Kym Dunton wrote: "Apparently there was some news story this past week
saying that breastfeeding for a year poses a risk for heart problems."


There has been masses and masses of debate about this in the week
since it arose. A paper was published in the British Medical Journal
last Friday which claimed to have found some evidence of a link
between breastfeeding for more than 4 months, and stiffening of the
arteries.
Try http://bmj.com/cgi/content/full/322/7287/643 for the full article,
and then
 http://bmj.com/cgi/eletters/322/7287/643#EL17 for the responses to
it. Also, this letter from a member of the BMJ's Editorial Board which
was published this morning:

========================================================
"Dear Editor,

The misleading publicity that the paper by Leeson et al[1] is
receiving in
the media proves that the main limitations of this paper were not
sufficiently highlighted. Nor were the consequences of limiting
breastfeeding to four months.

Surrogate outcomes, such as elasticity of an artery, should not be
used to
infer causality. The paper does not address any relevant clinical
outcome.
It is a small observational study. Chance, bias or confounding may be
responsible for the effects the authors found.

The evidence the paper provides suggesting a causative effect of
breastfeeding on heart disease is weak. Tobacco industry manipulated
research to obtain commercial benefit regardless of the harms they
caused.
The way the media has manipulated information provided by this paper,
raises
my concern of the role these study may have in the agenda of the
weaning
food industry. The brief note written in the competing interest
section does
not provide a clear picture on the degree of involvement of the
authors with
the weaning food industry.

BMJ has a responsibility not only to publish evidence. It also has to
foresee the effect of the published paper on global health and clearly
address it. The breach that allowed the media to manipulate the
results and
jump into the conclusion stating that breastfeeding more than four
months
causes cardiovascular disease is inadmissible and will for sure be
commercially exploited by unscrupulous purposes, here and in the
developing
world, with terrible consequences. Further explanatory letters may not
have
the same impact in media and may not compensate the damage that has
been
done.

Luis Gabriel Cuervo
Member of BMJ Editorial Board

Competing interests: I am also Clinical Editor for Clinical Evidence.

1 Leeson CPM, Kattenhorn M, Deanfield JE, Lucas A. Duration of breast
feeding and arterial distensibility in early adult life: population
based
study. BMJ 2001; 322: 643-647"
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