superficial results or tentative conclusions are
remembered and reproduced.

Lawrence M. Gartner, M.D.
Professor of Pediatrics and OB/GYN
The University of Chicago
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